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Supplementation of N-3 LCPUFA to the Diet of Children Older Than 2 Years: A Commentary by the ESPGHAN Committee on Nutrition

ESPGHAN Committee on Nutrition:; Agostoni, Carlo*,3; Braegger, Christian; Decsi, Tamás; Kolacek, Sanja§; Mihatsch, Walter||; Moreno, Luis A; Puntis, John#; Shamir, Raanan**,1; Szajewska, Hania††; Turck, Dominique‡‡,2; van Goudoever, Johannes§§

Journal of Pediatric Gastroenterology & Nutrition: July 2011 - Volume 53 - Issue 1 - p 2–10
doi: 10.1097/MPG.0b013e318216f009
Invited Review

The aim of this commentary is to review data on the effect of supplementation of paediatric patients ages 2 years or older with n-3 long-chain polyunsaturated fatty acids (LCPUFA). Some evidence for a positive effect on functional outcome in children with attention-deficit/hyperactivity disorder (ADHD) was found; however, benefit was seen in only about half of the randomised controlled trials (RCT), and studies varied widely not only in dose and form of supplementation but also in the functional outcome parameter tested. The committee concludes that there are insufficient data to recommend n-3 LCPUFA supplementation in the treatment of children with ADHD, but further research on n-3 LCPUFA supplementation in ADHD may be worthwhile. The committee was unable to find evidence of a favourable effect of n-3 LCPUFA supplementation on cognitive function in children. Although no benefit of n-3 LCPUFA supplementation was seen for major clinical outcome parameters in children with cystic fibrosis, a potentially beneficial shift towards less-inflammatory eicosanoid profiles seen in 2 studies provides grounds for further investigation; it is possible that earlier and longer supplementation periods may be needed to demonstrate clinical effect. For children with phenylketonuria, the limited data available suggest that supplementation of n-3 LCPUFA to the diet is both feasible and safe, but offers only transient benefit in visual function. For children with bronchial asthma there are insufficient data to suggest that LCPUFA supplementation has a beneficial effect. The committee advises paediatricians that most health claims about supplementation of n-3 LCPUFA in various diseases in children and adolescents are not supported by convincing scientific data.

*Department of Maternal and Pediatric Sciences, University of Milan, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico

University Children's Hospital, Zurich, Switzerland

Department of Paediatrics, University of Pecs, Hungary

§University Children's Hospital Zagreb, Croatia

||Department of Paediatrics, Deaconry Hospital, Schwaebisch Hall, Germany

Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Spain

#Leeds General Infirmary, UK

**Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University, Israel

††The Medical University of Warsaw, Poland

‡‡Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, France

§§Pediatrics, VU University Medical Center Amsterdam and Pediatrics, Emma Children's Hospital-AMC Amsterdam, The Netherlands.

1Committee Chair;

2Committee Secretary;


Received 11 February, 2011

Accepted 13 February, 2011

Address correspondence and reprint requests to Dr Tamás Decsi, Department of Paediatrics, University of Pécs, József A. u. 7, H-7623 Pécs, Hungary (e-mail:

The authors report no conflicts of interest other than those reported on the ESPGHAN Web site.

Copyright 2011 by ESPGHAN and NASPGHAN