Growth-Promoting Effects of Omega-3-Fatty Acid Supplementation in Children with Short Stature

Research Article

Ann Nutr Disord & Ther. 2020; 7(1): 1064.

Growth-Promoting Effects of Omega-3-Fatty Acid Supplementation in Children with Short Stature

Buchhorn R*

Department of Paediatrics, Caritas Krankenhaus, Germany

*Corresponding author: Reiner Buchhorn, Department of Paediatrics, Caritas Krankenhaus, Klinik für Kinder- und Jugendmedizin, Uhlandstr 7, 97980, Bad Mergentheim, Germany

Received: June 03, 2020; Accepted: June 24, 2020; Published: July 01, 2020


We proof the effect of an omega-3-fatty acid supplementation (245 days on average) on height and 24-hours Heart Rate Variability (HRV) in 34 children with short stature of whom 17 children received an ongoing growth hormone treatment.

Results: During Omega-3-fatty acid supplementation±growth hormone treatment the height percentile increased from the 6.2±9.7% to 7.0±9.4% (p=0.306) but the height standard deviation score significantly increase from -2.2±1.1 to -2.0±1.0 (p=0.009). Growth velocities are not significantly different after omega-3-fatty supplementation between growth hormone treated and untreated children (8.2±4.8 cm/year versus 8.1±3.4 cm/year; p=0.103). Mean 24-hours heart rate decreased from 103.9±16.1 bpm to 96.6±13.2 bpm (p<0.0001). Mean HRV significantly increased as indicated by a significant higher SDNN (111.9±30.8 ms versus 97.6±30.2 ms, p=0,001), RMSSD (29.4±12.2 ms versus 25.2±11.5 ms, p=0,003) and very low frequency power (1524±957 ms2 versus 1122±708 ms2, p=0,001).

Conclusion: Omega-3-fatty acid supplementation in children with short stature improves height and heart rate variability independently from an ongoing growth hormone treatment.


Per definition 3% of a population “suffers” from short stature. There are many discussions about the psychosocial burden of short stature and the need for further diagnostics and consecutive therapies with in part high economic burden. However, there are some diseases that have to be treated like coeliac disease and an often unrecognized impact of short stature on cardiovascular prognosis that is far away to be well defined. However, the Development Origin of Health and Disease (DOHaD) hypothesis occupied a lot researcher worldwide who try to explain the statistical relationship of fetal growth, short stature and cardiovascular risk. In this context there is a link to omega-3-fatty supplementation recently reviewed by MR Skilton [1]. There is a further link to a phenomenon called stunting in nearly 180 million children due to under nutrition most of all in the developing world who suffer from short stature and cognitive impairment [2].

Within the last 10 years we develop a pathophysiological model that try to explain short stature induced by early life stress due to heart failure, intrauterine growth retardation and genetic syndromes [3]. We use 24 hours analysis of Heart Rate Variability (HRV) to detect early stress and monitor the effect of therapeutic interventions on HRV in children:

1) We found a pathologic HRV response to clonidine in children with short stature [4],

2) We found reduced HRV in children with short stature except those with constitutional growth delay [3],

3) We found normal HRV in children with short stature after cessation of growth hormone therapy [5],

4) We found an improvement of HRV in children with short stature after 3 month omega-3-fatty acid supplementation [6].

We now proof the effect of omega-3-fatty acid supplementation on height in 34children with short stature.



The current study included 34 children with short stature with an age of 6.6±4.4 years on average who were referred to the outpatient clinic in the Pediatrics Department of the Caritas Hospital in Bad Mergentheim, Germany between the years 2013 and 2019 for further diagnostics and therapy of short stature. All patients and their parents were informed about recombinant growth hormone treatment according to the current guidelines. Cardiovascular risk stratification using 24-hour HRV analysis, measured by 24-hour Holter ECG is part of our clinical routine in children with short stature. In those children with significantly reduced 24-hour HRV we also offered the opportunity to supplement omega-3 fatty acids and participate in the study. If the supplementation was not covered by health insurance, patients usually purchased different products based upon 1-2 g fish oil per day from a retail store. The following dose recommendations were given: Children up to an age of 8 years should receive at least 400mg Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) as a suspension per day. Children who were able to swallow capsules should receive at least 800mg EPA and DHA per day. The following patients agreed to participate in the study (Figure 1):