Omega-3 PUFA concentrations in childhood prospectively associate with academic performance beyond a healthy diet: findings from the multiethnic Asian Growing Up in Singapore Towards healthy Outcomes cohort study

Omega-3 PUFA concentrations in childhood prospectively associate with academic performance beyond a healthy diet: findings from the multiethnic Asian Growing Up in Singapore Towards healthy Outcomes cohort study

The American Journal of Clinical Nutrition

10.1016/j.ajcnut.2026.101233

https://doi.org/10.1016/j.ajcnut.2026.101233

Karen Mei-Ling Tan, Jun Shi Lai, Jia Ying Toh, Yi Ying Ong, Michelle ZL Kee, Wei Wei Pang, Melvin Khee Shing Leow, Fabian Yap, Johan Gunnar Eriksson, David Cameron-Smith, Michael Meaney, Evelyn Chung Ning Law, Mary Foong-Fong Chong

04 February 2026

Tan, K. M.-L., Lai, J. S., Toh, J. Y., Ong, Y. Y., Kee, M. Z., Pang, W. W., Leow, M. K. S., Yap, F., Eriksson, J. G., Cameron-Smith, D., Meaney, M., Law, E. C. N., & Chong, M. F.-F. (2026). Omega-3 PUFA concentrations in childhood prospectively associate with academic performance beyond a healthy diet: findings from the multiethnic Asian Growing Up in Singapore Towards healthy Outcomes cohort study. The American Journal of Clinical Nutrition, 123(4), 101233. https://doi.org/10.1016/j.ajcnut.2026.101233

Background The influence of plasma DHA and overall omega-3 (n–3) long-chain PUFA (LC-PUFA) on child cognitive development is unclear. Objectives We examined if plasma LC-PUFA concentrations are prospectively associated with academic performance in primary school children and if diet patterns modulate the relationship. Methods Children were from the Growing Up in Singapore Toward healthy Outcomes cohort. Fasting LC-PUFA concentrations were measured using nuclear magnetic resonance spectroscopy at age 8 y (n = 557). Dietary patterns were derived using principal component analysis from a validated food frequency questionnaire at age 7 y. Academic performance was assessed using the Wechsler Individual Achievement Test-III at age 9 y (n = 288) and the primary school leaving examination (PSLE) at age 12 y (n = 408). The relationships of LC-PUFAs to academic performance scores were examined using multivariable linear regression models. Results Percent DHA at age 8 y was associated with higher reading fluency {β [95% confidence interval (CI)] = 3.54 (0.52, 6.56), P = 0.022} and spelling scores [4.49 (0.02, 8.95); P = 0.021] at age 9 y, and lower PSLE scores [β (95% CI) =−1.43 (−2.68, −0.618); P = 0.025] (indicating better performance) at age 12 y. However, these associations were attenuated after adjusting for an unhealthy dietary pattern. Total n–3 LC-PUFA at age 8 y was associated with higher reading fluency [β (95% CI) =1.55 (0.03, 3.07); P = 0.046] scores at age 9 y, and lower PSLE scores [β (95% CI) =−0.83 (−1.42, −0.24); P = 0.006] at age 12 y. The association with PSLE scores remained significant even after adjusting for healthy or unhealthy dietary patterns [β (95% CI) =−0.68 (−1.29, −0.08); P = 0.028]. Conclusions Higher plasma total n–3 LC-PUFA and DHA were prospectively associated with better academic performance in primary school children, but the relationship with DHA was modulated by an unhealthy dietary pattern. The results suggest that beyond DHA, total n–3 LC-PUFA status plays a significant role in the cognitive development of children.

Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

This research / project is supported by the National Medical Research Council - Open Fund Large Collaborative Grant
Grant Reference no. : MOH-000504

https://oar.a-star.edu.sg/communities-collections/articles/22870

0002-9165

Institute for Human Development and Potential