You’ve probably heard this before: omega-3s are lifelong nutrients, meaning that they are important at every stage of life.
The potential benefits of these polyunsaturated fatty acids (PUFAs)—especially these two main forms of omega-3s—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—are extensively researched. The body of science covers more than 40,000 published studies on EPA and DHA, including 4,000+ human clinical trials.
Scientific research associates the nutrients with a vast array of potential benefits including supporting a healthy heart, brain benefits like cognition and memory, eye health, sports performance, reduced inflammation, immune health and maybe even sexual health. Not all the research shows benefit, but enough does to compel you to consider adding omega-3s to your health regimen. Read more here.
In today’s blog, we’re going to narrow the focus, looking at the scientific evidence that suggests potential benefits for kids from pre-birth through the teenage years. In addition to that, we’re going to discuss how much omega-3 EPA and DHA your child needs to access those benefits.
When do Omega-3 Benefits Begin for Kids?
Scientific experts believe it’s never too early to ensure that your baby-to-be is getting optimal levels of omega-3 EPA and DHA.
In fact, the need for omega-3s for kids actually starts in utero.
Omega-3, specifically DHA, may help prevent premature births (a leading cause of infant mortality), morbidity and long-term disability. Some research points to a 10-fold increased risk of early preterm births for pregnant women with low DHA levels.
This meta-analysis of approximately 20,000 women from 70 randomized controlled trials (RCTs) strongly associated a reduced risk of preterm births (and other issues during pregnancy) with omega-3 EPA and DHA supplements. The review suggested that pregnant women taking omega-3 supplements (compared to those who weren’t) could reduce the risk of preterm birth (before 37 weeks) by 11% and of early (before 34 weeks) preterm birth by 42%.
The study authors stated that “[omega-3] supplementation during pregnancy is a simple and effective way to reduce preterm, early preterm birth and low birth weight, with low cost and little indication of harm.”
Kristina Harris Jackson, PhD, RD, Chief Operating Officer at OmegaQuant Analytics, advises that experts view the time from conception through the baby’s 2nd birthday as the most important period of time to influence health. She says that it’s a key time for brain growth and development of the eyes, and immune and nervous systems that will follow the child throughout his or her lifetime. EPA and DHA are crucial at this stage.
For example, without enough DHA during this timeframe, the infant may be at risk of developing memory problems and other learning issues.
This study found that “improving maternal DHA nutrition decreases the risk of poor infant and child visual and neural development.” In addition, the study confirmed that “maternal fatty acid nutrition is important to DHA transfer to the infant before and after birth, with short and long-term implications for neural function.”
The American Pregnancy Association has a lot to say about the necessity of omega-3s during pregnancy. For instance, this: “pregnant moms and women planning a pregnancy will want to follow a healthy diet and that includes taking a prenatal vitamin and a prenatal Omega-3 supplement that contains essential fats, with EPA and DHA, found in fish, being the most critical.”
Even after a woman gives birth, she can still help ensure the appropriate inclusion of omega-3s in her baby’s life. For example, through breastfeeding, she can confer continued benefits of DHA to her child. But, making sure her blood level of DHA is high enough to support both her and the infant during this critical time is important.
Is Omega-3 Good for Kids’ Brains?
According to this article, this is an area of emerging research and there are results that show omega-3 fatty acids may improve both brain function and mood in children, particularly in brain development, learning and memory. (And the article adds omega-3s may also help children improve sleep quality and reduce symptoms of ADHD and asthma.)
For example, a study from the Journal of Nutritional Biochemistry found a strong correlation between omega-3 blood levels, especially DHA, and better brain function in children 2-6 years old. The study population included 307 children from Northern Ghana who went through a series of age-appropriate cognitive function tests. Dried blood spot samples were taken to measure their omega-3 EPA and DHA blood serum levels on the Omega-3 Index (O3I) scale.
The results showed an average O3I of 4.6%, and ranged from 2.3% to 11.7%. Children with the highest levels of total omega-3s and DHA were three and four times, respectively, more likely to pass at least one condition of the test used to assess executive function than those with the lowest levels.
In another study, this one from Norway, the results directly associated infants’ problem-solving abilities at 1 years old with their mother’s level of DHA in the blood during pregnancy. This led the researchers to advise that “the results accentuate the importance for pregnant and lactating women to have a satisfactory DHA status from dietary intake of seafood or other sources rich in DHA.”
A recent study of adolescents published in the European Child & Adolescent Psychiatry journal found that higher dietary DHA levels were associated with better attention performance in typically developing adolescents. According to the study results, the cognitive benefits from DHA for this cohort were specifically associated with selective and sustained attention, as well as detecting and resolving conflict.
This observational study, looked at 700 healthy Dutch adolescents (aged 12-18 years), and collected fish consumption data, end term grades, scores on the Amsterdam Vocabulary Test, and scores on the Youth Self-Report. The researchers reported the results associated higher fish intake with more advanced vocabulary and higher end term grades; however, the authors also noted an inverted U-shape association whereby “eating more fish than the described norm seemed no longer beneficial.” Read more here.
What About Omega-3 and Kids and Asthma or Allergies?
Researchers are interested to know if getting enough omega-3 fatty acids in the womb and during early life can help prevent or control pediatric or childhood asthma. The theory is that the inflammation-reducing properties of omega-3s may help.
There are studies that show promise in this area. For example, a study in the Journal of Allergy and Clinical Immunology discovered that children with higher levels of omega-3s were less likely to have asthma or a recurrent wheeze at 3 years old. This was the case whether omega-3s were measured based on blood levels or dietary intake, and also after the results were adjusted for a variety of potential confounding variables. In addition, blood levels of omega-3 PUFAs were associated with lower allergy blood markers.
While the researchers found this to be good news, they called for “studies following children over time” as well as larger RCTs to further evaluate what they referred to as a “safe and inexpensive potential treatment for childhood asthma and allergies.” In addition, they were intrigued as to the potential interconnection that vitamin D may have played in these results.
Another study, published in the New England Journal of Medicine, followed 695 children whose pregnant moms approaching their third trimester were given either 2.4 grams of omega-3s EPA and DHA fish oil supplements or an olive oil placebo. Just over 95% of the children finished the 3-year, double-blind follow-up period. The results showed the risk of persistent wheeze or asthma was 17% in the treatment group versus 24% in the control group.
A third investigation, this one a 6-month study of 135 children in a low-income community, published online in the American Journal of Respiratory and Critical Care Medicine, compared omega-3 and omega-6, assessing their roles in childhood asthma. The results showed that having more omega-3 fatty acids in the diet resulted in fewer asthma symptoms sparked by indoor air pollution.
Researchers saw 3-4% lower odds of daytime asthma symptoms with each 100 mg increase in levels of omega-3 fatty acids in the diet, meaning children who consumed more omega-3s were less likely to have symptoms even at the same level of air pollution exposure.
Conversely, this study found that higher amounts of dietary omega-6 fatty acids may be associated with more severe asthma symptoms.
The children in the study were aged between 5 and 12 years old, and were approximately evenly divided as having mild, moderate or severe asthma. According to lead researcher, Emily Brigham, M.D., M.H.S., there is mounting evidence that diet, specifically omega-3 and 6 fatty acid levels, might play a role in lung health by shifting how the body responds to and processes inflammation.
Dr. Brigham added that “among populations known to be disproportionately affected by asthma, we may find that improving diet and air pollution together has the greatest impact on health.”
Read more specifics about these studies here.
Omega-3 for Kids: Safe?
According to this article, omega-3 fatty acids are essential for healthy growth and development in children and are considered generally safe.
So that leads us to this question: How can kids get the necessary amount of omega-3s EPA and DHA in their diet? There are two ways: from food and from dietary supplements.
This post from the Academy of Nutrition and Dietetics urges a food first approach. Just like for adults, the best way for children to get omega-3 EPA and DHA is from fatty fish, like salmon, sardines, shrimp and more.
It’s a great suggestion, but keep these things in mind:
- watch out for bones in fish which could present a choking hazard
- consider choosing fish with lower mercury content. This list may be helpful for finding fish sources and you can compare to this list that provides advice about fish and mercury.
- this helpful article from FDA also shares information about best fish sources and advises that specifically for children, a serving of fish is approximately 1 ounce (ages 1-3); 2 ounces (ages 4-7); 3 ounces (ages 8-10) and 4 ounces (at age 11).
- many kids turn up their noses at fish. What’s a parent to do? Present the fish in kid-friendly ways, such as baked fish nuggets or salmon sliders. Consider preparation using sauces that kids may like, such as honey barbecue source or teriyaki or a mustard dip. Maybe even ketchup if you can stomach watching fish dipped in ketchup.
There are also fortified foods, including eggs, yogurt and milk, to name a few, that add omega-3s. Check the labels for EPA and DHA.
Beyond EPA and DHA, omega-3s can be found in ALA form, which is plant-based. However, a few words of caution: The body converts ALA into EPA and DHA, but in very small amounts and not efficiently.
This brings us to dietary supplements. If you choose this option, look for omega-3 EPA and DHA supplements for kids. And, buy from a reputable company and source. Don’t use more than the suggested serving. Also, remember to discuss fish oil supplements with your child’s doctor or other trusted healthcare practitioner.
What’s the Recommended Amount of Omega-3s for Kids?
The answer to this question may be more difficult than figuring out how to get your child to eat fish.
That’s because the government has not established a recommended daily amount for EPA and DHA, only ALA.
Some parents choose to use a test (including ours) for not only themselves, but for their children, to determine blood levels of omega-3 EPA and DHA.
The Omega-3 Index established a range of 8-12% as an ideal target for adults, but what is the target range for children?
According to OmegaQuant’s Dr. Jackson, this published article shows that people ages to 10-19 have an average O3I of 3.5%. “That’s what we typically see in other papers too, that on average, younger people typically have lower levels on the Omega-3 Index.” In a scientific paper published in Nutrients, the authors proposed an Omega-3 Index target of 6% or greater for children and adolescents based on where studies have shown efficacy in cognitive data.
Says Dr. Jackson, “more research establishing an Omega-3 Index for children would go a long way in helping parents test to see if their children are reaching an optimal level for omega-3 EPA and DHA.”