AHRQ publishes draft of systematic review investigating omega-3 fatty acid intakes and child growth and development outcomes

The U.S. Agency for Healthcare Research and Quality (AHRQ) published its draft report¹ titled “Dietary Total Fat Intake and Dietary Polyunsaturated Fatty Acid Intake and Child Growth and Development Outcomes: A Systematic Review.” According to the agency’s abstract, the goal of the review is to “support possible updates and expansion [of] the 2025 U.S.-Canadian Dietary Reference Intakes (DRIs).” More specifically, the systemic review seeks to identify and summarize evidence on four questions:²

• What is the association between dietary intake of n-6 and/or n-3 polyunsaturated fatty acids during pregnancy and the risk of preterm birth? How are these associations affected by intervention/exposure characteristics (for example, the ratio of different fatty acids)?
• What is the association between dietary intake of n-6 and/or n-3 polyunsaturated fatty acids during pregnancy and/or lactation and infant/child growth and developmental outcomes? How are these associations affected by intervention/exposure characteristics (for example, the ratio of different fatty acids)?
• What is the association between dietary intake of total fat of individuals from birth through 18 years of age and measures of growth and development?
• What is the association between dietary intake of n-6 and/or n-3 polyunsaturated fatty acids of individuals from birth through 18 years of age and measures of growth and development?

In the abstract, the systematic review reached the following conclusion:

“There were few findings of differences across polyunsaturated fatty acid supplementation or dietary intake of fatty acids and growth and developmental outcomes in a healthy population during pregnancy and childhood. The largest body of evidence consisted of RCTs with moderate or high risk of bias evaluating polyunsaturated fatty acid supplementation during pregnancy or infancy and growth outcomes in the first year of life. Of outcomes with sufficient evidence, heterogeneity in study design, exposures and comparators, and outcomes resulted in the strength of evidence being rated mostly as low. Additional PUFA and total fat intake in healthy populations, at the amounts that have been studied, may not confer demonstrable advantages, but the consistent finding of no difference suggests no harm. Additional research in older children and adolescents, studies with longer exposure durations, and populations who have diet- or nutrition-related conditions that may benefit from PUFA or total fat supplementation is needed to inform future DRIs.”

In April of 2025, the Office of Dietary Supplements (ODS) updated³ its guidance on the omega-3 fatty acids for reducing the risk of preterm and early preterm births. While the daily recommended intake for docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) has not been established, the ODS guidelines⁴ indicate that “experts recommend all women of childbearing age consume at least 250 mg/day of DHA plus EPA from diet or supplements, and an additional 100 to 200 mg/day of DHA during pregnancy.” That guidance also notes that long-chain fatty acid supplements, particularly DHA, have been shown to reduce the risk of preterm and early preterm birth, and cites clinical practice guidelines from the American Journal of Obstetrics & Gynecology Maternal-Fetal Medicine, that pregnant women with low DHA intake can consume between 600-1000 mg of DHA plus EPA or DHA alone in the second trimester to further help reduce the risk of preterm birth.

While there is a good deal of evidence supporting the supplementation of omega-3 DHA and EPA amongpregnant women, such as those cited by ODS, according to the systematic review the current evidence is too heterogenous or biased to reach any strong conclusions. It’s therefore unclear whether a DRI will be developed for omega-3s. The review states: “While our ability to come to strong conclusions is limited, this literature and review will inform the NASEM working group tasked with updating and expanding the U.S. and Canadian government DRIs. It will also provide a foundation on which a robust research agenda can be developed to advance our understanding of the interaction of nutrition, particularly the impact of dietary fat and fatty acid consumption, on pregnancy outcomes, infant and child growth, cognitive development, and health at these important life stages and beyond.”

The public comment period is still in effect until September 29.

References

1. Draft Comments: Dietary Total Fat Intake and Dietary Polyunsaturated Fatty Acid Intake and Child Growth and Development Outcomes: A Systematic Review. Content last reviewed August 2025. Effective Health Care Program, Agency for Healthcare Research and Quality. https://effectivehealthcare.ahrq.gov/products/child-growth-development-outcomes/draft-report (Accessed 2025-09-12)
2. Research Protocol: Dietary Total Fat Intake and Dietary Polyunsaturated Fatty Acid Intake and Child Growth and Development Outcomes: A Systematic Review. Content last reviewed November 2024. Effective Health Care Program, Agency for Healthcare Research and Quality. https://effectivehealthcare.ahrq.gov/products/child-growth-development-outcomes/protocol (Accessed 2025-09-12)
3. McEvoy, E. New guidance from Office of Dietary Supplements on omega-3s for pregnancy health. Nutritional Outlook. April 22, 2025. https://www.nutritionaloutlook.com/view/new-guidance-from-office-of-dietary-supplements-on-omega-3s-for-pregnancy-health (Accessed 2025-09-12)
4. National Institutes of Health Office of Dietary Supplements. Dietary Supplements and Life Stages: Pregnancy https://ods.od.nih.gov/factsheets/Pregnancy-HealthProfessional/#en169 (Accessed 2025-09-12)