Polyunsaturated fatty acids and infant visual development: A critical appraisal of randomized clinical trials

At the Consensus and Controversies Conference held in Barcelona in November 1996, one of the sessions focused on an evaluation of the effects of dieta ry polyunsaturated fatty acids (PUFA) on infant visual development. The int ervention trials in preterm and term infants were reviewed and discussed in detail. Results of these trials, particularly those in term infants, were inconsistent; much discussion occurred concerning the causes of these diver se results. We attempt to reflect, rather than report exactly, the discussi on relating to these issues and address the clinical trials according to re cently published guidelines for conduct and reporting of randomized clinica l trials (RCT). Compared with these recent guidelines, the published papers of RCT involving PUFA and visual function are often incomplete, making it difficult to assess if we can have a high degree of confidence in the repor ted effects (or lack of effects). Despite this, valuable data relating to t he effect of diet on the visual development of infants were obtained. Our e valuation of the trials to date suggests that the definitive answer to the degree to which dietary long-chain PUFA is likely to influence visual devel opment may only be resolved with impeccably conducted RCT.