ABRAN Updates Consensus on DHA Consumption and Supplementation in Childhood and Adolescence

Recently, the Brazilian Association of Dietetics (ABRAN) updated its recommendations for DHA supplementation (Docosahexaenoic acid – Docosahexaenoic acid) in pregnancy, infancy, and childhood, based on scientific evidence. Article II Consensus of the Brazilian Nutrition Society on the recommendations of the Dubai Health Authority during pregnancy, lactation and childhood It was published in the magazine International Journal of Dietetics. In this text, we summarize consensus updates with a focus on childhood and adolescence.

DHA

DHA and food

The important omega-3 fatty acids for humans are linolenic acid and eicosapentaenoic acid (fatty acid – Environmental Protection Agency) and DHA. DHA is conditionally essential, which means that it is not produced by the human body in sufficient quantities. Like EPA, DHA performs important biochemical and physiological functions.

According to ABRAN, dietary sources of DHA are mainly found in fish and seaweed and the amount of DHA can vary greatly in each type of fish, such as wild salmon, which is not available in Brazil. The salmon consumed in our country comes from fish tanks and the content of DHA depends on the consumption of fortified feed. In Brazil, sardines are the main source of DHA in the diet, but its consumption is still insufficient TheRecommendations. Furthermore, in contrast to the potential health benefits of regular consumption of marine fish, some chemical contaminants such as heavy metals and chlorinated pesticides may be present. It is important to note that evidence shows that fish consumed in Brazil contains low amounts of omega-3s.

The consensus highlights that Brazil, despite having a wide coastal area and favorable natural conditions, such as the climate, does not occupy a prominent position, accounting for less than 1% of global fish production. Despite the growth in fish consumption by the Brazilian population, consumption per person It is still considered low, with an average of 9 kg/inhabitant/year, which is about 10 kg less than the global average and below the minimum average set by the World Health Organization (WHO), which is 12 kg of fish/inhabitant/year.

The importance of DHA in childhood and adolescence

DHA is an essential nutrient for the growth and development of children, and its main role is in the formation and functioning of the central nervous system (CNS) and the retina of the eye. Its deficiency can lead to impaired cognitive and visual development in children:

Impaired cognitive development:

– fewer neurons and less DHA in these cells;

Decreased production of neurotransmitters (acetylcholine, dopamine and norepinephrine);

Decreased myelin deposition.

Fewer synapses.

Impaired visual development:

Insufficient functional maturation of the retina.

Less differentiation of photoreceptors.

In the case of schoolchildren and adolescents, DHA is relevant for neurotransmission systems and for maintaining synaptic susceptibility.

DHA supplement for infants and preschoolers

Newborns (NB) and infants should receive adequate amounts of long-chain polyunsaturated fatty acids (Long-chain polyunsaturated fatty acids) – LCPUFA) to promote optimal visual and cognitive development, once the needs and importance of these acids in infant nutrition have been established. Breastfeeding, as long as the mother is taking in enough DHA, meets the needs of these babies. In the absence of breast milk, infant formulas enriched with DHA (0.2% to 0.5% of total fat) should be used. After six months of age, supplementation of this acid should be continued, although there are doubts about the ideal amount to achieve the benefits offered by this nutrient.

In preschoolers (between two and six years), DHA recommendations range from 100 to 200 mg/day. However, it is still recommended to follow a diet rich in DHA to reach the necessary daily amounts.

The table below shows the daily recommendations for DHA in infants and preschoolers according to ABRAN:

DHA daily recommendations for infants and preschoolers
age	daily recommendation
0 to 6 months	0.2 to 0.5% of total fat
6 months to 2 years	10 to 12 mg/kg/day
2 to 4 years old	100 to 150 mg/day
4 to 6 years old	150 to 200 mg/day

Subtitle: Dubai Health Authority – Docosahexaenoic acid.

source: Quoted from Nogueira de Almeida et al. (2022).

Currently, DHA derived from fish oil has a higher purity, as heavy metals and contaminated products have been extracted and prepared using techniques that do not degrade or de-saturate the fatty acids. These supplements can be found in liquid form to be offered as drops to younger children, and in capsule form for later ages.

DHA supplementation in school children and adolescents

According to the consensus, dietary supplementation for healthy children aged 10 to 12 years showed no difference in the eight-week intervention study. However, results may vary in children who have learning difficulties and are likely to have insufficient concentrations of DHA.

Regarding the use of DHA in the management of children and adolescents with attention deficit hyperactivity disorder (ADHD), some authors argue that there will be a promising use for individuals who are still young to use one or several drugs. ABRAN researchers concluded, based on several studies, that the use of DHA in behavioral and cognitive disorders and based on its anti-inflammatory effect is promising, although it still cannot be unanimously recommended for school children and adolescents.

According to ABRAN, the dose of DHA should be greater than or equal to 450 mg and it appears that doses of up to 1200 mg/day would still be safe. However, the researchers describe the belief that there is already a consensus that we must ensure that children and adolescents take the recommended doses of LCPUFA for their age and gender, because its function in the body is very important. Thus, they cite the Herter-Eberle survey and others. , Hey Swiss n-3 PUFA FFQFood Frequency Questionnaire to check intake of DHA and EPA so that populations at risk of low intake can be identified. Access to the survey in English over here.