Is high oily fish intake achievable and how does it affect nutrient status in 8-9-year-old children?: the FiSK Junior trial

Eur J Nutr. 2020 Apr;59(3):1205-1218. doi: 10.1007/s00394-019-01981-y. Epub 2019 May 9.

Abstract

Purpose: Most children do not meet dietary guidelines for fish intake. Fish is the main source of EPA (20:5n-3), DHA (22:6n-3) and vitamin D, but may replace better iron sources such as meat. We investigated if intake of 300 g/week oily fish was achievable in children and how it affected their nutrient status. Additionally, we validated a fish food frequency questionnaire (FFQ) by correlations against EPA + DHA in red blood cells (RBC).

Methods: In a randomised 12-week trial, 199 children (8-9 years) received oily fish or poultry (control) to be eaten five times/week. We measured dietary intake and analysed fasting RBC EPA + DHA, serum 25-hydroxyvitamin D (25(OH)D), blood haemoglobin and plasma ferritin.

Results: 197 (99%) children completed the study. The median (25th-75th percentile) intake was 375 (325-426) and 400 (359-452) g/week oily fish and poultry, respectively. The fish group increased their intake of EPA + DHA by 749 (593-891) mg/day and vitamin D by 3.1 (1.6-3.8) µg/day. Endpoint RBC EPA + DHA was 2.3 (95% CI 1.9; 2.6) fatty acid %-point higher than the poultry group (P < 0.001). The fish group avoided the expected 25(OH)D winter decline (P < 0.001) and had 23%-point less vitamin D insufficiency (winter subgroup, n = 82). Haemoglobin and ferritin decreased slightly in both groups (P < 0.05), but the number of children with low values did not change (P > 0.14). FFQ estimates moderately reflected habitual intake (r = 0.28-0.35) and sufficiently captured intervention-introduced changes in intake (r > 0.65).

Conclusion: Oily fish intake of 300 g/week was achievable and improved children's EPA + DHA and 25(OH)D status, without markedly compromising iron status. These results justify public health initiatives focusing on children's fish intake.

Keywords: Docosahexaenoic acid (DHA); Eicosapentaenoic acid (EPA); Iron; Vitamin D; n-3 Long-chain polyunsaturated fatty acids (n-3 LCPUFA).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Child
  • Child Nutritional Physiological Phenomena*
  • Denmark
  • Docosahexaenoic Acids / blood
  • Eicosapentaenoic Acid / blood
  • Female
  • Fish Oils / administration & dosage*
  • Fish Oils / blood
  • Fish Oils / pharmacology*
  • Humans
  • Male
  • Nutrition Surveys / methods
  • Nutrition Surveys / statistics & numerical data*
  • Seafood / statistics & numerical data*
  • Surveys and Questionnaires
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood

Substances

  • Fish Oils
  • Vitamin D
  • Docosahexaenoic Acids
  • 25-hydroxyvitamin D
  • Eicosapentaenoic Acid

Grants and funding