Introduction How the long-chain fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) in the diet permitted human brain evolution, and how much our brains need today to function optimally are still hot topics for debate. DHA and EPA are considered as semi-essential because only insufficient amounts can be produced from other nutrients, such that they must be ingested with the diet. However, the Dietary Reference Intake of DHA and EPA, or of fish containing these fatty acids, has not yet been established. Eating fish is often recommended and generally considered beneficial for health and cognitive development in children and adolescents. For this study, data from a large cohort study were analysed to assess the association between fish consumption and cognitive school performance in children and adolescents. Methods Data from the German cohort of children and adolescent health KiGGS, which was conducted 2003-06 and included more than 17 000 children, were analysed. Ordered logistic regressions were performed to test for associations between fish intake and school performance. Potential confounders were included in the models. Results A statistically significant association was found between an intake of 8 g of fish per day and the probability of increasing the final grade in German [odds ratio (OR) 1.193, 95% confidence interval (CI) 1.049-1.358] and mathematics (OR 1.16, 95% CI 1.022-1.317) by one point, compared to no or very limited fish consumption. For the outcome German, higher levels of fish intake also showed a positive effect. These relationships were not linear but tended to decrease again at higher doses of fish. Discussion Our result confirms previous reports of a positive association between fish intake and school performance. Interestingly, this relationship was not linear but tended to decrease again in the highest categories of fish intake. We hypothesize that mercury or other pollutants in the fish could be detrimental at high levels. As only half of all children met the minimal fish intake recommendations, fish consumption should be promoted more strongly in children to meet the minimal requirements of long-chain polyunsaturated fatty acids. Lay Summary Polyunsaturated fatty acids like DHA and EPA that are present in fish are essential for a healthy human brain development. We found a U-shaped association between fish intake and school performance in children. We hypothesize that mercury or other pollutants in the fish could be detrimental at high intake levels.

中文翻译：

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鱼类消费与儿童在校表现呈非线性关系：德国队列研究 KiGGS 的结果。

简介 饮食中的长链脂肪酸二十二碳六烯酸 (DHA) 和二十碳五烯酸 (EPA) 如何促进人类大脑进化，以及我们今天的大脑需要多少才能达到最佳功能仍然是争论的热门话题。DHA 和 EPA 被认为是半必需的，因为其他营养素只能产生不足的量，因此它们必须与饮食一起摄入。然而，尚未确定 DHA 和 EPA 或含有这些脂肪酸的鱼的膳食参考摄入量。经常推荐吃鱼，并且普遍认为对儿童和青少年的健康和认知发展有益。在这项研究中，分析了一项大型队列研究的数据，以评估鱼类消费与儿童和青少年认知学校表现之间的关联。方法 对来自德国儿童和青少年健康 KiGGS 队列的数据进行分析，该队列于 2003-06 年进行，包括 17 000 多名儿童。进行有序逻辑回归以测试鱼类摄入量与学校表现之间的关联。模型中包含潜在的混杂因素。结果 发现每天摄入 8 克鱼与提高德语最终成绩的概率[优势比 (OR) 1.193, 95% 置信区间 (CI) 1.049-1.358] 和数学 (OR 1.16, 95% CI 1.022-1.317) 提高了一点，而没有或非常有限的鱼消费。对于德国人的结果，较高水平的鱼类摄入量也显示出积极影响。这些关系不是线性的，但在鱼的剂量较高时往往会再次下降。讨论 我们的结果证实了之前关于鱼类摄入量与学校表现之间正相关的报道。有趣的是，这种关系不是线性的，而是在鱼类摄入量最高的类别中再次下降。我们假设鱼类中的汞或其他污染物在高水平时可能是有害的。由于只有一半的儿童达到了最低鱼类摄入量建议，因此应更强烈地促进儿童食用鱼类以满足长链多不饱和脂肪酸的最低要求。总结 鱼类中存在的多不饱和脂肪酸，如 DHA 和 EPA，对于人类大脑的健康发育至关重要。我们发现儿童的鱼摄入量与学校表现之间存在 U 型关联。