Linoleic and docosahexaenoic acids in human milk have opposite relationships with cognitive test performance in a sample of 28 countries

Polyunsaturated fatty acids play critical roles in brain development and function, and their levels in human breast milk closely reflect the long-term diet. The fatty acid contents of human milk samples from 28 countries were used to predict averaged 2009 and 2012 test scores in mathematics, reading, and science from the Program for International Student Assessment. All test scores were positively related to milk docosahexaenoic acid (r=0.48 to 0.55), and negatively related to linoleic acid (r=−0.28 to −0.56). Together, these two human milk fatty acids explained 46% to 48% of the variance in scores, with no improvement in predictive power when socioeconomic variables were added to the regression. The (log) ratio of linoleic to arachidonic acid was negatively related to scores (r=−0.45 to −0.48). Statistical effects were similar for the two sexes. In a separate US sample, estimated dietary linoleic was negatively related to the levels of all long-chain n-3 and n-6 plasma fatty acids. High levels of dietary linoleic may impair cognition by decreasing both docosahexaenoic and arachidonic acids in the brain.