Updated: Apr 20
Dr. Chase Davidson, DC
The Literature Low-Down
This segment is meant to give you the skinny; the short and simple; the low-down on a noteworthy scholarly article to give you the knowledge and power to take your health into your own hands (within reason).
Today we are going to discuss "Prenatal docosahexaenoic acid (DHA) supplementation long-term effects on childhood behavioral and brain responses during performance on an inhibitory task” written by Kathleen M. Gustafson, associate professor of Neurology, and neurophysiology core director at the Hoglund Brain Imaging Center, at University of Kansas Medical Center, along with her colleagues.
It was published in the journal Nutritional Neuroscience on 01/20/2020. Nutritional Neuroscience has an average impact factor of around 4. The impact factor basically gives you an estimation of how popularly cited the articles in the journal are and by proxy its reputation in the academic community. The most popular journal in the world, The New England Journal of Medicine, has an impact factor of around 70. It is important to note, the impact factor does not tell you anything about the content or validity of each of the articles written in the journal, just its popularity. Just like social media, the more popular journals have more reach and publicity than less popular journals.
This means that this information in this article might not be known by your healthcare provider due to the lack of reach the journal has and the fact that, at the time of writing this blog, the article is less than a month old. With those caveats out of the way, let’s dive into it.
The Low-Down on Prenatal DHA
Prenatal health has always been an important issue, but has gained even more traction in recent years. Parents want to know everything that they can do to ensure the health of their future children. Although there is a whole world of preconception medicine, prenatal supplementation is a very traditional thought process but this usually starts and stops with folate and a prenatal multivitamin. An undervalued building block to developing fetuses and their nervous systems are fats. This article looks at the supplementation of Omega-3 fatty acids, specifically docosahexaenoic acid (DHA), during pregnancy and the behavior and brain function when the kids are 5.5 years old.
Mothers at an average gestation age of 14.5 weeks were put on a daily supplement of either a 600mg DHA supplement or a corn and soy oil placebo until the day of delivery. Once the children reached an age of 5.5 years old they were asked to perform a number of exams to determine behavioral and cognitive abilities via Electroencephalography (EEG) and Event-related Potentials (ERP) brain activity readings.
To test cognitive abilities, researchers performed an impulse control game where they needed to act to one signal “catch a fish” and not act to another signal “don’t catch a shark”. A number of different markers were also computed, like reaction time and accuracy. Their hypothesis was that the children that received DHA supplements throughout their gestation would have better impulse control due to better neural development.
The study was a success! “All children whose mothers were randomized to DHA supplementation during pregnancy made fewer false alarms than children in the placebo group, confirming our hypothesis that prenatal DHA would result in a greater ability to inhibit a response”. They go on to further explain how the ERP signals reflect aspects of neural inhibition, and the significance of the presence or absence of each wave.
The Kansas University DHA Outcome Study (KUDOS) found that performance on rule learning and flexibility was significantly accelerated in children whose mothers supplemented with 600mg/day of DHA compared to placebo at 36 months of age.
The Discussion section of this study also has some amazing references to studies that support the thought process that DHA is a great supplement for individuals who are pregnant and/or are thinking about getting pregnant. DHA has shown to reduce early preterm birth, improve fetal heart rate variability and score higher on autonomic and motor tests. Also, in adults who consume more DHA, they have more gray matter in multiple structures in the brain including the hippocampus which is responsible for the conversion of short term to long term memory.
DHA is Dope! In all seriousness, if I was stranded on an island and only had one supplement to live with (what a weird island) it would be DHA, preferably from whole fish or algae sources. There are so many other benefits that DHA has that we didn't include in this article. Some of those benefits include;
Decreased Cardiovascular Risk factors
Better Blood Sugar and Insulin Control
Neuroprotective properties against Concussion, Alzheimer’s, and More
We should take a quick swing at fish intake and heavy metals. There has been a lot of fear-mongering around fish intake during pregnancy and mercury toxicity. We need not throw the baby out with the bathwater...no pun intended. Fish contain many vital and beneficial nutrients beyond DHA. Selecting your fish sources is the easiest and most efficient way to make sure you reduce your exposure to things like mercury. Fish that are lower on the food chain like herring, anchovies, and sardines contain very little mercury as compared to fish higher on the food chain like tuna, halibut, mackerel, and salmon. It is also important to note that pacific and Alaskan harvested seafood is going to be less toxic than Atlantic caught, or worse yet farmed fish due to the concentration of environmental pollutants.
Having a plan on how to best support these factors should be something you discuss with your healthcare provider. If you, or someone you know, is currently or thinking of getting pregnant share this blog and spread the knowledge. For access to the article Click Here. If you have any other questions or comments, please leave a comment so a discussion can take place and those answers can help other people.
Kathleen M. Gustafson, Ke Liao, Nicole B. Mathis, D. Jill Shaddy, Elizabeth H. Kerling, Danielle N. Christifano, John Colombo & Susan E. Carlson (2020): Prenatal docosahexaenoic acid supplementation has long-term effects on childhood behavioral and brain responses during performance on an inhibitory task, Nutritional Neuroscience, DOI: 10.1080/1028415X.2020.1712535
Other supporting articles
Colombo J, Shaddy DJ, Gustafson K, Gajewski BJ, Thodosoff JM, Kerling E, Carlson SE. The Kansas University DHA outcomes study (KUDOS) clinical trial: long-term behavioral follow-up of the effects of prenatal DHA supplementation. Am J Clin Nutr. 2019;109 (5):1380–92.
Taylor, C. M., Emmett, P. M., Emond, A. M., & Golding, J. (2018). A review of guidance on fish consumption in pregnancy: is it fit for purpose?. Public health nutrition, 21(11), 2149–2159. https://doi.org/10.1017/S1368980018000599
Gustafson KM, Carlson SE, Colombo J, Yeh HW, Shaddy DJ, Li S, Kerling EH. Effects of docosahexaenoic acid supplementation during pregnancy on fetal heart rate and variability: a randomized clinical trial. Prostaglandins Leukot Essent Fatty Acids. 2013;88 (5):331–8.
Hoyer D, Schmidt A, Schneider U, Gustafson K. Fetal developmental deviations reflected in a functional autonomic brain age score. Computing in Cardiology; 23-26 Sept 2018; Maastricht, Netherlands: IEEE; 2018.
Chase Davidson, DC is a Board Eligible Chiropractic Neurologist and specializes in concussion and sports rehab, as well as functional medicine and immunology. He is the founder of Action Potential - Sports and Neurological Rehab. He also is a member of the International Association of Functional Neurology and Rehabilitation (IAFNR). Stay connected with Dr. Davidson on Linkedin @dr-davidson or on Instagram @washparkchiro or @thatneurologyguy.