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

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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.

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Abbreviations

CRP:

C-reactive protein

DDPCB:

Dioxins and dioxin-like polychlorinated biphenyls

DHA:

Docosahexaenoic acid (22:6n-3)

EFSA:

European food safety authority

EPA:

Eicosapentaenoic acid (20:5n-3)

FA%:

Fatty acid w/w% of total fatty acids in red blood cells

FFQ:

Food frequency questionnaire

n-3 LCPUFA:

n-3 Long-chain polyunsaturated fatty acids

RBC:

Red blood cells

25(OH)D:

25-Hydroxyvitamin D

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Acknowledgements

SV helped design the study, conducted the study, analysed the data, and drafted and finalised the manuscript; MNT helped design the study and conducted the study; NGB conducted the study; KS analysed the blood fatty acid content; JJ analysed serum 25(OH)D; CM designed the study; LL designed the study; CTD designed the study, analysed the data and drafted the manuscript. All the authors reviewed, provided input to and approved the final manuscript.

Funding

The FiSK study was supported by Nordea-fonden (Grant no. 02-2015-1429). Study foods were purchased from Skagenfood A/S, Sødam A/S via gaardmester.dk and REMA1000 Danmark A/S with discount, and provided in kind by Amanda Seafoods A/S.

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Authors and Affiliations

  1. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, Frederiksberg C, Denmark

    Stine Vuholm, Marie N. Teisen, Nanna Glent Buch, Christian Mølgaard, Lotte Lauritzen & Camilla T. Damsgaard

  2. Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada

    Ken D. Stark

  3. Research Group for Bioactives-Analysis and Application, National Food Institute, Technical University of Denmark, Lyngby, Denmark

    Jette Jakobsen

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  1. Stine Vuholm
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  2. Marie N. Teisen
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Correspondence to Stine Vuholm.

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Supplementary Figure S1. Flow chart of children in the FiSK Junior study from invitation letter to study completion. (PDF 74 kb)

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Vuholm, S., Teisen, M.N., Buch, N.G. et al. 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 59, 1205–1218 (2020). https://doi.org/10.1007/s00394-019-01981-y

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