DHA Omega-3 in the Early Years – Why Fortify?

By: Lucy Jones, MRES BSC Hons RD MBDA

April 21, 2017

Recent years have seen a rise in parents wishing to offer diets based on natural, unprocessed ingredients1 but there are some nutrients we often fall short on, meaning that fortification can play a real role in maintaining and optimizing our little one’s health. For example, fortified milks can increase intakes of vital nutrients, like vitamin D for their immune systems2 and docosahexaenoic acid (DHA) omega-3. Many countries now recommend widespread supplementation of vitamin D3; particularly in the Northern hemisphere where sun exposure can be reduced and yet substantial proportions of the population do not take supplements routinely4. In the UK, guidelines exist to encourage all children younger than 5 to take vitamin supplements including A, C and D5. While this advice doesn’t yet include DHA omega-3, the European Food Safety Authority (EFSA) gave a positive opinion for a health claim for DHA and brain development in infants and young children in 2014; after already finding that DHA helps to maintain our brain function throughout our lives6. They noted that the developing brain in childhood accumulates large amounts of DHA, particularly during the first two years of life, but also throughout childhood and concluded that studies have shown that a diet rich in DHA omega-3 directly affects and contributes to our brain development6. This health claim has still to be approved by the European Commission and Member States.

The human brain is made up of 60 percent fat and DHA is the primary structural component not only of the human brain, but also of the retina in our eyes6.

Fish, especially oily fish, is nearly only the real source of omega-3s, especially DHA, but our consumption of fish has plummeted over the last 100 years.  We know that generally, oily fish intakes now fall well below the recommended levels4. In the DOLAB trial focused on DHA in children, nearly 90 percent reported eating less than two portions of fish or seafood per week and their blood concentrations of DHA/EPA (at 2.46 percent – worse than the high risk level for cardiovascular disease in adults – correlated with their intake of fish7.

The study showed lower levels of DHA in the blood correlated with poorer reading skills, poorer working memory and worse general behavior rates7. Following this, the DOLAB intervention study looked at children aged 7 to 9, who were in the bottom third of reading skills, and eating less than two portions of fish per week. They were given DHA oil or a placebo for 16 weeks. The results showed that the supplements had a very significant effect on the worst readers among the group. Among 224 children who were in the bottom fifth for their reading, reading performance improved by 20 percent relative to the children on the placebo oil tablets; for the children with the worst reading skills, those below the 10the percentile, the improvement was even more dramatic at 50 percent7.

Results like this show just how important it is to ensure adequate intakes of DHA omega-3 for brain development in early years and I as a dietitian, encourage early introduction of oily fish during weaning.

During periods of picky eating, food refusal or where attempts to optimize oily fish intakes prove difficult, alternative sources should be sought. DHA can be found in supplement form, as well as in fortified foods such as fortified milks, eggs, and even orange juice. This can make breakfast time an ideal opportunity to boost intakes either through eggs, orange juice or milk containing DHA omega-3. The benefits of meeting nutritional needs during this rapid time of growth and development can influence their potential for their whole life and we have the power to make meaningful changes to their diets and health…through very simple changes.


  1. Financial Times (2017) Big food in health drive to keep market share. Accessed from Last accessed 7th March 2017
  2. EFSA (2015) Vitamin D and contribution to the normal function of the immune system: evaluation of a health claim pursuant to Article 14 of Regulation (EC) No 1924/2006. Accessed from Last accessed 7th March 2017
  3. Public Health England (2016) PHE published new advice on vitamin D. Accessed from Last accessed 7th March 2017
  4. FSA and PHE (2016) National Diet and Nutrition Survey years 5+6 combined. Accessed from Last accessed 7th March 2017
  5. National Health Service (2015) Vitamins for Children. Accessed from Last accessed 7th March 2017
  6. EFSA (2014) Scientific Opinion on the substantiation of a health claim related to DHA and contribution to normal brain development pursuant to Article 14 of Regulation (EC) No 1924/2006. Accessed from Last accessed 7th March 2017
  7. Richardson AJ, Burton JR, Sewell RP, Spreckelsen TF, Montgomery P (2012) Docosahexaenoic Acid for Reading, Cognition and Behavior in Children Aged 7–9 Years: A Randomized, Controlled Trial (The DOLAB Study). PLoS ONE 7(9): e43909. doi:10.1371/journal.pone.0043909

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