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Effect of fish oil supplementation in pregnancy on bone, lean, and fat mass at six years: randomised clinical trial.

Abstract

OBJECTIVE

To examine the effect of supplementation with n-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) in pregnancy on anthropometry and body composition in offspring.

DESIGN

Double blinded, randomised controlled trial.

SETTING

Copenhagen Prospective Studies on Asthma in Childhood2010 cohort.

PARTICIPANTS

736 pregnant women and their offspring.

INTERVENTION

n-3 LCPUFA (fish oil) or control (olive oil) daily from pregnancy week 24 until one week after birth.

MAIN OUTCOME MEASURES

Height/length, weight, head, and waist measurements and body composition from dual energy x ray absorptiometry (all pre-specified secondary endpoints of the n-3 LCPUFA trial; the primary outcome for the trial was persistent wheeze/asthma).

RESULTS

The mean body mass index (BMI) z score was increased between age 0 and 6 years in the fish oil supplementation group compared with the control group (0.14 (95% confidence interval 0.04 to 0.23); P=0.006). At 6 years, supplementation was associated with a higher BMI z score (0.19 (0.06 to 0.32); P=0.004), a higher weight/height (3.48 (0.38 to 6.57) g/cm; P=0.03), and a larger waist circumference (0.6 (0.0 to 1.2) cm; P=0.04) but not a higher proportion of obese children, using International Obesity Task Force grades. The dual energy x ray absorptiometry scan at age 6 years showed a higher total mass (395.4 (86.6 to 704.3) g; P=0.01) in the supplementation versus the control group, explained by a higher lean mass (280.7 (98.9 to 462.4) g; P=0.002), a higher bone mineral content (10.3 (2.3 to 18.1) g; P=0.01), and a non-significantly higher fat mass (116.3 (-92.9 to 325.5) g; P=0.28), but no differences were seen in total body fat or lean mass percentage.

CONCLUSION

Fish oil supplementation from the 24th week of pregnancy led to a higher BMI in the offspring from 0 to 6 years of age but not an increased risk of obesity at age 6. The body composition at age 6 years in children given fish oil supplementation was characterised by a proportional increase in lean, bone, and fat mass suggesting a general growth stimulating effect of n-3 LCPUFA.

TRIAL REGISTRATION

Clinicaltrials.gov NCT00798226.

Links

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  • Authors+Show Affiliations

    ,

    COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark. Department of Pediatrics, Naestved Hospital, Naestved, Denmark.

    ,

    COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.

    ,

    COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.

    ,

    COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark. Department of Pediatrics, Naestved Hospital, Naestved, Denmark.

    ,

    COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.

    ,

    COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.

    ,

    COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.

    ,

    MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, UK.

    ,

    Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University Hospital of Copenhagen, Denmark.

    COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark bisgaard@copsac.com.

    Source

    BMJ (Clinical research ed.) 362: 2018 Sep 04 pg k3312

    MeSH

    Absorptiometry, Photon
    Adult
    Body Mass Index
    Bone Density
    Bone Development
    Child
    Dietary Supplements
    Double-Blind Method
    Fatty Acids, Omega-3
    Female
    Fish Oils
    Humans
    Infant
    Infant Nutritional Physiological Phenomena
    Maternal Nutritional Physiological Phenomena
    Pregnancy
    Prenatal Care
    Prenatal Exposure Delayed Effects
    Prospective Studies

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    30181143

    Citation

    Vinding, Rebecca Kofod, et al. "Effect of Fish Oil Supplementation in Pregnancy On Bone, Lean, and Fat Mass at Six Years: Randomised Clinical Trial." BMJ (Clinical Research Ed.), vol. 362, 2018, pp. k3312.
    Vinding RK, Stokholm J, Sevelsted A, et al. Effect of fish oil supplementation in pregnancy on bone, lean, and fat mass at six years: randomised clinical trial. BMJ. 2018;362:k3312.
    Vinding, R. K., Stokholm, J., Sevelsted, A., Sejersen, T., Chawes, B. L., Bønnelykke, K., ... Bisgaard, H. (2018). Effect of fish oil supplementation in pregnancy on bone, lean, and fat mass at six years: randomised clinical trial. BMJ (Clinical Research Ed.), 362, pp. k3312. doi:10.1136/bmj.k3312.
    Vinding RK, et al. Effect of Fish Oil Supplementation in Pregnancy On Bone, Lean, and Fat Mass at Six Years: Randomised Clinical Trial. BMJ. 2018 Sep 4;362:k3312. PubMed PMID: 30181143.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of fish oil supplementation in pregnancy on bone, lean, and fat mass at six years: randomised clinical trial. AU - Vinding,Rebecca Kofod, AU - Stokholm,Jakob, AU - Sevelsted,Astrid, AU - Sejersen,Tobias, AU - Chawes,Bo L, AU - Bønnelykke,Klaus, AU - Thorsen,Jonathan, AU - Howe,Laura D, AU - Krakauer,Martin, AU - Bisgaard,Hans, Y1 - 2018/09/04/ PY - 2018/9/6/entrez PY - 2018/9/6/pubmed PY - 2019/3/15/medline SP - k3312 EP - k3312 JF - BMJ (Clinical research ed.) JO - BMJ VL - 362 N2 - OBJECTIVE: To examine the effect of supplementation with n-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) in pregnancy on anthropometry and body composition in offspring. DESIGN: Double blinded, randomised controlled trial. SETTING: Copenhagen Prospective Studies on Asthma in Childhood2010 cohort. PARTICIPANTS: 736 pregnant women and their offspring. INTERVENTION: n-3 LCPUFA (fish oil) or control (olive oil) daily from pregnancy week 24 until one week after birth. MAIN OUTCOME MEASURES: Height/length, weight, head, and waist measurements and body composition from dual energy x ray absorptiometry (all pre-specified secondary endpoints of the n-3 LCPUFA trial; the primary outcome for the trial was persistent wheeze/asthma). RESULTS: The mean body mass index (BMI) z score was increased between age 0 and 6 years in the fish oil supplementation group compared with the control group (0.14 (95% confidence interval 0.04 to 0.23); P=0.006). At 6 years, supplementation was associated with a higher BMI z score (0.19 (0.06 to 0.32); P=0.004), a higher weight/height (3.48 (0.38 to 6.57) g/cm; P=0.03), and a larger waist circumference (0.6 (0.0 to 1.2) cm; P=0.04) but not a higher proportion of obese children, using International Obesity Task Force grades. The dual energy x ray absorptiometry scan at age 6 years showed a higher total mass (395.4 (86.6 to 704.3) g; P=0.01) in the supplementation versus the control group, explained by a higher lean mass (280.7 (98.9 to 462.4) g; P=0.002), a higher bone mineral content (10.3 (2.3 to 18.1) g; P=0.01), and a non-significantly higher fat mass (116.3 (-92.9 to 325.5) g; P=0.28), but no differences were seen in total body fat or lean mass percentage. CONCLUSION: Fish oil supplementation from the 24th week of pregnancy led to a higher BMI in the offspring from 0 to 6 years of age but not an increased risk of obesity at age 6. The body composition at age 6 years in children given fish oil supplementation was characterised by a proportional increase in lean, bone, and fat mass suggesting a general growth stimulating effect of n-3 LCPUFA. TRIAL REGISTRATION: Clinicaltrials.gov NCT00798226. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/30181143/Effect_of_fish_oil_supplementation_in_pregnancy_on_bone_lean_and_fat_mass_at_six_years:_randomised_clinical_trial_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=30181143 DB - PRIME DP - Unbound Medicine ER -