Essential fatty acids in growth and development

Genetic variants in the metabolism of omega-6 and omega-3 fatty acids: their role in the determination of nutritional requirements and chronic disease risk

The tissue composition of polyunsaturated fatty acids is important to health and depends on both dietary intake and metabolism controlled by genetic polymorphisms that should be taken into consideration in the determination of nutritional requirements. Therefore at the same dietary intake of linoleic acid (LA) and alpha-linolenic acid (ALA), their respective health effects may differ due to genetic differences in metabolism. Delta-5 and delta-6 desaturases, FADS1 and FADS2, respectively, influence the serum, plasma and membrane phospholipid levels of LA, ALA and long-chain polyunsaturated fatty acids during pregnancy, lactation, and may influence an infant's IQ, atopy and coronary heart disease (CHD) risk. At low intakes of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), polymorphisms at the 5-lipoxygenase (5-LO) level increase the risk for CHD whereas polymorphisms at cyclooxgenase-2 increase the risk for prostate cancer. At high intakes of LA the risk for breast cancer increases. EPA and DHA influence gene expression. In future, intervention studies on the biological effects of LA, ALA and LC-PUFAs, and the effects of genetic variants in FADS1 and FADS2, 5-LO and cyclooxygenase-2 should be taken into consideration both in the determination of nutritional requirements and chronic disease risk. Furthermore, genome-wide association studies need to include environmental exposures and include diet in the interaction between genetic variation and disease association.

Retailoring docosahexaenoic acid-containing phospholipid species during impaired neurogenesis following omega-3 alpha-linolenic acid deprivation

Diminished levels of docosahexaenoic acid (22:6n-3), the major fatty acid (FA) synthesized from alpha-linolenic acid (18:3n-3), have been implicated in functional impairment in the developing and adult brain. We have now examined the changes in phospholipid (PL) molecular species in the developing postnatal cortex, a region recently shown to be affected by a robust aberration in neuronal cell migration, after maternal diet alpha-linolenic acid deprivation (Yavin et al. (2009)Neuroscience162(4),1011). The frontal cortex PL composition of 1- to 4-week-old rats was analyzed by gas chromatography and electrospray ionization/tandem mass spectrometry. Changes in the cortical PL molecular species profile by dietary means appear very specific as 22:6n-3 was exclusively substituted by docosapentaenoic acid (22:5n-6). However, molecular species were conserved with respect to the combination of specific polar head groups (i.e. ethanolamine and serine) in sn-3 and defined saturated/mono-unsaturated FA in sn-1 position even when the sn-2 FA moiety underwent diet-induced changes. Our results suggest that substitution of docosahexaenoic acid by docosapentaenoic acid is tightly regulated presumably to maintain a proper biophysical characteristic of membrane PL molecular species. The importance of this conservation may underscore the possible biochemical consequences of this substitution in regulating certain functions in the developing brain.

Long-chain polyunsaturated fatty acid status in phenylketonuric patients treated with tetrahydrobiopterin

OBJECTIVES

To evaluate LCPUFA composition in PKU patients treated with BH(4).

DESIGN AND METHODS

Cross-sectional study of plasma and erythrocyte LCPUFA composition of 13 PKU patients treated with BH(4) compared with data from 48 PKU patients on protein-restricted diet, and 17 mild HPA patients on free diet. PUFA were analysed by gas chromatography.

RESULTS

Plasma and erythrocyte docosahexaenoic acid (DHA), and LCPUFA deficiency markers did not show significant differences in PKU patients on BH(4) compared with those with mild HPA and our reference values, but they did in comparison with PKU on protein-restricted diet (p<0.0001). Essential fatty acids and arachidonic acid composition were not significantly different in any of the studied groups. DHA values correlate with the index of dietary control only in PKU patients on protein-restricted diet (p=0.002).

CONCLUSION

LCPUFA status is within the reference values in PKU patients treated with BH(4). This translates to a further advantage of BH(4) therapy.

Long chain polyunsaturated fatty acids in mothers and term babies

AIM

To establish the levels of docosahexaenoic acid (DHA) and arachidonic acid (AA) in both plasma and erythrocytes of maternal and cord blood as well as in breast milk of mothers delivering babies at term.

METHODS

A total of 148 mothers delivering babies at term were recruited from Bharati Medical Hospital, Pune, India.

RESULTS

Levels of DHA and AA in both plasma and erythrocyte were higher in cord blood compared to levels in maternal blood (P<0.001). Maternal plasma and erythrocyte DHA levels had a positive association with the respective levels in cord blood (P<0.001). However, such an association was not seen for AA levels. Maternal plasma omega 3 and omega 6 fatty acids were positively associated with the respective milk fatty acids (P<0.01).

CONCLUSIONS

Our results indicate that milk long-chain polyunsaturated fatty acids (LCPUFA) status reflects the concentrations of maternal LCPUFA in women delivering babies at term. Improving the maternal LCPUFA status throughout pregnancy and lactation may improve the milk LCPUFA status and ultimately benefit the infant.

Gender-specific fatty acid profiles in platelet phosphatidyl-choline and -ethanolamine

Previous studies suggested that women synthesise docosahexaenoic acid (DHA) more efficiently from their precursors than men. This study investigated the relationship between diet, platelet phospholipids fatty acids and gender. Dietary intake and platelet phosphatidyl-choline (PC) and phosphatidylethanolamine (PE) fatty acids were determined in Caucasian 40 men and 34 women. Absolute and %energy intakes of arachidonic acid (AA), eicosapentaenoic acid (EPA), and DHA, and the ratios of total n-6/n-3 PUFA and linoleic/alpha-linolenic acids did not differ between the sexes. However, women had higher DHA in PC (1.19 vs 1.05 wt%, p<0.05) and PE (3.62 vs 3.21 wt%, p<0.05) than men. Also EPA (1.10 vs 0.93 wt%, p<0.05) was higher in women's PE. Conversely, men had elevated AA and total n-6 fatty acids in PC. The higher platelet DHA levels and lower platelet AA/EPA and AA/DHA ratios in women of child-bearing age compared with men, may lead to less platelet aggregation and vaso-occlusion.

Linoleic acid is associated with lower long-chain n-6 and n-3 fatty acids in red blood cell lipids of Canadian pregnant women

BACKGROUND

Arachidonic (ARA), eicosapentaenoic (EPA), and docosahexaenoic (DHA) acids are important in membrane glycerophospholipids. Higher maternal blood ARA, EPA, and DHA concentrations in gestation are associated with higher maternal-to-fetal transfer of ARA, EPA, and DHA, respectively, which emphasizes the importance of maternal fatty acid status in gestation. As in the brain, red blood cell (RBC) ethanolamine phosphoglycerides (EPGs) are high in plasmalogen, ARA, and DHA.

OBJECTIVE

We determined the relation between dietary n-6 (omega-6) and n-3 (omega-3) fatty acid intakes and n-6 and n-3 fatty acids in RBC EPGs and phosphatidylcholine in near-term pregnant women.

DESIGN

The subjects were 105 healthy Canadian pregnant (36 wk gestation) women. Fatty acid intakes were estimated by food-frequency questionnaire, and fasting venous blood samples were collected.

RESULTS

DHA and EPA intakes were positively associated with RBC EPG and phosphatidylcholine concentrations of DHA (rho = 0.309 and 0.369, respectively; P < 0.001) and EPA (rho = 0.391 and 0.228, respectively; P < 0.001) and inversely associated with RBC EPG 22:4n-6 and 22:5n-6 (P < 0.001). In RBCs, concentrations of linoleic acid (LA, 18:2n-6) were inversely associated with DHA, EPA, and ARA, respectively, in EPGs (r = -0.432, P < 0.01; r = -0.201, P < 0.04; and r = -0.303, P < 0.01) and phosphatidylcholine (r = -0.460, -0.490, and -0.604; P < 0.01 for all).

CONCLUSIONS

Membrane fatty acids are influenced by the amount and balance of fatty acid substrates. Our results suggest the competitive interaction of LA with ARA, EPA, and DHA, with no evidence that higher LA increases ARA. Biochemical indicators to suggest that DHA is limiting are present in our population. This trial was registered at clinicaltrials.gov as NCT00620672.

Dietary arachidonic acid to EPA and DHA balance is increased among Canadian pregnant women with low fish intake

Arachidonic [ARA, 20:4(n-6)], eicosapentaenoic [EPA, 20:5(n-3)], and docosahexaenoic acids [DHA, 22:6(n-3)] occur in the diet in animal tissue lipids, play important roles in human development and health, but have interactive and opposing functions. Meat and poultry have higher ARA and fish are richer in EPA and DHA. National databases were recently revised to include complete data on ARA in foods. We used a validated FFQ and the revised nutrient databases to quantify the distribution of ARA, EPA, and DHA intakes and balance for 204 healthy Canadian pregnant women. We focused on intake distributions because risk of adverse health effects increases at lower nutrient intakes. RBC fatty acids were analyzed concurrenly with dietary assessment. The distribution of ARA, EPA, and DHA intakes were skewed (P < 0.001), with a median (5-95th percentile) of 107 (41-225), 65 (10-228), and 105 (10-430) mg/d ARA, EPA, and DHA, respectively. Fish provided 66 and 76% of EPA and DHA, respectively, whereas eggs, poultry, and meats provided 81% of ARA. Women consuming <101 g fish/wk consumed less EPA and DHA and had markedly elevated median dietary ARA:EPA and ARA:DHA ratios and RBC lipid ARA:EPA + DHA ratios compared with women consuming >or=101 g fish/wk (P < 0.001). Relatively small increases in fish intake of 1-2 servings (25-50 g)/wk corrected the distorted dietary (n-6):(n-3) fatty acid balance among women consuming meats, but not fish. Median fish and DHA intakes below the recommended 1-2 servings/wk fish for pregnant women suggest major changes in the availability, cost, or acceptance of fish are needed.

Whole-body synthesis secretion of docosahexaenoic acid from circulating eicosapentaenoic acid in unanesthetized rats

Dietary docosahexaenoic acid (DHA; 22:6n-3) and eicosapentaenoic acid (EPA; 20:5n-3) are considered important for maintaining normal heart and brain function, but little EPA is found in brain, and EPA cannot be elongated to DHA in rat heart due to the absence of elongase-2. Ingested EPA may have to be converted in the liver to DHA for it to be fully effective in brain and heart, but the rate of conversion is not agreed on. This rate was determined in male adult rats fed a standard n-3 PUFA, containing diet by infusing unesterified albumin-bound [U-(13)C]EPA intravenously for 2 h and measuring esterified [(13)C]labeled PUFAs in arterial plasma lipoproteins, as well as the specific activity of unesterified plasma EPA. Whole-body (presumably hepatic) synthesis secretion rates from circulating unesterified EPA, calculated from peak first derivatives of plasma esterified concentration x volume curves, equaled 2.61 micromol/day for docosapentaenoic acid (22:5n-3) and 5.46 micromol/day for DHA. The DHA synthesis rate was 24-fold greater than the reported brain DHA consumption rate in rats. Thus, dietary EPA could help to maintain brain and heart DHA homeostasis because it is converted at a relatively high rate in the liver to circulating DHA.

Enhanced circulating retinol and non-esterified fatty acids in pregnancies complicated with intrauterine growth restriction

IUGR (intrauterine growth restriction) increases the incidence of perinatal complications and, although several placental transport functions have been shown to be altered in pregnancies complicated by IUGR, the mechanism behind it is not well understood. The aim of the present study was to investigate factors in maternal and cord blood plasma from normal and IUGR-complicated pregnancies associated with the body weight of newborns. At the time of Caesarean section, 24 women with IUGR pregnancies were compared with a group of 30 normal controls with AGA (appropriate gestational age) fetuses who were studied at Caesarean section, which took place 5 weeks later than IUGR pregnancies, and also to a group of 25 non-delivered gestational age-matched control pregnant women (AGA-35wk). Maternal plasma retinol, gamma- and alpha-tocopherol, NEFAs (non-esterified fatty acids), and palmitic, palmitoleic, gamma-linolenic and arachidonic acids were higher in women with IUGR pregnancies than in AGA-35wk controls, whereas stearic and alpha-linolenic acids were lower. Smaller differences were found when comparing these variables for IUGR and AGA women. However, umbilical vein plasma gamma-tocopherol, cholesterol, triacylglycerols and NEFAs were higher in the IUGR group than in the AGA group, whereas arachidonic acid was lower. Maternal plasma retinol and NEFAs were the only variables negatively correlated with birthweight when multiple linear regressions were analysed. In conclusion, the increased levels of circulating retinol and NEFAs in maternal plasma are negatively associated with birth and placental weights, which may reflect an impaired placental transfer in IUGR pregnancies. As retinoids are involved in the control of gene transcription, it is proposed that a decrease in placental transfer of retinol could underlie the metabolic dysfunction of IUGR pregnancies.

Fatty acid composition of diet, cord blood and breast milk in Chinese mothers with different dietary habits

The influence of two different dietary patterns on maternal fatty acid (FA) intake on the composition of umbilical cord blood plasma phospholipids and transitional breast milk was investigated. A 7-day dietary record was completed in the last trimester of pregnancy by women living in an inland and a coastal area of south-eastern China. The FA composition in maternal diet was calculated using the 2002 Chinese food composition database. Cord blood and transitional breast milk samples were collected and their FA composition was analyzed by capillary gas-liquid chromatography. Mothers in the coastal area showed higher intake of long-chain polyunsaturated FA (LCPUFA) including docosahexaenoic acid (DHA, 22:6omega) and eicosapentaenoic acid (EPA,20:5omega3) but lower linoleic acid (LA, 18:2omega6) and alpha-linolenic acid (ALA, 18:3omega3) than the mothers in the inland area. The intake of arachidonic acid (AA, 20:4omega6) did not differ between the two areas. LA, ALA, AA and DHA in breast milk of day 5 reflected the maternal diet except that the EPA content in breast milk at day 5 was similar for the areas. LA, ALA and AA were lower and EPA higher in umbilical cord plasma phospholipids in infants from the costal compared to the inland area. There were significant differences in maternal intakes of FA confirming different dietary habits, which influenced the FA composition of cord plasma phospholipids and transitional breast milk. Since FA influence gene expression the found variation implies that the long-term follow-up of this cohort will be interesting.

A linhaça (Linum usitatissimum) como fonte de ácido α-linolênico na formação da bainha de mielina

A linhaça (Linum usitatissimum) é uma semente oleaginosa que tem sido estudada por seus efeitos benéficos à saúde. É considerada um alimento funcional, pelo fato de ser uma fonte natural de fitoquímicos, e por conter o ácido graxo α-linolênico (C18:3 n-3), que pode ser metabolicamente convertido nos ácidos docosaexahenóico (C22:6 n-3) e eicosapentaenóico (C20:5 n-3), sendo o primeiro essencial para o desenvolvimento do sistema nervoso central. Durante o crescimento do cérebro, há uma grande incorporação do ácido docosaexahenóico, que tem papel importante na formação de suas membranas celulares. Diante disto, esta comunicação visa a abordar os prováveis mecanismos pelos quais o ácido docosaexahenóico, proveniente do ácido α-linolênico presente abundantemente na semente de linhaça, interfere na formação da bainha de mielina, assim como relatar a técnica mais adequada para visualização desta bainha.

Synthesis and characterization of a structured lipid from amaranth oil as a partial fat substitute in milk-based infant formula

The aim of this study was to use enzymatic interesterification techniques to modify underutilized amaranth oil as a structured lipid (SL) by increasing its palmitic acid content at the sn-2 position and incorporating docosahexaenoic acid (DHA). This SL can be partially or complementarily used in milk-based infant formulas to deliver a lipid component similar to that in breast milk. Amaranth oil was modified by enzymatic interesterification in two stages. First, the palmitic acid content was increased specifically at the sn-2 position to resemble breast milk triacylglycerols (TAGs) using Novozym 435 lipase. Then DHA was incorporated, mainly at the sn-1,3 positions using Lipozyme RM IM, a sn-1,3 specific lipase. An optimization model was developed to determine the exact parameter combinations to incorporate a specific amount of DHA (1.0-2.5%). The model suggestions were used for a gram-scale interesterification to yield the expected product. The final SL composition was as follows: palmitic acid, 33.9%; stearic acid, 2.8%; oleic acid, 23.3%; linoleic acid, 37.3%; linolenic acid, 0.7%; and docosahexaenoic acid, 1.9%. The original amaranth oil and the final SL were characterized by determining the fatty acid composition, melting profile, chemical characteristics, oxidative stability (peroxide, p-anisidine, and total oxidation values), and phytosterol, tocopherol, and squalene contents. The physical and chemical characteristics determined in this study support the potential application of DHA-containing customized amaranth oil (DCAO) as a partial fat substitute or complement for milk-based infant formula. Research on the application and stability of this SL used in an infant formula is being conducted.

Associations between term birth dimensions and prenatal exposure to essential and trans fatty acids

BACKGROUND

Certain essential long-chain polyunsaturated fatty acids (LCPUFAs) are considered important for fetal growth and brain development, whereas industrial trans fatty acids (mainly 18:1trans) have been associated with negative effects. The aim of this study was to investigate associations between term birth dimensions and prenatal exposure to some of these fatty acids, reflected by neonatal fatty acid concentrations at birth.

METHODS

Data of up to 700 infant-mother pairs from the Maastricht Essential Fatty Acid Birth Cohort were used for the present study. Unadjusted and multivariable-adjusted linear regression analyses were performed to investigate associations between birth weight, birth length or head circumference and relative concentrations of docosahexaenoic acid (DHA), arachidonic acid (AA), dihomo-gamma-linolenic acid (DGLA) and trans-octadecenoic acids (18:1t) measured in phospholipids of the walls of umbilical arteries and veins, and in umbilical cord plasma and erythrocytes.

RESULTS

After optimal adjustment, a significant negative association was observed between birth weight and umbilical plasma DHA concentrations. Negative associations were also found for AA concentrations measured in umbilical plasma and in arterial and venous vessel walls. Birth length was negatively related to arterial vessel wall AA concentrations only. A significant negative association was observed for the relationship between 18:1t in cord erythrocytes and birth weight. For DGLA no significant associations were observed.

CONCLUSIONS

Results seem to preclude a role of DHA and AA as growth factors per se. Their negative relationships with birth dimensions may result from a limited maternal-fetal LCPUFA transfer capacity. Potential effects of 18:1t and DGLA on birth dimensions are probably small or non-existing.

Alpha-linolenic acid and its conversion to longer chain n-3 fatty acids: benefits for human health and a role in maintaining tissue n-3 fatty acid levels

There is little doubt regarding the essential nature of alpha-linolenic acid (ALA), yet the capacity of dietary ALA to maintain adequate tissue levels of long chain n-3 fatty acids remains quite controversial. This simple point remains highly debated despite evidence that removal of dietary ALA promotes n-3 fatty acid inadequacy, including that of docosahexaenoic acid (DHA), and that many experiments demonstrate that dietary inclusion of ALA raises n-3 tissue fatty acid content, including DHA. Herein we propose, based upon our previous work and that of others, that ALA is elongated and desaturated in a tissue-dependent manner. One important concept is to recognize that ALA, like many other fatty acids, rapidly undergoes beta-oxidation and that the carbons are conserved and reused for synthesis of other products including cholesterol and fatty acids. This process and the differences between utilization of dietary DHA or liver-derived DHA as compared to ALA have led to the dogma that ALA is not a useful fatty acid for maintaining tissue long chain n-3 fatty acids, including DHA. Herein, we propose that indeed dietary ALA is a crucial dietary source of n-3 fatty acids and its dietary inclusion is critical for maintaining tissue long chain n-3 levels.

Fatty acid patterns early after premature birth, simultaneously analysed in mothers' food, breast milk and serum phospholipids of mothers and infants

Background

The supply of long-chain polyunsaturated fatty acids via the placenta is interrupted in premature infants, making them exclusively dependent on breast milk, which varies in fatty acid (FA) concentrations depending on the mother's diet.

Objective

To in a longitudinal study explore the relation between FA status in mothers and infants from an unselected cohort of prematures, not requiring intensive care.

Design

Breast milk and mothers' and infants' plasma phospholipid FA concentrations from birth to 44 weeks of gestational age were analysed and compared with mothers' food intake, assessed using a 3-day diary. Fatty acids were analysed by capillary gas-liquid chromatography.

Results

The energy intake was low in 75% of mothers, and 90% had low intake of essential FAs (EFAs). Dietary linoleic acid (LA, 18:2w6), but not w3 FAs, correlated to concentrations in breast milk. Infants' plasma and breast milk correlated for arachidonic (AA, 20:4w6), eicosapentaenoic (EPA, 20:5w3) and docosahexaenoic (DHA, 22:6w3) acids. A high concentration of mead acid (20:3w9) in the infants at birth correlated negatively to the concentrations of LA, AA and w3 FAs. Infants of mothers who stopped breastfeeding during the study period showed decreased DHA concentrations and increased w6/w3 ratios, with the opposite FA pattern seen in the mothers' plasma.

Conclusion

Although dietary w3 FAs were insufficient in an unselected cohort of mothers of premature infants, breastfeeding resulted in increased levels of DHA in the premature infants at the expense of the mothers, suggesting a general need to increase dietary w3 FAs during pregnancy and lactation.

Very low-density lipoprotein in the cord blood of preterm neonates

Human fetuses have markedly low levels of serum lipids and a unique lipoprotein profile with respect to quality, with low-density lipoprotein (LDL)-like particle as the dominant cholesterol carrier. However, little is known about triglyceride (TG) distribution. In addition, lipid metabolism is important in lung development, with indications that TG from very low-density lipoprotein (VLDL) is essential for surfactant synthesis. We investigated TG distribution in preterm neonate cord blood and the relationship of VLDL-TG levels with respiratory distress syndrome (RDS). The study included 103 appropriate-for-gestational-age neonates (61 males). We performed serum lipoprotein analyses in cord blood by high-performance liquid chromatography with gel permeation columns. Term neonates had low cord blood TG concentrations distributed equally to the LDL and VLDL fractions. However, preterm neonates had even lower TG concentrations, with VLDL as the dominant carrier. The LDL-TG and high-density lipoprotein-TG concentrations in cord blood increased gradually with gestational age, but cord blood VLDL-TG concentrations increased dramatically from 32 to 34 weeks of gestational age. Neonates with RDS exhibited no RDS-specific lipoprotein profile; however, most were born before the timing of the dramatic VLDL-TG increase. Our results suggest that 34 weeks of gestation is a critical period for TG metabolism, indicating the need for evaluation of the lipid nutritional state in preterm neonates.

Dietary linoleic acid has no effect on arachidonic acid, but increases n-6 eicosadienoic acid, and lowers dihomo-gamma-linolenic and eicosapentaenoic acid in plasma of adult men

High intakes of linoleic acid (LA,18:2n-6) have raised concern due to possible increase in arachidonic acid (ARA, 20:4n-6) synthesis, and inhibition of alpha linolenic acid (ALA, 18:3n-3) desaturation to eicosapentaenoic (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3). In healthy men, 10.5% energy compared to 3.8% energy LA with 1% energy ALA increased plasma phospholipid LA and 20:2n-6, the elongation product of LA, and decreased EPA, with no change in ARA. However, LA was inversely related to ARA at both 10.5% energy and 3.8% energy LA, (r=-0.761, r=-0.817, p<0.001, respectively). A two-fold variability in ARA among individuals was not explained by the dietary LA, ARA, ALA, or fish intake. Our results confirm LA requirements for ARA synthesis is low, <3.8% energy, and they suggest current LA intakes saturate Delta-6 desaturation and adversely affect n-3 fatty acid metabolism. Factors other than n-6 fatty acid intake are important modifiers of plasma ARA.

The negative effects of hydrogenated trans fats and what to do about them

Partially hydrogenated vegetable oils have been in the American diet since 1900. More than 50 years ago they were found to contain trans fatty acids that were different from natural fatty acids in plant oils and in animal fat. There was growing evidence that the consumption of trans fats have negative health effects, including increasing plasma lipid levels. In 2003, the Food and Drug Administration (FDA) ruled that the amount of trans fat in a food item must be stated on the label after January 1, 2006; food items could be labeled 0% trans if they contain less than 0.5g/serving. Since the initial ruling, it is now known that the fatty acids in partially hydrogenated vegetable oil are 14 cis and trans isomers of octadecenoic and octadecadienoic acids that are formed during hydrogenation. They cause inflammation and calcification of arterial cells: known risk factors for coronary heart disease (CHD). They inhibit cyclooxygenase, an enzyme required for the conversion of arachidonic acid to prostacyclin, necessary for the regulation of blood flow. There have been several reformulations of hydrogenated fat containing varying amounts of trans fatty acids and linoleic acid, an essential fatty acid that is converted to arachidonic acid. Epidemiological data suggest that when trans fat percentages go up and linoleic acid percentages go down, death rates rise; when trans goes down, death rates go down. In spite of the harmful effects of trans fats, the FDA allows it in the food supply as long as the amount in a food item is declared on the label. Trans fat should be banned from the food supply.

Omega-3 Fatty acids and neural development to 2 years of age: do we know enough for dietary recommendations?

The omega (omega)-3 fatty acids are essential nutrients, explained by the absence of a Delta-15 desaturase in mammalian cells. The omega-3 fatty acids are found in the diet as alpha-linolenic acid (18:3omega-3) and eicosapentaenoic acid (20:5omega-3), as well as docosahexaenoic acid (DHA), with different functions of each of the omega-3 fatty acids in different cells. One essential role of the omega-3 fatty acids is fulfilled by the 22 carbon DHA (22:6omega-3). Depletion of DHA from brain and retina interferes with normal neurogenesis and neurological function, and visual signaling pathways. Observation and intervention studies with pregnant and lactating women, and with infants fed some formulas show that dietary DHA is associated with higher scores on tests of visual and neural development in infants and children. The estimated average requirement and variability in requirement among individuals both of which are needed to set dietary recommended intakes (DRIs) for the different omega-3 fatty acids are unknown. However, because omega-3 fatty acids are essential, adequate intakes to minimize risk of poor neural development and function can be justified, but dose-response data to provide a safe upper limit with different omega-6 fatty acid intakes are needed. Dietary recommendations do affect the food supply and supplements and are used in labeling, all impacting population health. When scientific information is incomplete, consideration must be given to the implications of recommendations that focus on individual nutrients, rather than dietary patterns such as breast-feeding and consuming fish that promote health and minimize disease risk.

Human milk arachidonic acid and docosahexaenoic acid contents increase following supplementation during pregnancy and lactation

INTRODUCTION

Docosahexaenoic acid (DHA) and arachidonic acid (AA) are important for neurodevelopment. Maternal diet influences milk DHA, whereas milk AA seems rather constant. We investigated milk AA, DHA and DHA/AA after supplementation of AA plus DHA, or DHA alone during pregnancy and lactation.

SUBJECTS AND METHODS

Women were supplemented with AA+DHA (220mg each/day), DHA (220mg/day) or placebo during pregnancy and lactation. Milk samples were collected at 2 (n=86) and 12 weeks (n=69) postpartum.

RESULTS

Supplementation of AA+DHA elevated milk AA (week 2, 14%; week 12, 23%) and DHA (43% and 52%) as compared to placebo. DHA tended to decrease milk AA and vice versa. Milk AA, DHA and DHA/AA decreased from 2 to 12 weeks postpartum.

CONCLUSIONS

Milk AA and in particular DHA are sensitive to maternal supplementation. It seems that maternal AA and notably DHA status decline with advancing lactation.

Enrichment of intestinal mucosal phospholipids with arachidonic and eicosapentaenoic acids fed to suckling piglets is dose and time dependent

Infant formula companies began fortifying formulas with long-chain PUFA in 2002, including arachidonic acid (ARA) at approximately 0.5% of total fatty acids. The primary objective of this study was to determine the time-specific effects of feeding formula enriched with supra-physiologic ARA on fatty acid composition of intestinal mucosal phospholipids. One-day-old pigs (n = 96) were fed a milk-based formula for 4, 8, or 16 d. Diets contained either no PUFA (0% ARA, negative control), 0.5% ARA, 2.5% ARA, 5% ARA, or 5% eicosapentaenoic acid (EPA) of total fatty acids (wt:wt). Growth (299 +/- 21 g/d) and clinical hematology were unaffected by treatment (P > 0.6). Although minimal on d 4, concentrations of ARA in jejunal mucosa were enriched 47, 272 and 428% by d 8 and 144, 356, and 415% by d 16 in pigs fed the 0.5% ARA, 2.5% ARA, and 5% ARA diets, respectively, compared with the 0% ARA control pigs (P < 0.01). On d 16, ARA enrichment increased progressively with increasing dietary ARA supplementation from 0 to 2.5% but plateaued as dietary ARA rose to 5%. A similar pattern of ARA enrichment was observed in ileal mucosal phospholipids, but maximal enrichment in the ileum exceed that in the jejunum by >50%. As ARA increased, linoleic acid content decreased reciprocally. Although maximal enterocyte enrichment with EPA approached 20-fold by d 8, concentrations were only approximately 50% of those attained for ARA. Negligible effects on gross villus/crypt morphology were observed. These data demonstrate a dose-dependent response of intestinal mucosal phospholipid ARA concentration to dietary ARA with nearly full enrichment attained within 8 d of feeding formula containing ARA at 2.5% of total fatty acids and that supra-physiologic supplementation of ARA is not detrimental to growth.

Maternal and fetal fatty acid profile in normal and intrauterine growth restriction pregnancies with and without preeclampsia

The aim of this study was to evaluate maternal and fetal lipid profile in intrauterine growth restriction (IUGR) pregnancies with and without preeclampsia (PE). Thirteen normal pregnancies studied during the third trimester (control M) and 29 at elective cesarean section (control CS) were compared with 18 pregnancies complicated by IUGR (IUGR only) and with seven pregnancies complicated by both IUGR and PE (IUGR-PE). Total plasma fatty acids, triglycerides, cholesterol, and nonesterified fatty acids (NEFA) were determined in maternal and fetal plasma. Nutritional intake was analyzed. IUGR only mothers had lower percentage of linoleic acid (LA) and higher arachidonic acid (AA) than controls, partly explained by higher AA dietary intake. Higher levels of NEFA were observed both in IUGR only and in IUGR-PE mothers whereas triglyceride levels were increased in IUGR-PE mothers only. In IUGR-PE fetuses, LA and AA were significantly decreased, whereas triglyceride and NEFA concentrations were significantly increased compared with normal fetuses. In conclusion, IUGR only is associated with altered fatty acids profile not completely accounted by dietary changes. We hypothesize that the differences observed in IUGR with PE for triglycerides and other lipids could be related to a difference in maternal phenotype.

Growth of Pre-ruminant Kid Goats and the Composition of Carcass Fat Deposits: Effects of Providing a PUFA-rich Fat in the Milk Replacer and Influence of the Kidding Season

The aim of this study is to investigate the possibility of improving the composition of goat meat in terms overall, of the fatty acid composition of different fat deposits. The experiment is designed in an 2 × 2 factorial arrangement. The treatments consist of two different milk replacers, one including and one excluding 2% of fish oil, and two different kidding seasons (spring or autumn). Twelve animals are allocated at random, to each treatment. Animals are slaughtered when they reached a body weight of 7000 ± 200 g. The inclusion of fish oil has no significant effect on growth rate, food efficiency ratio or dressing percentage. The cover, intermuscular and intramuscular fat of the leg from the animals fed with the milk replacer including fish oil, present higher and lower proportions of n-3 PUFA and saturated fatty acids respectively, while that of n-6 PUFA remains unchanged. The inclusion of fish oil in the milk replacer increases the 20 : 5 content in the leg muscle from about 0.4 to 3.5% and 22: 6 content from 0.4 to 2.3%. The fatty acids 20: 5 and 22: 6 are also detected in the cover and intermuscular fat when fish oil is included in the diet. The kid goats born in autumn, show a higher birth weight and growth rate. The leg obtained from these animals, presents a higher proportion of muscle and a lower proportion of bone. However, in the animals born in spring, a somewhat more favourable composition is obtained in the leg fat deposits. The improvement in the quality of meat obtained is discussed, taking into account the feeding strategy provided and the class of animals in question.

Hypolipidemic and hepatoprotective effects of flax and pumpkin seed mixture rich in omega-3 and omega-6 fatty acids in hypercholesterolemic rats

Flax and pumpkin seeds are a rich source of unsaturated fatty acids, antioxidants and fibers, known to have anti-atherogenic and hepatoprotective activities. These effects were evaluated in Wistar rats fed with 1% cholesterol diet. The study was performed on 30 male rats divided into three groups: a control group (CD), CD-chol group fed diet with 1% cholesterol and MS-chol group fed diet enriched with flax and pumpkin seed mixture. In CD-chol group, total cholesterol TC, triacylglycerol TG in plasma and liver, plasma LDL-C, atherogenic index AI and LDL/HDL ratio significantly increased. In MS-chol group lipid parameters decreased significantly, plasma and liver fatty acid composition showed an increase of PUFAs (ALA and LA), and MUFAs (oleic and eicosaenoic acid) and a decrease of SFA (palmitic and stearic acid). In plasma and liver of MS-chol group, malondialdehyde levels decreased and the efficiency of antioxidant defense system was improved compared to CD-chol group. Liver histological sections showed lipid storage in hepatocytes of CD-chol group and an improvement was noted in MS-chol group. Our results suggested that flax and pumpkin seed mixture had anti-atherogenic and hepatoprotective effects which were probably mediated by unsaturated fatty acids present in seed mixture.

Lipid characterization of Mortierella alpina grown at different NaCl concentrations

Effects of sodium chloride (NaCl) concentration on the lipid and fatty acid profiles of the polyunsaturated fatty acid (PUFA)-producing fungus, Mortierella alpina SC9, were investigated. The cells were cultivated in the medium with 4 different NaCl concentrations (0, 1, 2, 4%) for 6 days. The lipid and fatty acid profiles were analyzed by thin layer chromatography and gas chromatography. In the cultures with NaCl concentration up to 2%, PUFAs accounted for over 50% of the total fatty acids (TFAs) of the cells. Triacylglycerol (TAG) was the major lipid class, followed by monoacylglycerol (MAG) and diacylglycerol (DAG). TAG was found to contain the highest proportion of arachidonic acid (C20:4n-6, AA), suggesting that AA was mainly stored in the TAG. Comparing cultures at different NaCl concentrations indicated that TFA and TAG contents were higher in the cells grown at 2% NaCl. Similar results were found when 2% NaCl was added at day 3 of cultivation (late-log phase). In addition, the gene expression level of a TAG biosynthesis enzyme, diacylglycerol acyltransferase 2 (DGAT2), was also higher in the NaCl treated cells. This suggested that the increase of TFA and TAG contents might be related to the NaCl-stimulated DGAT2 expression.

Dietary omega 3 fatty acids and the developing brain

The omega-3 fatty acids are essential dietary nutrients and one of their important roles is providing the fatty acid with 22 carbons and 6 double bonds known as docosahexaenoic acid (DHA) for nervous tissue growth and function. Inadequate intakes of omega-3 fatty acids decrease DHA and increase omega-6 fatty acids in the brain. Decreased DHA in the developing brain leads to deficits in neurogenesis, neurotransmitter metabolism, and altered learning and visual function in animals. Western diets are low in omega-3 fatty acids, including the 18 carbon omega-3 fatty acid alpha linolenic acid found mainly in plant oils, and DHA, which is found mainly in fish. The DHA status of the newborn and breast-fed infant depends on the maternal intake of DHA and varies widely. Epidemiological studies have linked low maternal DHA to increased risk of poor child neural development. Intervention studies have shown improving maternal DHA nutrition decreases the risk of poor infant and child visual and neural development. Thus, sufficient evidence is available to conclude that maternal fatty acid nutrition is important to DHA transfer to the infant before and after birth, with short and long-term implications for neural function. However, genetic variation in genes encoding fatty acid desaturases also influence essential fatty acid metabolism, and may increase requirements in some individuals. Consideration of omega-3 fatty acid to include brain development, optimizing omega-3 and omega-6 fatty acids in gestation and lactation, and in fatty acid nutrition support for intravenous and formula-fed neonates is important.

High dietary omega-6 fatty acids contribute to reduced docosahexaenoic acid in the developing brain and inhibit secondary neurite growth

Docosahexaenoic acid (DHA, 22:6omega-3) is a major polyunsaturated fatty acid in the brain and is required in large amounts during development. Low levels of DHA in the brain are associated with functional deficits. The omega-3 fatty acids are essential nutrients and their metabolism and incorporation in developing brain depends on the composition of dietary fat. We assessed the importance of the intake of the omega-3 fatty acid, 18:3omega-3 and the balance with the omega-6 fatty acid, 18:2omega-6, and the effects of dietary arachidonic acid (20:4omega-6) and DHA in milk diets using the piglet as a model of early infant nutrition. Piglets were fed (% energy) 1.2% 18:2omega-6 and 0.05% 18:3omega-3 (deficient), 10.7% 18:2omega-6 and 1.1% 18:3omega-3 (contemporary), 1.2% 18:2omega-6 and 1.1% 18:3omega-3 (evolutionary), or the contemporary diet with 0.3% 20:4omega-6 and 0.3% DHA (supplemented) from birth to 30 days of age. Our results show that a contemporary diet, high in 18:2omega-6 compromises DHA accretion and leads to increased 22:4omega-6 and 22:5omega-6 in the brain. However, an evolutionary diet, low in 18:2omega-6, supports high brain DHA. DHA supplementation effectively increased DHA, but not the intermediate omega-3 fatty acids, 20:5omega-3 and 22:5omega-3. Using primary cultures of cortical neurons, we show that 22:5omega-6 is efficiently acylated and preferentially taken up over DHA. However, DHA, but not 22:5omega-6 supports growth of secondary neurites. Our results suggest the need to consider whether current high dietary omega-6 fatty acid intakes compromise brain DHA accretion and contribute to poor neurodevelopment.

Cystic Fibrosis and Nutrition: Linking Phospholipids and Essential Fatty Acids with Thiol Metabolism

Cystic fibrosis (CF) is the most common lethal inherited disorder among Caucasians and results from mutation in the gene encoding the CF transmembrane conductance regulator. In addition to its multisystem clinical effects, the disease is characterized by increased proinflammatory mediators and oxidant stress, and systemic redox imbalance with reduced glutathione (GSH), together with alterations in circulating and tissue (n-6) and (n-3) fatty acids, particularly a decrease in docosahexaenoic acid. The metabolism of phospholipids and fatty acids is closely related to GSH through the methionine-homocysteine cycle, in which choline via betaine provides methyl groups to regenerate S-adenosylmethionine, important in generating phosphatidylcholine and amino acid precursors for GSH. Current research focuses both on fatty acid supplementations to normalize altered (n-6) to (n-3) fatty acid balance and decrease generation of (n-6) fatty acid-derived inflammatory mediators, and strategies to improve oxidant defenses and redox balance. However, further research is needed before such strategies can be included in clinical care of individuals with CF.

Associations between neonatal birth dimensions and maternal essential and trans fatty acid contents during pregnancy and at delivery

Since birth dimensions have prognostic potential for later development and health, possible associations between neonatal birth dimensions and selected maternal plasma fatty acid contents were investigated, using data from 782 mother–infant pairs of the Maastricht Essential Fatty Acid Birth cohort. Unadjusted and multivariable-adjusted regression analyses were applied to study the associations between birth weight, birth length or head circumference and the relative contents of DHA, arachidonic acid (AA), dihomo-γ-linolenic acid (DGLA) and 18 : 1trans (18 : 1t) in maternal plasma phospholipids sampled during early, middle and late pregnancies, and at delivery. Where appropriate, corrections were made for relevant covariables. Significant ‘positive’ associations were observed between maternal DHA contents (especially early in pregnancy) and birth weight (B = 52·10 g, 95 % CI 20·40, 83·80) and head circumference (B = 0·223 cm, 95 % CI 0·074, 0·372). AA contents at late pregnancy were ‘negatively’ associated with birth weight (B = − 44·25 g, 95 % CI − 68·33, − 20·16) and birth length (B = − 0·200 cm, 95 % CI − 0·335, − 0·065). Significant ‘negative’ associations were also observed for AA contents at delivery and birth weight (B = − 27·08 g, 95 % CI − 47·11, − 7·056) and birth length (B = − 0·207 cm, 95 % CI − 0·330, − 0·084). Maternal DGLA contents at delivery were also significantly ‘negatively’ associated with neonatal birth weight (B = − 85·76 g, 95 % CI − 130·9, − 40·61) and birth length (B = − 0·413 cm, 95 % CI − 0·680, − 0·146). No significant associations were observed for maternal 18 : 1t contents. We conclude that during early pregnancy, maternal DHA content may programme fetal growth in a positive way. Maternal AA and DGLA in late pregnancy might be involved in fetal growth limitation.

Prenatal long-chain polyunsaturated fatty acid status: the importance of a balanced intake of docosahexaenoic acid and arachidonic acid

This review addresses the effect of prenatal long-chain polyunsaturated fatty acid (LCPUFA) status on neurodevelopmental outcome. It focuses on the major LPCUFA doxosahexaenoic acid (DHA; 22:6omega3) and arachidonic acid (AA; 20:4omega6). Due to enzymatic competition high DHA intake results in lower tissue levels of AA. LCPUFA accumulation in the brain starts early and increases during the third trimester. Initially brain AA-accretion exceeds DHA-accretion; after term age DHA-accretion surpasses AA-accretion. Animal studies indicated that early omega3-depletion results in poorer developmental outcome. They also showed that early omega3-supplementation had no effect on cognitive outcome, promotes visual development and impairs auditory and motor development. Only limited human data are available. Correlational studies suggest that neonatal AA status shows a positive relation with early neurodevelopmental outcome and that neonatal DHA status also might be correlated with improved outcome beyond infancy. Results of human intervention studies are equivocal: most studies were unable to demonstrate a positive effect of prenatal omega3-supplementation. It is concluded that only limited evidence exists to support the notion that prenatal omega3-supplementation favours developmental outcome. Caution is warranted for an unbalanced high DHA intake during the first two trimesters of pregnancy, i.e., DHA without additional AA supplementation.

Fish oil prevents essential fatty acid deficiency and enhances growth: clinical and biochemical implications

Fish oil, a rich source of omega-3 fatty acids, has never been used as the sole source of lipid in clinical practice for fear of development of essential fatty acid deficiency, as it lacks the believed requisite levels of linoleic acid, an omega-6 fatty acid. The objectives of this study were to establish biochemical standards for fish oil as the sole fat and to test the hypothesis that fish oil contains adequate amounts of omega-6 fatty acids to prevent essential fatty acid deficiency. Forty mice were divided into 2 groups that were either pair fed or allowed to eat ad libitum. In each group, 4 subgroups of 5 mice were fed 1%, 5%, and 10% fish oil diets by weight or a control soybean diet for 9 weeks. Blood was collected at 4 time points, and fatty acid analysis was performed. Food intake and weight status were monitored. All groups but the pair-fed 1% fish oil group gained weight, and the 5% fish oil group showed the highest caloric efficiency in both pair-fed and ad libitum groups. Fatty acid profiles for the 1% fish oil group displayed clear essential fatty acid deficiency, 5% fish oil appeared marginal, and 10% and soybean oil diets were found to prevent essential fatty acid deficiency. Fish oil enhances growth through higher caloric efficiency. We established a total omega-6 fatty acid requirement of between 0.30% and 0.56% of dietary energy, approximately half of the conventionally believed 1% as linoleic acid. This can presumably be attributed to the fact that fish oil contains not only a small amount of linoleic acid, but also arachidonic acid, which has greater efficiency to meet omega-6 fatty acid requirements.

Maternal and fetal brain contents of docosahexaenoic acid (DHA) and arachidonic acid (AA) at various essential fatty acid (EFA), DHA and AA dietary intakes during pregnancy in mice

We investigated essential fatty acids (EFA) and long-chain polyunsaturated fatty acids (LCP) in maternal and fetal brain as a function of EFA/LCP availability to the feto-maternal unit in mice. Diets varying in parent EFA, arachidonic acid (AA), and docosahexaenoic acid (DHA) were administered from day 3 prior to conception till day 15 of pregnancy. We concentrated on DHA, AA, Mead acid, and EFA-index [(omega-3+omega-6)/(omega-7+omega-9)] in maternal erythrocytes, maternal brain, and fetal brain. It was found that erythrocyte EFA/LCP sensitively reflects declining EFA/LCP status in pregnancy, although this decline was not apparent in maternal brain. Differences in erythrocyte EFA/LCP coincided with larger differences in fetal brain EFA/LCP as compared to EFA/LCP in maternal brain. Both maternal and fetal brains were affected by short-term EFA/LCP intake, but the developing fetal brain proved most sensitive. The inverse relationship between fetal brain AA and DHA suggests the need of a maternal dietary DHA/AA balance, at least in mice.

Essential n-3 fatty acids in pregnant women and early visual acuity maturation in term infants

BACKGROUND

Docosahexaenoic acid (DHA) is important to neural development. Whether DHA intakes are low enough in some pregnant women to impair infant development is uncertain.

OBJECTIVE

We sought to determine whether DHA deficiency occurs in pregnant women and contributes to poor infant development.

DESIGN

Biochemical cutoffs, dietary intakes, or developmental scores indicative of DHA deficiency are not defined. Infant development has a distribution in which an individual's potential development is unknown. This was a randomized intervention to establish a distribution of developmental scores for infants of women with DHA intakes considered to be above requirements against which to compare the development of infants of mothers consuming their usual diet. DHA (400 mg/d; n = 67) or a placebo (n = 68) was consumed by the women from 16 wk gestation until delivery. We determined maternal red blood cell ethanolamine phosphoglyceride fatty acids, dietary intakes at 16 and 36 wk gestation, and infant visual acuity at 60 d of age.

RESULTS

We described an approach to identify DHA deficiency when biochemical and functional markers of deficiency are unknown. In multivariate analyses, infant visual acuity was related to sex (beta = 0.660, SE = 0.93, and odds ratio = 1.93) and maternal DHA intervention (beta = 1.215, SE = 1.64, and odds ratio = 3.37). More infant girls in the placebo than in the DHA intervention group had a visual acuity below average (P = 0.048). Maternal red blood cell ethanolamine phosphoglyceride docosatetraenoic acid was inversely related to visual acuity in boys (rho = -0.37, P < 0.05) and girls (rho = -0.48, P < 0.01).

CONCLUSIONS

These studies suggest that some pregnant women in our study population were DHA-deficient.

Beneficial effects of a polyunsaturated fatty acid on infant development: evidence from the inuit of arctic Quebec

OBJECTIVES

To examine the relation of cord plasma docosahexaenoic acid (DHA) concentration to gestation length, birth size, growth, and infant visual acuity, cognitive, and motor development and the effects on growth and development associated with DHA intake from breast-feeding.

STUDY DESIGN

DHA, other polyunsaturated fatty acids, and 3 environmental contaminants (polychlorinated biphenyls, mercury, and lead) were assessed in cord plasma and maternal plasma and milk in 109 Inuit infants in Arctic Quebec. Multiple regression was used to examine the relation of cord DHA and DHA from breast-feeding on growth and development at 6 and 11 months, after controlling for contaminant exposure and other potential confounders.

RESULTS

Higher cord DHA concentration was associated with longer gestation, better visual acuity and novelty preference on the Fagan Test at 6 months, and better Bayley Scale mental and psychomotor performance at 11 months. By contrast, DHA from breast-feeding was not related to any indicator of cognitive or motor development in this full-term sample.

CONCLUSIONS

The association of higher cord DHA concentration with more optimal visual, cognitive, and motor development is consistent with the need for substantial increases in this critically important fatty acid during the third trimester spurt of synaptogenesis in brain and photoreceptor development.

Systematic review of fatty acid composition of human milk from mothers of preterm compared to full-term infants

BACKGROUND

Fatty acid composition of human milk serves as guidance for the composition of infant formulae. The aim of the study was to systematically review data on the fatty acid composition of human milk of mothers of preterm compared to full-term infants.

METHODS

An electronic literature search was performed in English (Medline and Medscape) and German (SpringerLink) databases and via the Google utility. Fatty acid compositional data for preterm and full-term human milk were converted to differences between means and 95% confidence intervals.

RESULTS

We identified five relevant studies publishing direct comparison of fatty acid composition of preterm versus full-term human milk. There were no significant differences between the values of the principal saturated and monounsaturated fatty acids. In three independent studies covering three different time points of lactation, however, docosahexaenoic acid (DHA) values were significantly higher in milk of mothers of preterm as compared to those of full-term infants, with an extent of difference considered nutritionally relevant.

CONCLUSION

Higher DHA values in preterm than in full-term human milk underlines the importance of using own mother's milk for feeding preterm babies and raises the question whether DHA contents in preterm formulae should be higher than in formulae for full-term infants.

Negative confounding in the evaluation of toxicity: the case of methylmercury in fish and seafood

In observational studies, the presence of confounding [corrected] can distort the true association between an exposure and a toxic-effect outcome, if the confounding variable is not controlled for in the study design or analysis phase. While confounding is often assumed to occur in the same direction as the toxicant exposure, the relationship between the benefits and risks associated with fish and seafood consumption is a classic example of negative confounding: the exposure to methylmercury occurs with fish and seafood, which are also associated with beneficial nutrients, and the signs of mercury toxicity [corrected] Mercury and nutrients may affect the same epidemiological outcomes, but most studies addressing one of them have ignored the potential for negative confounding by the other. This article reviews the existing evidence of effects of both nutrient and contaminant intakes as predictors of neurodevelopmental and cardiovascular outcomes. Substantial underestimation of the effects of mercury toxicity and of fish benefits occurs from the lack of confounder adjustment and imprecision of the exposure parameters. Given this inherent bias in observational studies, regulatory agencies should reconsider current dietary advice in order to provide better guidance to consumers in making prudent choices to maintain a nutritious diet with seafood that is low in mercury concentrations. Attention should also be paid to the occurrence of negative confounding in other connections.

Cognitive assessment of children at age 2(1/2) years after maternal fish oil supplementation in pregnancy: a randomised controlled trial

OBJECTIVE

To assess the effects of antenatal omega 3 long-chain polyunsaturated fatty acid (n-3 LC PUFA) on cognitive development in a cohort of children whose mothers received high-dose fish oil in pregnancy.

DESIGN

A double-blind randomised placebo-controlled trial.

SETTING

Perth, Western Australia, Australia.

PATIENTS

98 pregnant women received the supplementation from 20 weeks' gestation until delivery. Their infants (n = 72) were assessed at age 2(1/2) years.

INTERVENTIONS

Fish oil (2.2 g docosahexaenoic acid (DHA) and 1.1 g eicosapentaenoic acid (EPA)/day) or olive oil from 20 weeks' gestation until delivery.

OUTCOME MEASURES

Effects on infant growth and developmental quotients (Griffiths Mental Development Scales), receptive language (Peabody Picture Vocabulary Test) and behaviour (Child Behaviour Checklist).

RESULTS

Children in the fish oil-supplemented group (n = 33) attained a significantly higher score for eye and hand coordination (mean ((SD) score 114 (10.2)) than those in the placebo group (n = 39, mean score 108 (SD 11.3); p = 0.021, adjusted p = 0.008). Eye and hand coordination scores correlated with n-3 PUFA levels in cord blood erythrocytes (EPA: r = 0.320, p = 0.007; DHA: r = 0.308, p = 0.009) and inversely correlated with n-6 PUFA (arachidonic acid 20:4n-6: r = -0.331, p = 0.005). Growth measurements in the two groups were similar at age 2(1/2) years.

CONCLUSION

Maternal fish oil supplementation during pregnancy is safe for the fetus and infant, and may have potentially beneficial effects on the child's eye and hand coordination. Further studies are needed to determine the significance of this finding.