Highest Honor from the International Society for the Study of Fatty Acids and Lipids (ISSFAL) to be presented at 2012 Biennial Congress in Vancouver, May 28

Clinical Effects of Fats: Scaly Tales from Down Under

Clinical studies and observations were important in the early studies of essential fatty acids and they have remained an inspiration of Dr Robert Gibson and his team.  Dr Gibson’s first appointment in the Department of Paediatrics at the Flinders Medical Centre in Adelaide set the focus of much of his research career.  While his early work was concentrated on the basic biochemistry of fatty acids in animal models, this clinical setting fostered a shift to peri-natal nutrition. After writing a seminal paper on the fatty acid composition of human breast milk Dr Gibson directed research in to the role of milks (breast and formula) on the fatty acid status and health of term infants. Together with his collaborators, Bob Gibson was the first to demonstrate that term infants receiving breast milk (naturally containing omega-3 fatty acids) had improved neural maturity and greater erythrocyte DHA relative to those fed formula (which at the time did not contain DHA and EPA).  A subsequent randomised trial published in the Lancet was also the first to reveal in term infants that the disparity between breast and formula feeding could be corrected by the addition of fish oil, containing DHA, to infant formula. These findings, together with the report showing that breastfed infants had higher brain DHA concentrations than those fed formula that was published in AJCN provided compelling evidence for a role for dietary DHA in ensuring optimal infant development.  These three seminal studies sparked in excess of 30 new randomised controlled trials world-wide, four of which were conducted by Dr Gibson and his group. Importantly, these findings have been pivotal in directing infant formula regulations, and as a result of this research n-3 LCPUFA are included in all commercial infant formulas.

Dr Gibson’s research teammoved into the large scale clinical trial arena when they received Australian federal government funding for the DINO trial that is still the largest randomised controlled trial (n=650 infants) investigating the role of DHA in preterm infants. The DINO trial demonstrated that a consistent benefit on the neurodevelopment of preterm infants was dependant on a level of DHA 3 times higher than current practice.  The trial also demonstrated the beneficial effect of adequate DHA (1% of total dietary fats) on respiratory outcomes such as chronic lung disease. Most importantly the trial demonstrated the safety of adequate DHA as indicated by normal growth patterns in the treated infants. The primary paper was published in JAMA in 2009 and the study has led to 10 additional publications, most in high impact journals. The DINO cohort is being followed up at 7 years to determine whether the effects of DHA on neurodevelopment are sustained.

The Gibson team went on to conduct the DOMInO trial as the largest randomised controlled trial to date (n=2399) to investigate the impact of maternal DHA supplementation during pregnancy on the incidence of maternal depression and neurodevelopmental outcomes in the children.  While there was no benefit on post-natal depression there was a significant reduction in the number of infants with mild cognitive delay at 18 months despite no change in the mean cognitive scores.  An important secondary outcome from the DOMInO trial was that the incidence of early preterm birth was halved by DHA treatment in pregnancy. The primary paper was published in JAMA in 2010 and has set new international benchmarks for clinical trials of nutritional interventions in pregnancy. DOMInO has generated a number of follow-up studies, which will determine the impact of maternal DHA supplementation on various other important clinical outcomes, including allergy and asthma, body fat mass and insulin sensitivity in children. These studies have the potential to identify an intervention which could feasibly be applied to improve children’s health on a population level.

Dr Gibson’s research is demonstrating that omega-3 LCPUFA are proving to have clinical benefits commensurate with that of some pharmaceuticals, and offers new hope for many clinical conditions.

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For more information about the 2012 ISSFAL Biennial Congress, please visit the Congress site

For more information about this award and the recipient, please contact ISSFAL Headquarters.