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Effect of long-chain polyunsaturated fatty acids in infant formula on long-term cognitive function in childhood: A systematic review and meta-analysis of randomised controlled trials

Verfuerden, ML; Dib, S; Jerrim, J; Fewtrell, M; Gilbert, RE; (2020) Effect of long-chain polyunsaturated fatty acids in infant formula on long-term cognitive function in childhood: A systematic review and meta-analysis of randomised controlled trials. PLOS One , 15 (11) , Article e0241800. 10.1371/journal.pone.0241800. Green open access

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Abstract

Lack of preformed long-chain polyunsaturated fatty acids (LCPUFA) in infant formula has been hypothesised as contributing to cognitive differences between breast-fed and formulafed infants. Previous systematic reviews found no cognitive differences between infants fed formula with LCPUFA and those fed formula without, but focused on early developmental measures, such as Bayley Scales of Infant Development, which are poorly differentiating and not predictive of cognitive ability in childhood. This systematic review examined the effect of randomising infants to formula supplemented with LCUFA vs unsupplemented formula on cognitive function � age 2.5 years. We searched Medline, Embase the Cochrane Central Register of Controlled Trials without date limit, following a pre-published protocol according to PRISMA guidelines. We conducted random effects meta-analyses in RevMan v5.4 and followed GRADE and Cochrane Guidelines to evaluate strength of evidence and potential for bias. We included 8 trial cohorts which randomised participants between 1993 and 2004 and analyse 6 previously unpublished outcomes provided by various trialists. Age at the last available cognitive test ranged from 3.3 to 16 years. The pooled mean difference in Wechsler Preschool and Primary Scale of Intelligence-Revised from four trials in termborn children showed no benefit of LCPUFA: -0.04 points (95% confidence interval -5.94 to 5.85, 95% prediction interval -14.17 to 14.25). The pooled mean difference in Wechsler Abbreviated Scale of Intelligence score from two trials in preterm-born children also showed no benefit of LCPUFA: -7.71 (95% CI -24.63 to 9.22, 95% PI -97.80 to 82.38). Overall quality of evidence was low, due to substantial heterogeneity, low rates of follow-up, and indications of selective publication. The long-term effect of LCPUFA supplementation in term and preterm- born infants on cognition is highly uncertain and includes potential for large benefit as well as large harm. Based on our findings, LCPUFA supplementation of infant formula is not recommended until further robust evidence excludes long-term harm.

Type: Article
Title: Effect of long-chain polyunsaturated fatty acids in infant formula on long-term cognitive function in childhood: A systematic review and meta-analysis of randomised controlled trials
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0241800
Publisher version: https://doi.org/10.1371/journal.pone.0241800
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10114772
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