DOI: https://doi.org/10.18370/2309-4117.2019.47.54-62

Value of long-chain polyunsaturated fatty acids for infants’ health and development

Д. О. Добрянський, Т. К. Знаменська, О. В. Воробйова, І. І. Воробйова

Abstract


The level of intake of essential polyunsaturated fatty acids (PUFAs) in pregnant, newborns and young children affects the quality of growth, state of the cardiovascular system, neurological and immune functions in childhood and later life. Child receives PUFAs through the placenta and with the mother's milk, and therefore the peculiarities of the mother's diet affect the supply of these fetal acids, as well as their content in breast milk. In the vast majority of countries with limited resources the use of docosahexaenoic and arachidonic acids in pregnant women, infants and young children may be significantly lower than recommended. Numerous randomized, controlled studies examined the effect of additional PUFAs consumption during pregnancy, lactation and postnatal period on physical, psychomotor, speech and mental development of children, their behavior, visual acuity, cardiovascular function and immune responses. Available data suggests that the additional consumption of long-chain PUFAs for children on breast or artificial feeding does not improve visual acuity, physical development or speech development. Additional n-3 PUFA may also affect some aspects of motor development, cardiovascular health, behavior and immunity with a more positive effect on breast-feeding children than children fed with milk nutrition. There is also evidence that an additional use of n-3 long-chain PUFA, in particular docosahexaenoic acid and eicosopentaenoic acid may reduce the incidence or severity of the most commonly occurring diseases specific to premature infants.

In 2013, the European Food Safety Authority considered adequate daily intake levels of double-stranded PUFAs for most infants and young children to be adequate: 100 mg of docosahexaenoic acid and 140 mg of arachidonic acid from birth to 6 months, 100 mg of docosahexaenoic acid from 6 to 24 months and 250 mg eykozopentaenovoy + docosahexaenoic acid later than 24 months of age.


Keywords


long-chain polyunsaturated fatty acids; docosahexaenoic acid; arachidonic acid; eicosapentaenoic acid; infants and toddlers

References


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Makrides, M., Neumann, M.A., Byard, R.W., et al. “Fatty acid composition of brain, retina, and erythrocytes in breast- and formula-fed infants.” Am J Clin Nutr 60 (1994): 189–94.

Birch, E.E., Castaneda, Y.S., Wheaton, D.H., et al. “Visual maturation of term infants fed long-chain polyunsaturated fatty acid supplemented or control formula for 12 mo.” Am J Clin Nutr 81 (2005): 871–9.

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Forsyth, S., Gautier, S., Salem, N. Jr. “Global estimates of dietary intake of docosahexaenoic acid and arachidonic acid in developing and developed countries.” Ann Nutr Metab 68 (2016): 258–67.

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Salem, N. Jr, Wegher, B., Uauy, R. “Arachidonic and docosahexaenoic acids are biosynthesized from their 18-carbon precursors in human infants.” Proc Natl Acad Sci USA 93 (1996): 49–54.

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Uauy, R., Mena, P., Wegher, B., et al. “Long chain polyunsaturated fatty acid formation in neonates: effect of gestational age and intrauterine growth.” Pediatr Res 47 (2000): 127–33.

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GOST Style Citations


1.         Koletzko, B., Boey, C.C., Campoy, C., et al. “Current information and Asian perspectives on long-chain polyunsaturated fatty acids in pregnancy, lactation, and infancy: systematic review and practice recommendations from an Early Nutrition Academy Workshop.” Ann Nutr Metab 65 (2014): 49–80.

2.         Abedi, E., Sahari, M.A. “Long-chain polyunsaturated fatty acid sources and evaluation of their nutritional and functional properties.” Food Sci Nutr 2 (2014): 443–63.

3.         Makrides, M., Neumann, M.A., Byard, R.W., et al. “Fatty acid composition of brain, retina, and erythrocytes in breast- and formula-fed infants.” Am J Clin Nutr 60 (1994): 189–94.

4.         Birch, E.E., Castaneda, Y.S., Wheaton, D.H., et al. “Visual maturation of term infants fed long-chain polyunsaturated fatty acid supplemented or control formula for 12 mo.” Am J Clin Nutr 81 (2005): 871–9.

5.         Calder, P.C. “Functional roles of fatty acids and their effects on human health.” J Parenter Enteral Nutr 39 (2015): 18S–32S.

6.         Forsyth, S., Gautier, S., Salem, N. Jr. “Global estimates of dietary intake of docosahexaenoic acid and arachidonic acid in developing and developed countries.” Ann Nutr Metab 68 (2016): 258–67.

7.         Добрянський, Д.О. Роль довголанцюгових поліненасичених жирних кислот у харчуванні немовлят / Д.О. Добрянський // Здоров’я дитини. – 2015. – № 4(64). –С. 21–30.

8.         Forsyth, S., Gautier, S., Salem, N. Jr. “Estimated dietary intakes of arachidonic acid and docosahexaenoic acid in infants and young children living in developing countries.” Ann Nutr Metab 69 (2016): 64–74.

9.         Salem, N. Jr, Wegher, B., Uauy, R. “Arachidonic and docosahexaenoic acids are biosynthesized from their 18-carbon precursors in human infants.” Proc Natl Acad Sci USA 93 (1996): 49–54.

10.       Carnielli, V.P., Simonato, M., Verlato, G., et al. “Synthesis of long-chain polyunsaturated fatty acids in preterm newborns fed formula with long-chain polyunsaturated fatty acids.” Am J Clin Nutr 86 (2007): 1323–30.

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12.       Huffman, S.L., Harika, R.K., Eilander, A., Osendarp, S.J.M. “Essential fats: how do they affect growth and development of infants and young children in developing countries? A literature review.” Maternal and Child Nutrition 7 Suppl 3 (2011): 44–65.

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14.       Baack, M.L., Puumala, S.E., Messier, S.E., et al. “Daily enteral DHA supplementation alleviates deficiency in premature infants.” Lipids 51.4 (2016): 423–33.

15.       Martin, C.R., Cheesman, A., Brown, J., et al. “Factors determining optimal fatty acid absorption in preterm infants.” J Pediatr Gastroenterol Nutr 62.1 (2016): 130-6.

16.       Mathias, R.A., Pani, V., Chilton, F.H. “Genetic variants in the FADS gene: implications for dietary recommendations for fatty acid intake.” Curr Nutr Rep 3 (2014): 139–48.

17.       Koletzko, B., Lattka, E., Zeilinger, S., et al. “Genetic variants of the fatty acid desaturase gene cluster predict amounts of red blood cell docosahexaenoic and other polyunsaturated fatty acids in pregnant women: findings from the Avon longitudinal study of parents and children.” Am J Clin Nutr 93 (2011): 211–9.

18.       Harslof, L.B., Larsen, L.H., Ritz, C., et al. “FADS genotype and diet are important determinants of DHA status: a cross-sectional study in Danish infants.” Am J Clin Nutr 97 (2013): 1403–10.

19.       Koletzko, B., Larque, E., Demmelmair, H. “Placental transfer of long-chain polyunsaturated fatty acids (LC-PUFA).” J Perinat Med 35 (2007): S5–11.

20.       Koletzko, B., Cetin, I., Brenna, J. “Dietary fat intakes for pregnant and lactating women.” Br J Nutr 98 (2007): 873–7.

21.       Brenna, J.T. “Efficiency of conversion of alpha-linolenic acid to long chain n-3 fatty acids in man.” Curr Opin Clin Nutr Metab Care 5 (2002): 127–32.

22.       Koletzko, B., Lien, E., Agostoni, C., et al. “The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations.” J Perinat Med 36 (2008): 5–14.

23.       Yuhas, R., Pramuk, K., Lien, E.L. “Human milk fatty acid composition from nine countries varies most in DHA.” Lipids 41 (2006): 851–8.

24.       Brenna, J.T., Varamini, B., Jensen, R.G., et al. “Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide.” Am J Clin Nutr 85 (2007): 1457–64.

25.       Fu, Y., Liu, X., Zhou, B., et al. “An updated review of worldwide levels of docosahexaenoic and arachidonic acid in human breast milk by region.” Public Health Nutr 19 (2016): 2675–87.

26.       Hurtado, J.A., Iznaola, C., Pena, M., et al. “Effects of maternal omega-3 supplementation on fatty acids and on visual and cognitive development: a randomized trial.” J Pediatr Gastroenterol Nutr 61.4 (2015): 472–80.

27.       Smit, E.N., Koopmann, M., Boersma, E.R., Muskiet, F.A. “Effect of supplementation of arachidonic acid (AA) or a combination of AA plus docosahexaenoic acid on breastmilk fatty acid composition.” Prostaglandins Leukot Essent Fatty Acids 62 (2000): 335–40.

28.       Del Prado, M., Villalpando, S., Elizondo, A., et al. “Contribution of dietary and newly formed arachidonic acid to human milk lipids in women eating a low-fat diet.” Am J Clin Nutr 74 (2001): 242–7.

29.       Gibson, R.A., Neumann, M.A., Makrides, M. “Effect of increasing breast milk docosahexaenoic acid on plasma and erythrocyte phospholipid fatty acids and neural indices of exclusively breast fed infants.” Eur J Clin Nutr 51 (1997): S78–84.

30.       Hibbeln, J.R. “Seafood consumption, the DHA content of mothers’ milk and prevalence rates of postpartum depression: a cross-national, ecological analysis.” J Affect Disord 69 (2002):15–29.

31.       Martinez, M. “Polyunsaturated fatty acids in the developing human brain, red cells and plasma: influence of nutrition and peroxisomal disease.” J World Rev Nutr Diet 75 (1994): 70–7.

32.       Stillwell, W., Wassall, S.R. “Docosahexaenoic acid: membrane properties of a unique fatty acid.” Chem and Phys of Lipids 126 (2003): 1–7.

33.       Uauy, R., Mena, P., Wegher, B., et al. “Long chain polyunsaturated fatty acid formation in neonates: effect of gestational age and intrauterine growth.” Pediatr Res 47 (2000): 127–33.

34.       Krauss-Etschmann, S., Shadid, R., Campoy, C., et al. “Fish oil and folate supplementation of pregnant women and maternal and fetal DHA and EPA plasma levels – a randomized European multicenter trial.” Am J Clin Nutr 85 (2007): 1392–400.

35.       Carnielli, V.P., Wattimena, D.J., Luijendijk, I.H., et al. “The very low birth weight premature infant is capable of synthesizing arachidonic and docosahexaenoic acids from linoleic and linolenic acids.” Pediatr Res 40 (1996): 169–74.

36.       Hoffman, D.R., Birch, E.E., Birch, D.G., et al. “Impact of early dietary intake and blood lipid composition of long-chain polyunsaturated fatty acids on later visual development.” J Pediatr Gastroenterol Nutr 31 (2000): 540–53.

37.       Agostoni, C., Galli, C., Riva, E., et al. “Reduced docosahexaenoic acid synthesis may contribute to growth restriction in infants born to mothers who smoke.” J Pediatr 147 (2005): 854–6.

38.       Quin, C., Erland, B.M., Loeppky, J.L., Gibson, D.L. “Omega-3 polyunsaturated fatty acid supplementation during the pre and post-natal period: A meta-analysis and systematic review of randomized and semi-randomized controlled trials.” JNIM 5 (2016): 34–54.

39.       Bernard, J.Y., Armand, M., Peyre, H., et al. “Breastfeeding, polyunsaturated fatty acid levels in colostrum and child intelligence quotient at age 5-6 years.” J Pediatr 183 (2017): 43–50.

40.       Forsyth, J.S., Willatts, P., Agostoni, C., et al. “Long chain polyunsaturated fatty acid supplementation in infant formula and blood pressure in later childhood: follow up of a randomized controlled trial.” Br Med J 326 (2003): 953–8.

41.       Molloy, C., Doyle, L.W., Makrides, M., Anderson, P.J. “Docosahexaenoic acid and visual functioning in preterm infants: a review.” Neuropsychol Rev 22 (2012): 425–37.

42.       Moon, K., Rao, S.C., Schulzke, S.M., et al.

“Longchain polyunsaturated fatty acid supplementation in preterm infants.” Cochrane Database Sys Rev 12 (2016): CD000375.

43.       Lapillonne, A., Eleni Dit Trolli, S., Kermorvant-Duchemin, E. “Postnatal docosahexaenoic acid deficiency is an inevitable consequence of current recommendations and practice in preterm infants.” Neonatology 98 (2010): 397–403.

44.       Fewtrell, M.S., Abbott, R.A., Kennedy, K., et al. “Randomized, double-blind trial of long-chain polyunsaturated fatty acid supplementation with fish oil and borage oil in preterm infants.” J Pediatr 144 (2004): 471–9.

45.       Henriksen, C., Haugholt, K., Lindgren, M., et al. “Improved cognitive development among preterm infants attributable to early supplementation of human milk with docosahexaenoic acid and arachidonic acid.” Pediatrics 121 (2008) :1137–45.

46.       Makrides, M., Gibson, R.A., McPhee, A.J., et al. “Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: a randomized controlled trial.” JAMA 301 (2009): 175–82.

47.       Wang, Q., Cui, Q., Yan, C. “The effect of supplementation of long-chain polyunsaturated fatty acids during lactation on neurodevelopmental outcomes of preterm infant from infancy to school age: a systematic review and meta-analysis.” Pediatr Neurol 59 (2016): 54–61.

48.       Dammann, O., Leviton, A. “Inflammation, brain damage and visual dysfunction in preterm infants.” Semin Fetal Neonatal Med 11 (2006): 363–8.

49.       Strunk, T., Inder, T., Wang, X., et al. “Infection-induced inflammation and cerebral injury in preterm infants.” Lancet Infect Dis 14 (2014): 751–62.

50.       Marchant, E.A., Kan, B., Sharma, A.A., et al. “Attenuated innate immune defenses in very premature neonates during the neonatal period.” Pediatr Res 78 (2015): 492–7.

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