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Recent data from a Danish prospective clinical trial has raised concerns about the potential adverse effects of fish oil supplementation during pregnancy on the long-term health of offspring. The study, published in the April 2024 issue of the American Journal of Clinical Nutrition, suggests that children whose mothers received fish oil supplementation during pregnancy may have an increased risk of overweight and higher metabolic syndrome scores at age 10.
The trial, which involved 736 pregnant women and their offspring, randomly assigned participants to receive either 2.4 grams of n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs) or a placebo daily from pregnancy week 24 until 1 week post-birth. Initial analyses at 6 years showed that children whose mothers received fish oil supplementation had higher body mass indexes (BMIs) with no difference in fat percentage. However, at 10 years, these children still exhibited higher BMIs, a higher body fat percentage, an increased risk for overweight, and higher metabolic syndrome scores compared to children of non-supplemented mothers.
Lead author Klaus Bønnelykke, senior physician at Herlev and Gentofte Hospital and professor of pediatrics at the University of Copenhagen, Denmark, cautioned that supplementation might increase the risk of obesity in the long run. Despite this, he highlighted the benefits observed in previous reports from the same study, which indicated a reduction in the risk of early childhood asthma and infections among children whose mothers received fish oil supplementation.
In an editorial accompanying the study, Sjurdur Frodi Olsen, PhD, senior physician at Statens Serum Institut and professor of epidemiology at the University of Copenhagen, Denmark, praised the efforts of the researchers but stressed the need for replication of the findings in future independent studies.
Olsen emphasized the importance of considering the broader context of maternal supplementation, particularly regarding the prevention of preterm birth. He referenced a recent international expert review supporting the use of long-chain n-3 fatty acids to reduce the risk of preterm birth, with recommended doses ranging from ≥ 250 mg/d of docosahexaenoic acid (DHA) plus eicosapentaenoic acid (EPA) from diet or supplements, to additional intake of ≥ 100 to 200 mg/d of DHA during pregnancy.
While acknowledging the significance of the study’s findings, Olsen underscored the need for caution, noting that a single study is insufficient to prompt changes in recommendations. He suggested that if increased risk of overweight in children is confirmed in further research, interventions such as physical activity and dietary adjustments may help mitigate this risk.
The study was funded by the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), with core support provided by the Lundbeck Foundation, the Ministry of Health, the Danish Council for Strategic Research, and the Capital Region Research Foundation. Sjurdur Frodi Olsen reported no disclosures.
The findings add nuance to discussions surrounding maternal nutrition and supplementation, highlighting the importance of balancing potential benefits with possible risks to offspring health in the long term.
