The Relationship Between DHA+Choline Supplementation and the Frequency of Infection-Related Admissions and Antibiotic Use in Children Aged 7–15 Years: A Retrospective Multicenter Cohort Study

Abstract

Aim: This study aimed to evaluate the effect of three-month DHA+choline supplementation on infection-related outpatient visits and antibiotic use in children aged 7–15 years. Materials and Methods: This retrospective, observational, two-group cohort study was conducted at 13 independent pediatric centers between January 1 and March 31, 2026. Group 1 (n=75) received daily DHA 308 mg + Choline 41 mg (total omega-3: 444 mg); Group 2 (n=75) was the untreated control group. Assessments were performed at T0, T1, T2, and T3 using a 50-item, 10-subscale Likert questionnaire (0–200 points). Mann-Whitney U, Wilcoxon, and Chi-square tests were applied (p<0.05). Results: Both groups had a mean age of 11.0 ± 2.6 years with homogeneous distribution for age (p=0.922) and sex (p=1.000). Baseline total scores were identical (83.0 ± 0.0). By month 3, Group 1 reached 186.8 ± 3.7 (Δ=103.8 ± 3.7; p<0.001) while Group 2 remained unchanged. Significant improvements were observed in immunity/infection (Δ=10.91), attention (Δ=10.85), antibiotic use (Δ=10.84), learning/academic performance (Δ=10.37), mental focus (Δ=10.29), and sleep quality (Δ=9.77) subscales (all p<0.001). Only two children (2.7%) in Group 1 reported mild nausea; no serious adverse events occurred. Conclusion: Three-month DHA+choline supplementation was associated with significant improvements in infection-related visits, antibiotic use, and multidimensional clinical parameters in children aged 7–15 years.

Keywords

• fish oils
• choline
• child
• infection
• anti-bacterial aents

Supporting Institution

This study received no financial support from any public, commercial, or not-for-profit funding agency.

Ethical Statement

Ethics committee approval was obtained from the Scientific Research Ethics Committee of Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital (Decision No: 157; Decision Date: April 13, 2026). The study was conducted in accordance with the principles of the Declaration of Helsinki. Due to the retrospective observational design of the study, informed consent was waived by the ethics committee.

Thanks

The authors would like to thank all participating pediatric centers and healthcare professionals who contributed to the data collection process.

7-15 Yaş Çocuklarda DHA+ Kolin Takviyesi Kullanımının Enfeksiyon Nedeniyle Başvuru Sıklığı ve Antibiyotik Kullanımı ile İlişkisi: : Retrospektif Multisentrik Bir Kohort Çalışması

Abstract

Amaç: 7-15 yaş grubundaki çocuklarda üç aylık DHA+kolin takviyesi kullanımının enfeksiyon nedeniyle poliklinik başvuru sıklığı ve antibiyotik kullanım gereksinimi üzerindeki etkisini değerlendirmek amaçlandı. Gereç ve Yöntem: Çalışma, 01 Ocak–31 Mart 2026 tarihleri arasında birbirinden ayrı 13 pediatri merkezinde yürütülen retrospektif, gözlemsel, iki gruplu karşılaştırmalı bir kohort çalışmasıdır. Grup 1 (n=75), günlük DHA 308 mg + Kolin 41 mg (toplam omega-3: 444 mg) kullanan; Grup 2 (n=75) ise takviye almayan kontrol grubundan oluşturuldu. Değerlendirmeler başlangıç (T0), 1. ay (T1), 2. ay (T2) ve 3. ayda (T3) yapıldı. Ebeveyn bildirimine dayalı 50 maddelik, 10 alt ölçekli Likert tipi anket (0–200 puan) kullanıldı. İstatistiksel analizde Mann-Whitney U, Wilcoxon ve Ki-kare testleri uygulandı (p<0,05). Bulgular: Her iki grupta ortalama yaş 11,0 ± 2,6 yıl olup yaş (p=0,922) ve cinsiyet (p=1,000) açısından homojen dağılım gösterdi. Başlangıçta toplam puan her iki grupta özdeşti (83,0 ± 0,0). Üçüncü ayda Grup 1'de toplam puan 186,8 ± 3,7'ye ulaşırken (Δ=103,8 ± 3,7; p<0,001) Grup 2 tüm zaman noktalarında sabit kaldı (Δ=0,0 ± 0,0). Bağışıklık/enfeksiyon (Δ=10,91), dikkat (Δ=10,85), antibiyotik kullanımı (Δ=10,84), öğrenme/akademik performans (Δ=10,37), zihinsel odaklanma (Δ=10,29) ve uyku düzeni (Δ=9,77) alt ölçeklerinde istatistiksel olarak anlamlı iyileşmeler saptandı (tümü p<0,001). Grup 1'de yalnızca iki çocukta (%2,7) hafif mide bulantısı bildirildi; ciddi yan etki veya bırakma görülmedi. Sonuç: Üç aylık DHA+kolin takviyesi, 7-15 yaş çocuklarda enfeksiyon başvurusu, antibiyotik kullanımı ve çok boyutlu klinik parametreler üzerinde anlamlı iyileşmelerle ilişkili bulundu.

Keywords

• balık yağı
• kolin
• çocuk
• enfeksiyon
• antibiyotik

Supporting Institution

Bu çalışma herhangi bir kamu kurumu, ticari kuruluş veya kâr amacı gütmeyen organizasyon tarafından finansal olarak desteklenmemiştir.

Ethical Statement

Bu çalışma için İstanbul Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi Bilimsel Araştırmalar Etik Kurulu’ndan onay alınmıştır (Karar No: 157; Karar Tarihi: 13 Nisan 2026). Çalışma Helsinki Deklarasyonu ilkelerine uygun olarak yürütülmüştür. Çalışmanın retrospektif gözlemsel tasarımı nedeniyle etik kurul tarafından aydınlatılmış onam gerekliliği kaldırılmıştır.

Thanks

Yazarlar, veri toplama sürecine katkı sağlayan tüm pediatri merkezlerine ve sağlık çalışanlarına teşekkür eder.

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