Impact of nutrition on serum levels of docosahexaenoic acid among Omani children with autism

doi:10.1016/j.nut.2013.03.009

Nutrition

Volume 29, Issue 9, September 2013, Pages 1142-1146

https://doi.org/10.1016/j.nut.2013.03.009 Get rights and content

Abstract

Objectives

Autism is a lifelong neurodevelopmental disorder of early childhood. Dietary supplementation of the ω-3 fatty acid (docosahexaenoic acid [DHA]) during prenatal and postnatal life is considered a protective dietary intervention strategy to minimize the risk for autism spectrum disorder (ASD). To our knowledge, no relevant studies have been conducted in the Middle East investigating the status of DHA among children with autism during early childhood. The aim of this study was to investigate the serum levels and dietary intake status of DHA among Omani children recently diagnosed with ASD.

Methods

The present case–control study involved 80 Omani children (<5 y), 40 cases and 40 controls matched for age and sex. A semi-quantitative food frequency questionnaire was used to assess dietary intake of all the participants, while serum levels of DHA were measured using high-performance liquid chromatography.

Results

Our results showed that children with ASD had lower dietary consumption of foodstuff containing DHA, as well as lower serum levels of DHA than controls.

Conclusion

The present finding from Oman supports the view of other studies that there are low serum levels of DHA among children with ASD.

Introduction

Docosahexaenoic acid (DHA) is a polyunsaturated fatty acid of the ω-3 series, which is essential for the structural component of the central nervous system (CNS) and has direct bearing on normal development of the CNS and its counterpart, cognitive, emotional, and behavioral functioning [1], [2], [3]. Previous studies suggest that maternal milk or fish oil is a rich source of DHA and therefore low intake of DHA during pregnancy has been linked with increasing risk for developing autism among children with vulnerable predisposition [4], [5], [6]. Low intake of DHA during pregnancy appears as a physiological stress for depleting the mothers’ body stores of DHA, and their subsequent offspring [7], [8], [9]. During preschool age, lower levels of DHA among children with autism was associated with exacerbation of cognitive and emotional symptoms [10], [11], [12].Conversely, ω-3 fatty acid supplementations has been shown to attenuate core and associated symptoms of autism spectrum disorders (ASD). On the whole, there is evidence suggesting that the impairments associated with ASD may be partially linked to deficits of DHA, and that supplementation with DHA may result in the improvement of some of the debilitating symptoms commonly found in children with ASD. However, recent meta-analysis suggests that it may be premature to assume that supplementation with DHA is effective for improving the cognitive and emotional impairments associated with ASD due to a lack of studies that have employed rigorous methodology [13]. Therefore, more groundwork is needed to establish a link between DHA and ASD. Most of the previous links between DHA and ASD have been with ω-3 fatty acid supplementations and have been limited to studies from other parts of the world. There is a paucity of studies from Arabian Gulf countries. The contribution of such regions is likely to confirm whether the partial linkage between DHA and ASD is not simply an anomaly limited to cultural practice rather than integral parts of the pathogenesis of ASD. In order to fill the gap in the literature, the present study aims to investigate the status of DHA among Omani children with ASD. To our knowledge, no studies of such nature have emanated from Oman or its regional counterpart. In our quest to study correlates of ASD in Oman, we previously indicated that ASDs exhibited significant reduction in indices of folate and vitamin B₁₂ [14], oxidative stress in ASD [15], elevated levels of heavy metals, and selective depletion of essential minerals [16].The present study was, therefore, conducted to investigate both the dietary intake and serum levels of DHA among Omani children recently diagnosed with autism. This study is expected to shed light on the effect of prenatal and postnatal nutrition on the DHA status of autistic children.

Section snippets

Study participants and study setting

A case–control study approach was used for this study from July to December 2010. The study was held in the Child and Adolescent Psychiatry psychiatry outpatient clinic in the Department of Behavioral Medicine, Sultan Qaboos University Hospital, a tertiary referral hospital in Oman. All study participants were Omani nationals under the age of 5 y. The accompanying parents were briefed about the study protocol, and on a voluntary basis they signed a consent form to enroll in the study.

Power

Results

The participants (cases and controls) enrolled in this study did not receive any DHA supplements or fish oil during their whole term of pregnancy. The maternal educational level (higher education and secondary school), monthly income (an average of 500–600 Omani Rials/month), and their employment status were comparable in both groups with no statistical differences (P > 0.05). Also, none of the enrolled children were receiving dietary supplements, vitamins, or following a special dietary

Discussion

This study investigated the changes in the serum levels of DHA in Omani children recently diagnosed with autism who were compared with their respective controls. Because no background information on the normal blood levels of DHA in Omani children were available, we compared DHA levels of the case group with their age-matched and sex-matched controls. We also compared the intake of ω-3fatty acid and α-linolenic acid in both groups.

Several studies have indicated that macronutrient and

Conclusion

Our data demonstrated that DHA serum levels were markedly low in children with ASD. This study established the temporal relationship, but not the cause and effect. There is a broad assumption in the literature that inadequate intake of food rich in ω-3 fatty acids during pregnancy and in early childhood may result in children having low DHA serum levels. If this study will withstand further scrutiny, there will be grounds to recommend that all pregnant Omani women, as well as their children,

Acknowledgments

The authors extend their appreciation to all the staff at the outpatient clinic, both the Behavioral Medicine and the Child Health departments, Sultan Qaboos Univerity Hospital, for their cooperation and dedicated effort to complete this study. This study was supported by His Majesty Sultan Qaboos Grant (SR/MED/FMCO/11/01) and the Internal Grant (AGR/Food/IG/10/01) funds.

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: Drs. Al-Farsi and Waly equally contributed to study design, statistical analysis, interpretation of data, and drafting the manuscript. Other authors made full contribution to data acquisition and collection. All authors read and approved the final manuscript. The authors indicated no potential or actual conflict of interest pertaining to this study.

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Applied nutritional investigationImpact of nutrition on serum levels of docosahexaenoic acid among Omani children with autism

Abstract

Objectives

Methods

Results

Conclusion

Introduction

Section snippets

Study participants and study setting

Results

Discussion

Conclusion

Acknowledgments

Nutrition

Arch Med Res

Biol Psychiatry

Nutrition

J Lipid Res

Res Autism Spectr Disord

Nutrition

Am J Clin Nutr

Poult Sci

Am J Obstet Gynecol

Omega-3 polyunsaturated fatty acids and cognition in a college-aged population

Exp Clin Psychopharmacol

Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids

Altern Med Rev

Visual, cognitive, and language assessments at 39 months: a follow-up study of children fed formulas containing long-chain polyunsaturated fatty acids to 1 year of age

Pediatrics

Omega-3 polyunsaturated fatty acids and cognition throughout the lifespan: a review

Nutr Neurosci

Therapeutic effects of larger doses of arachidonic acid added to DHA on social impairment and its relation to alterations of polyunsaturated fatty acids in individuals with autism spectrum disorders

Nihon Shinkei Seishin Yakurigaku Zasshi

Depression and low serum level of docosahexaenoic acid (DHA) are associated with increasing number of pregnancies among postpartum Omani women

Can J Appl Sci

Applied nutritional investigation
Impact of nutrition on serum levels of docosahexaenoic acid among Omani children with autism