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By Richard N. Podell, M.D.
An infant's brain grows rapidly during the first
year of life--tripling its size from birth. In that year, the
foundations for intelligence, vision and language are built.
Since the human brain is about 60 percent fat, all this brain
building requires fatty acids. Proper foods, rich in those fats,
might even give babies an intelligence advantage.
Animal experiments show one cause of low intelligence is prenatal
deficiency of essential fatty acids, particularly docosahexaenoic
acid (DHA), [1, 2] found in fatty fish and algae
supplements. DHA is an omega-3 fatty acid and cousin to the
better-known omega-3 eicosapentaenoic acid (EPA). Postnatal
studies are also beginning to confirm the connection between DHA
DHA and the omega-6 fatty acid arachidonic acid are the dominant
fats in the nerve cells of fetal and infant brains. So does low
DHA cause brain damage or less than optimal brain function in
humans? There is some evidence to suggest the answer is yes. For
example, premature infants are often low in DHA and are at higher
than average risk for neurological problems.  Children
with hyperactivity or attention deficit disorder also tend to
have low levels of DHA. 
These observations suggest a causative role for essential fatty
acid deficiencies in childhood neurological problems. However, we
need prospective interventions to test whether adding DHA can
prevent or treat neurological or mental disease.
A recent article in The Lancet reported the groundbreaking
news that infants given a DHA-enriched formula had superior
problem-solving ability at 10 months compared with infants who
drank the standard, low-DHA commercial product.
P. Willatts, Ph.D., and colleagues at the University of Dundee in
Scotland obtained parental cooperation on behalf of 44 healthy,
full-term newborns. Starting shortly after birth, half the babies
received a standard infant formula while the others received the
same formula supplemented with arachidonic acid and DHA. The fat
supplement was derived from milk fat, vegetable oils and egg
When tested at 10 months, both groups had normal physical
development and were equally able to solve simple mental
problems. However, faced with a more complex mental challenge,
those taking DHA-supplemented formula did better--and their
advantage was statistically significant. 
In this study the 10-month-olds were presented with the following
challenge: They watched a toy being placed under a cover. The
covered toy was set on a long cloth with the end of the cloth
near the child. A barrier stood between the cloth and the child.
To get the toy, infants had to solve this three-step problem.
In four trials both groups were equally successful at removing
the barrier and starting to tug on the cloth. However, the last
step -- pulling the covered toy all the way into reach and removing
the cover -- was accomplished more often by the group receiving
Since higher problem-solving scores in infancy are related to
higher childhood IQs, this study suggests that the simple
addition of crucial fats to infant formula could improve IQs in
millions of children. If other studies reproduce and extend
Willatts' results, infant formula manufacturers will be under
pressure to add essential fats to their products--making the
composition of their formulas closer to that of mother's milk,
which is relatively rich in DHA.
Until formulas are fortified with essential fatty acids, should
pregnant women increase their intake of fish or take DHA-enriched
supplements? We do not know enough to say. Although there are no
known downsides to DHA-enriched formula, DHA supplements derived
from fish oil are not recommended for pregnant women and children
5 years and younger. Fish oil contains fairly large amounts of
EPA and moderate amounts of DHA. In adults, both are assimilated.
In infants and fetuses, however, there is concern that EPA might
compete with DHA for a place in nerve-cell membranes, making
administration of fish oil at a young age counterproductive.
Algae supplements are a better source of DHA for children.
Pregnant or lactating women should consult with their health care
providers before taking any supplements.
DHA is relatively new to the limelight. More research and
attention have focused on EPA, an omega-3 thought able to combat
heart disease, rheumatoid arthritis and Crohn's disease. The
complex actions of essential fatty acids are still not fully
understood. However, this promising preliminary research means
more studies are sure to follow--particularly if there is
potential to increase infant intelligence.
Richard N. Podell, M.D., is director of the Podell
Medical Center in New Providence, N.J.
1. Crawford M. Are deficits of arachidonic and
docosahexaenoic acids responsible for the neural and vascular
complications of preterm babies? Am J Clin Nutr
2. Crawford M. The role of essential fatty acids in neural
development: implications for perinatal nutrition. Am J Clin Nutr
3. Makrides M. Are long-chain polyunsaturated fatty acids
essential nutrients in infancy? Lancet 1995;345:1463-8.
4. Stevens L. Essential fatty acid metabolism in boys with
attention-deficit hyperactivity disorder. Am J Clin Nutr
5. Willatts P, et al. Effect of long-chain polyunsaturated
fatty acids in infant formula on problem solving at 10 months of
age. Lancet 1998;352:688-91.