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 dietary polyunsaturated fatty acids (PUFA) on infant visual development. The intervention 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 diverse results. We attempt to reflect, rather than report exactly, the discussion relating to these issues and address the clinical trials according to recently published guidelines for conduct and reporting of randomized clinical 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 reported effects (or lack of effects). Despite this, valuable data relating to the effect of diet on the visual development of infants were obtained. Our evaluation of the trials to date suggests that the definitive answer to the degree to which dietary long-chain PUFA is likely to influence visual development may only be resolved with impeccably conducted RCT.