Factors affecting long-chain polyunsaturated fatty acid composition of plasma choline phosphoglycerides in preterm infants

Long-chain polyunsaturated fatty acid (LCPUFA) composition of choline phosphoglycerides was measured in the plasma of 22 preterm infants at birth and at expected date of delivery (EDD). In a subgroup of 10 infants, data were also collected at regular intervals between birth and EDD. Levels at birth showed a positive correlation between arachidonic acid (AA) and birth weight, p less than 0.01, and between docosahexaenoic acid (DHA) and gestational age, p less than 0.01. Percentage compositions of both AA and DHA fell rapidly between preterm birth and expected date of delivery, at a time when they would remain high in utero. For AA, the mean value fell from 16.52 to 7.18%, and for DHA from 4.49 to 2.63%. Levels of DHA fell less in babies fed breast milk than in those fed formula milk, p less than 0.05, and levels of AA fell less in those requiring a large number of blood transfusions, p less than 0.05. The level of DHA fell more in those infants with intrauterine growth retardation, p less than 0.05. Although these nutrients share common metabolic pathways for their synthesis, they appear to be affected by different factors in both the fetus and the preterm infant. Low levels at this time may adversely affect brain and retinal development.

Chick nutritional encephalomalacia and prostanoid formation

Nutritional encephalomalacia (NE) was induced in young chicks using a diet low in vitamin E and containing 8% ethyl esters derived from safflower oil fatty acids (S-E group). The same diet with added alpha-tocopheryl acetate (S+E) failed to produce the pathology, and chicks receiving aerated linseed oil--high in alpha-linolenic acid and low in alpha-tocopherol (L-E)--did not develop symptoms. Formation of metabolites from labeled arachidonic acid (AA) by thrombocytes was similar in the S+E and S-E groups, yielding thromboxane B2 (TXB2) and hydroxy fatty acids as the major products. Collagen-induced thrombocyte aggregation and TXB2 production were not significantly different in the S-E and S+E groups, but aggregation values and TXB2 synthesis were significantly less in the L-E group than in the ataxic S-E chicks. Prostaglandin E2 production by aortal rings was significantly influenced by the diet; S-E yielded the highest value and L-E the lowest. These results show that alpha-linolenic acid causes alterations in the AA metabolism and thrombocyte function in young chicks.

The effect of dietary change on in vitro erythrocyte haemolysis, skin lesions and alopecia in common marmosets (Callithrix jacchus)

1. The effect of dietary change on common marmosets (Callithrix jacchus) exhibiting high in vitro erythrocyte haemolysis, skin lesions and alopecia was investigated. 2. The experimental diet was low in lipid, high in vitamin E and was devoid of n-3 long chain polyunsaturated fatty acids. 3. There were significant increases in the concentrations of plasma alpha-tocopherol (vitamin E) (P less than 0.05), all-trans retinol (vitamin A) (P less than 0.001) and total lipid (P less than 0.025), and a reduction in fibrinogen (P less than 0.02) concentration and neutrophil count (P less than 0.02). 4. Moreover, the mean in vitro erythrocyte haemolysis declined from an initial value of 64% to less than 2%, and there was a regression of skin lesions and alopecia with complete fur regrowth. 5. The amelioration of the conditions appear to be due to high circulating vitamin E which provided protection against oxidative stress, and the correction of membrane n-6:n-3 balance.

The nutritional contribution to bovine spongiform encephalopathy

Evidence that changes in feeding style alter the membrane fatty acid composition of ruminant tissue is presented here by comparing zoo giraffe with the same species from their natural habitat. The membrane changes seen are similar to those used experimentally to make animals susceptible to basic brain protein and encephalomalacia. Similar membrane responses have been noted in cattle. Use of animal protein and increased nitrogen in cattle feeds would lead to a relative deficiency of essential fatty acids in the cell membranes and hence reduced membrane stability. By analogy with crazy chick disease (nutritional encephalomalacia) and experimental encephalomyelitis in rats, the possibility that the changes in animals feeds would have depleted cattle tissue membranes and made them susceptible to BSE is discussed. The assumption being made is that the principle of a requirement of essential fatty acids for neural integrity and immune system function would apply to cattle as well as to other species.

Nutrition of women in anticipation of pregnancy

A causal connection between maternal nutrient intake and birth outcome is not universally accepted. In this paper further empirical support is provided, particularly in relation to the impact of maternal nutrition around the time of conception or very early in pregnancy. It is argued that the hypothesis that maternal nutrition has no connection with birthweight is very easily refuted. It is suggested that there should be a new category of recommended dietary allowances; "women in anticipation of pregnancy". The diet of 513 pregnant London women were recorded for 7 days during the first trimester of their pregnancy. Birthweight and nutrient intakes were found to be significantly correlated but only over the lower half of the birthweight range. The optimum birthweight range with the lowest perinatal and infant mortalities is 3,500-4,500 g and it is suggested that the nutrient intake of th 165 women who had babies in this optimum weight range provide tentative values for nutrient intake recommendations in anticipation of pregnancy, but are not claimed to be representative. The need for adjustments of recommendations for the individual, for example for a low body mass index, is discussed. A body mass index of 24 kg/m2 is recommended based on the median of the 165 women.

Potential diagnostic value of the umbilical artery as a definition of neural fatty acid status of the fetus during its growth: the umbilical artery as a diagnostic tool

Summary

Low birth weight (LBW) is associated with handicaps, the most prevelant of which affect the brain or its sensory attributes and have a life long impact. We have therefore been interested in nutrition and fetal growth and have studied the relationship between maternal diet and the outcome of pregnancy.

Essential fatty acids are methylene-interrupted, polyenoic fatty acids that are required for cell membrane structure, integrity and function. Some 60% of the structural material of the brain and nervous system is lipid and it uses 20- and 22-carbon-chain-length polyenoic acids specifically in sites of signal transduction and high activity (Fig. 1).

We have been interested in the acquisition of these fatty acids during fetal growth and along with deficits of several nutrients found low intakes of essential fatty acids (EFA) in the mothers of LBW babies. In order to test this food intake data we have analysed the lipids of the umbilical artery as representative of fetal tissue.

We found surprisingly high proportions of the n − 9 eicosatrienoic acid (20:3, n − 9) and docosatrienoic acid (22:3, n − 9). The 20:3, n − 9 is known as the Mead acid and is recognized as a biochemical index of EFA deficiency [1,2]. The 20:3, n − 9/2:4, n − 6 ratio has been used as a biochemical test of general EFA deficiency and the 22:5, n − 6/ 22:4, n − 6 ratio as a marker of docosahexaenoic or n − 3 deficiency. Both ratios were unusually high. Further analysis of 14 babies of different birth weights produced highly significant Pearson correlation coefficients between birth weights and head circumferences, and these two indices, which were negative, and greater in the ethanolamine phosphoglycerides than in the choline phosphoglycerides of the umbilical artery.

The ethanolamine phosphoglycerides are inner membrane lipids and therefore the presence of the Mead acid and high levels of 22:5, n − 6 are statements about the biochemical history of the individual fetus. These indices may therefore have a diagnostic value as a measure of the nutritional status of the fetus during its growth. Because they describe the status of fatty acids specifically used for neural tissue growth, this diagnostic tool has a potential, which needs now to be tested, for assessing risk of neural deficits or damage in, for example, LBW and premature infants.

Alterations in transfer and lipid distribution of arachidonic acid in placentas of diabetic pregnancies

Placental tissue from nondiabetic term pregnancies and pregnancies complicated by maternal insulin-dependent diabetes mellitus (IDDM) was perfused in vitro to compare the transfer and lipid distribution of arachidonic acid (AA). Radiolabeled albumin-bound AA was administered into the maternal afferent circulation, and samples of fetal and maternal effluent were collected at 10-min intervals. Perfused placental tissue was collected at the end of each experiment. The effluent was analyzed for total radioactivity, and extracts were subjected to thin-layer chromatography for the assessment of radioactivity associated with various lipid fractions. Placental AA uptake was significantly increased in perfused tissue from diabetic pregnancies (0.88 vs. 1.72 nM.min-1.g-1 in nondiabetic and IDDM, respectively; P less than 0.01), as was AA transfer (0.22 vs. 0.42 ml/min in nondiabetic and IDDM, respectively; P less than 0.01). However, transfer of the highly diffusible marker substance antipyrine was significantly reduced in IDDM placentas (1.79 vs. 2.49 ml/min in IDDM and nondiabetic, respectively; P less than 0.01). Compared with nondiabetic placentas, incorporation of AA into triglyceride was significantly increased in both maternal and fetal effluents and in placental tissue from IDDM pregnancies, whereas the percentage of AA remaining unesterified was reduced in both placental tissue and fetal effluent. Incorporation of AA into phosphoglycerides was significantly reduced in placental tissue but increased in fetal effluent in placentas from IDDM pregnancies. The results of these studies suggest that transfer and lipid distribution of AA are significantly altered in placentas from IDDM pregnancies. These findings may be relevant to the increased incidence of abnormal fetal growth and development associated with IDDM pregnancies.

n-6 and n-3 fatty acids during early human development

The food intakes of pregnant women were analysed from two contrasting socio-economic areas in London. There were significant differences in mean calorie and EFA intakes. Analysis of maternal and cord blood essential fatty acids (EFAs) in relation to birth weight, placental weight and head circumference were consistent with the dietary data. To assess the EFA tissue status of the low birth weight babies, the umbilical arteries from 14 separate babies of different birth weights were studied. Surprisingly high levels of the Mead acid (20:3 n-9) were found, with the highest appearing in the artery from the baby with the lowest birth weight. This data may not necessarily imply an EFA deficiency, but at the least it probably indicates a remarkable thirst for long chain n-6 and n-3 fatty acids for fetal brain development.

Maternal magnesium intake and pregnancy outcome

The magnesium intakes of 513 women towards the end of the first trimester of pregnancy were calculated from a record of food consumption for one week. Magnesium intake was found to be correlated with weight, length, and head circumference at birth as well as length of gestation up to a threshold of around 3200 g birthweight. Of the seven elements found to be significantly associated with these outcomes of pregnancy, magnesium was third in order of significance, after sodium and chloride. A subsample of mothers were given a supplement which provided 100 mg/day of magnesium during the second and third trimester: there was no effect on the outcome of pregnancy, suggesting that any influence of magnesium was confined to the first trimester or before. A maternal magnesium intake of 300 mg/day was compatible with observed optimum birthweight, length and head circumference.

Breast-milk fatty acids of rural Gambian mothers: effects of diet and maternal parity

The influence of diet and maternal parity on the fatty acid composition of mature breast milk have been studied in 23 rural Gambian mothers. The subjects' habitual diet was low in fat (16% total energy), groundnuts (peanuts) constituting the principal fat source. The high abundance of oleic and linoleic acids in groundnut fat were reflected in the proportions of these fatty acids in breast milk (47.0 +/- 1.5 and 13.0 +/- 0.3 g/100 g fat, respectively), which were elevated compared with mothers in other African communities. Estimates of daily breast-milk fatty acid secretion indicated that there was little risk of essential fatty acid deficiency in Gambian infants. The proportions of fatty acids synthesized de novo (10:0, 12:0, 14:0) were less than expected from published studies of mothers consuming low-fat diets, averaging 16.8 +/- 1.4 g/100 g fat. As the study was conducted at a time of food shortage and high energy expenditure, it is argued that mobilisation of body fat during negative energy balance increased the availability of long-chain fatty acids to the breast. The proportion of endogenous fatty acids was markedly reduced in the milk of mothers of very high parity (parity 1 = 19.3 +/- 1.6 g/100 g fat; parities 10 + = 11.4 +/- 1.5 g/100 g fat; p less than 0.01). It is hypothesised that this represents an impairment of the ability to synthesise breast-milk fatty acids de novo in these mothers.

Aspects of in vitro placental perfusion: effects of hyperoxia and phenol red

The study of a number of parameters of placental function indicated that the perfused human placental lobe maintained its structural and functional integrity when PO2 levels in buffer perfusate were near physiological values, despite low O2 consumption. High O2 content in the perfusate may reduce placental transfer either through a direct vasoconstrictor effect or in combination with the destruction of vascular cyclo-oxygenase, resulting in the reduced synthesis of the vasodilator prostacyclin. A similar mechanism may be involved in the reduction of placental transfer observed in the presence of phenol red. These studies suggest that aspects of in vitro methodologies which may relate to prostaglandin production deserve careful consideration and further study.

Ophthalmic corticosteroid therapy: systemic effects in the dog

Degenerative myopathy suggestive of glucocorticoid-induced myopathy was diagnosed in a 10-year-old female Poodle X Pekingese dog with a history of progressive lameness. Electromyography revealed bizarre high-frequency discharges. Evidence of adrenal suppression was obtained in response to exogenous ACTH. The predominant source of corticosteroid was an ophthalmic preparation used in the management of keratoconjunctivitis sicca. Considering the apparent adverse effects of the corticosteroid in this case, a study was undertaken to determine the systemic effects, if any, induced by long-term ophthalmic administration of 0.1% dexamethasone suspension in healthy adult dogs. Dogs in one group (n = 5) were treated 4 times daily for 8 weeks, and dogs in another group (n = 5) were treated 4 times daily for 16 weeks. All dogs remained healthy throughout the study, but dexamethasone-treated dogs developed marked adrenal suppression, beginning the second week of treatment and intensifying throughout the treatment period. Histopathologic changes in the liver of dexamethasone-treated dogs included scattered foci of vacuolated hepatocytes, increased hepatocytic glycogen content, and ballooning degeneration of hepatocytes. Muscle specimens were histologically, histochemically, and electromyographically normal.

Multiple organ metastasis of an aortic body tumor in a boxer

A 9-year-old sexually intact male Boxer with a history of multiple episodes of syncope and various cardiac arrhythmias was determined radiographically to have a large mass in the heart-base region and was subsequently euthanatized upon worsening of clinical signs. Histologic and ultrastructural examination of tissue from the heart-base mass indicated that the tumor was most likely a chemodectoma derived from the aortic body (aortic body tumor, extra-adrenal paraganglioma). Macroscopic and/or microscopic evidence of metastasis of the tumor was seen in the lungs, myocardium, spleen, liver, kidneys, and dura mater over the cerebellum.

Nutritional encephalomalacia in the chick: an exposure of the vulnerable period for cerebellar development and the possible need for both omega 6- and omega 3-fatty acids

1. Cockerels (1-d-old) received over a period of 4 weeks, a balanced diet containing either safflower oil (diet S) or linseed oil (diet L) as a source of polyunsaturated fatty acids (PUFA). Body-weight, and weights of cerebrum and cerebellum increased at similar rates in the two dietary groups. The total fatty acids (FA) of the cerebellum differed from the cerebral FA by their higher PUFA and oleic acid contents and their lower stearic acid level. During the 3rd week of life there was a spurt in accretion of PUFA in the cerebellum, but not in the cerebrum. At the end of the experimental period phosphatidylethanolamine was present at twice the concentration in the cerebellum, compared with the cerebrum. 2. Diets S and L resulted in extensive mutual replacement of omega 6- and omega 3-FA in brain, without any significant change in the total PUFA. Brain oleic acid concentration was higher in the diet-L group than in the diet-S group, but saturated FA were not affected by the dietary treatments. 3. These results may be relevant to basic brain biology and to chick nutritional encephalomalacia (NE). This disease, which specifically affects the cerebellum and is readily induced by diets supplying linoleic acid but deficient in vitamin E, usually reaches its highest incidence during the 3rd week of life and may thus be related to the cerebellar PUFA spurt that occurs at that time. The fact that NE was induced by linoleic acid, while alpha-linolenic acid exerted a protective action, points to an overproduction of arachidonic-derived eicosanoids as a factor in the etiology of the cerebellar lesion and possibly a structural change due to a loss of docosahexaenoic acid and gain of arachidonic acid in the chicks given diet S.

The effect of nutritional counselling on diet and plasma EFA status in multiple sclerosis patients over 3 years

The dietary intake of 83 people with multiple sclerosis (MS) was assessed by the 7-day weighed intake method prior to dietary advice and at 6-monthly intervals thereafter up to 36 months. The P:S ratio of the diet increased from an initial value of 0.8 to 1.5 after 6 months and 1.34 at 36 months. Biochemical investigation of plasma essential fatty acid (EFA) status specifically linoleic, eicosapentanoic and docosahexanoic acids showed significant correlations with diet. Concurrent 6-monthly neurological and physiotherapy assessments were also carried out, the neurological results are discussed in relation to a nutrient scoring system.

In vivo incorporation of labeled fatty acids in rat liver lipids after oral administration

Striking differences were found in the compartmentalization of fatty acids into liver lipid fractions. The saturated fatty acids--lauric, myristic, palmitic and stearic--were incorporated into phosphoglycerides at faster rates with increasing chain lengths, while triglyceride incorporation was almost uniform. The degree of incorporation of the unsaturated fatty acids into phosphoglycerides (structural) compared to triglyceride (storage and energy) was the converse of their oxidation rates. The incorporation of oleic, linoleic and alpha-linolenic acids was mainly into triglyceride, whereas dihomo-gamma-linolenic acid and arachidonic acid were preferentially incorporated into phosphoglycerides. The data suggest that distribution of each fatty acid is different depending on its destination for structural or energy function.