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Lundgren P, Jacobson L, Gränse L, Hård AL, Sävman K, Hansen-Pupp I, Ley D, Nilsson AK, Pivodic A, Smith LE, Hellström A. Visual outcome at 2.5 years of age in ω-3 and ω-6 long-chain polyunsaturated fatty acid supplemented preterm infants: a follow-up of a randomized controlled trial. THE LANCET REGIONAL HEALTH. EUROPE 2023; 32:100696. [PMID: 37671123 PMCID: PMC10477038 DOI: 10.1016/j.lanepe.2023.100696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/29/2023] [Accepted: 07/07/2023] [Indexed: 09/07/2023]
Abstract
Background We investigated ophthalmological outcomes at 2.5 years of corrected age in children born extremely preterm (EPT) to evaluate the effects of postnatal enteral supplementation with ω-3 and ω-6 long-chain polyunsaturated fatty acids. Methods In the Mega Donna Mega clinical trial, EPT infants born at less than 28 weeks of gestation were randomized to receive an enteral supplementation of docosahexaenoic acid (DHA) and arachidonic acid (AA) from birth to 40 weeks postmenstrual age. In this exploratory follow-up at 2.5 years of corrected age, we assessed visual acuity (VA), refraction, manifest strabismus, and nystagmus. Satisfactory VA was defined as ≥20/63. Multiple imputation (MI) was used to address the issue of missing data. Findings Of 178 children in the trial, 115 (with median gestational age (GA) of 25 + 4/7 weeks and median birth weights of 790 g) were ophthalmologically assessed at a median corrected age of 2.7 years (range 2.0-3.9 years). VA assessment was missing in 42.1% (75/178), in 41.7% (35/84) of the AA/DHA supplemented infants, and in 42.6% (40/94) of the control infants. After MI and adjustments for GA, study center, plurality, and corrected age at VA exam, no significant effect of AA/DHA supplementation was detected in VA outcome (≥20/63) (odds ratio 2.16, confidence interval 95% 0.99-4.69, p = 0.053). Interpretation In this randomized controlled trial follow-up, postnatal supplementation with enteral AA/DHA to EPT children did not significantly alter VA at 2.5 years of corrected age. Due to the high loss to follow-up rate and the limited statistical power, additional studies are needed. Funding The Swedish Medical Research Council #2020-01092, The Gothenburg Medical Society, Government grants under the ALF agreement ALFGBG-717971 and ALFGBG-971188, De Blindas Vänner, Knut and Alice Wallenberg Foundation - Wallenberg Clinical Scholars, NIHEY017017, EY030904BCHIDDRC (1U54HD090255 Massachusetts Lions Eye Foundation) supported the study.
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Affiliation(s)
- Pia Lundgren
- The Sahlgrenska Centre for Pediatric Ophthalmology Research, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Jacobson
- The Sahlgrenska Centre for Pediatric Ophthalmology Research, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Lotta Gränse
- Department of Clinical Sciences, Ophthalmology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Anna-Lena Hård
- The Sahlgrenska Centre for Pediatric Ophthalmology Research, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karin Sävman
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Neonatology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingrid Hansen-Pupp
- Department of Clinical Sciences Lund, Pediatrics, Lund University, Skåne University Hospital, Lund, Sweden
| | - David Ley
- Department of Clinical Sciences Lund, Pediatrics, Lund University, Skåne University Hospital, Lund, Sweden
| | - Anders K Nilsson
- The Sahlgrenska Centre for Pediatric Ophthalmology Research, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Aldina Pivodic
- The Sahlgrenska Centre for Pediatric Ophthalmology Research, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lois E Smith
- The Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ann Hellström
- The Sahlgrenska Centre for Pediatric Ophthalmology Research, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Burdge GC. α-linolenic acid interconversion is sufficient as a source of longer chain ω-3 polyunsaturated fatty acids in humans: An opinion. Lipids 2022; 57:267-287. [PMID: 35908848 DOI: 10.1002/lipd.12355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 01/20/2023]
Abstract
α-linolenic acid (αLNA) conversion into the functionally important ω-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), has been regarded as inadequate for meeting nutritional requirements for these PUFA. This view is based on findings of small αLNA supplementation trials and stable isotope tracer studies that have been interpreted as indicating human capacity for EPA and, in particular, DHA synthesis is limited. The purpose of this review is to re-evaluate this interpretation. Markedly differing study designs, inconsistent findings and lack of trial replication preclude robust consensus regarding the nutritional adequacy of αLNA as a source of EPC and DHA. The conclusion that αLNA conversion in humans is constrained is inaccurate because it presupposes the existence of an unspecified, higher level of metabolic activity. Since capacity for EPA and DHA synthesis is the product of evolution it may be argued that the levels of EPA and DHA it maintains are nutritionally appropriate. Dietary and supra-dietary EPA plus DHA intakes confer health benefits. Paradoxically, such health benefits are also found amongst vegetarians who do not consume EPA and DHA, and for whom αLNA conversion is the primary source of ω-3 PUFA. Since there are no reported adverse effects on health or cognitive development of diets that exclude EPA and DHA, their synthesis from αLNA appears to be nutritionally adequate. This is consistent with the dietary essentiality of αLNA and has implications for developing sustainable nutritional recommendations for ω-3 PUFA.
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Affiliation(s)
- Graham C Burdge
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
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West AL, Miles EA, Han L, Lillycrop KA, Napier JA, Calder PC, Burdge GC. Dietary Supplementation with Transgenic Camelina sativa Oil Containing 20:5n-3 and 22:6n-3 or Fish Oil Induces Differential Changes in the Transcriptome of CD3 + T Lymphocytes. Nutrients 2021; 13:3116. [PMID: 34578993 PMCID: PMC8466821 DOI: 10.3390/nu13093116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/23/2022] Open
Abstract
Eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3) are important for leukocyte function. This study investigated whether consuming transgenic Camelina sativa (tCSO) seed oil containing both 20:5n-3 and 22:6n-3 is as effective as fish oil (FO) for increasing the 20:5n-3 and 22:6n-3 content of leukocytes and altering mitogen-induced changes to the T cell transcriptome. Healthy adults (n = 31) consumed 450 mg/day of 20:5n-3 plus 22:6n-3 from either FO or tCSO for 8 weeks. Blood was collected before and after the intervention. 20:5n-3 and 22:6n-3 incorporation from tCSO into immune cell total lipids was comparable to FO. The relative expression of the transcriptomes of mitogen-stimulated versus unstimulated T lymphocytes in a subgroup of 16 women/test oil showed 4390 transcripts were differentially expressed at Baseline (59% up-regulated), 4769 (57% up-regulated) after FO and 3443 (38% up-regulated) after tCSO supplementation. The 20 most altered transcripts after supplementation differed between test oils. The most altered pathways were associated with cell proliferation and immune function. In conclusion, 20:5n-3 and 22:6n-3 incorporation into immune cells from tCSO was comparable to FO and can modify mitogen-induced changes in the T cell transcriptome, contingent on the lipid matrix of the oil.
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Affiliation(s)
- Annette L. West
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (A.L.W.); (E.A.M.); (P.C.C.)
| | - Elizabeth A. Miles
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (A.L.W.); (E.A.M.); (P.C.C.)
| | - Lihua Han
- Department of Plant Sciences, Rothamsted Research, Harpenden AL5 2JQ, UK; (L.H.); (J.A.N.)
| | - Karen A. Lillycrop
- Centre for Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK;
| | - Johnathan A. Napier
- Department of Plant Sciences, Rothamsted Research, Harpenden AL5 2JQ, UK; (L.H.); (J.A.N.)
| | - Philip C. Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (A.L.W.); (E.A.M.); (P.C.C.)
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Graham C. Burdge
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (A.L.W.); (E.A.M.); (P.C.C.)
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Hellström A, Nilsson AK, Wackernagel D, Pivodic A, Vanpee M, Sjöbom U, Hellgren G, Hallberg B, Domellöf M, Klevebro S, Hellström W, Andersson M, Lund AM, Löfqvist C, Elfvin A, Sävman K, Hansen-Pupp I, Hård AL, Smith LEH, Ley D. Effect of Enteral Lipid Supplement on Severe Retinopathy of Prematurity: A Randomized Clinical Trial. JAMA Pediatr 2021; 175:359-367. [PMID: 33523106 PMCID: PMC7851754 DOI: 10.1001/jamapediatrics.2020.5653] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Lack of arachidonic acid (AA) and docosahexaenoic acid (DHA) after extremely preterm birth may contribute to preterm morbidity, including retinopathy of prematurity (ROP). OBJECTIVE To determine whether enteral supplementation with fatty acids from birth to 40 weeks' postmenstrual age reduces ROP in extremely preterm infants. DESIGN, SETTING, AND PARTICIPANTS The Mega Donna Mega trial, a randomized clinical trial, was a multicenter study performed at 3 university hospitals in Sweden from December 15, 2016, to December 15, 2019. The screening pediatric ophthalmologists were masked to patient groupings. A total of 209 infants born at less than 28 weeks' gestation were tested for eligibility, and 206 infants were included. Efficacy analyses were performed on as-randomized groups on the intention-to-treat population and on the per-protocol population using as-treated groups. Statistical analyses were performed from February to April 2020. INTERVENTIONS Infants received either supplementation with an enteral oil providing AA (100 mg/kg/d) and DHA (50 mg/kg/d) (AA:DHA group) or no supplementation within 3 days after birth until 40 weeks' postmenstrual age. MAIN OUTCOMES AND MEASURES The primary outcome was severe ROP (stage 3 and/or type 1). The secondary outcomes were AA and DHA serum levels and rates of other complications of preterm birth. RESULTS A total of 101 infants (58 boys [57.4%]; mean [SD] gestational age, 25.5 [1.5] weeks) were included in the AA:DHA group, and 105 infants (59 boys [56.2%]; mean [SD] gestational age, 25.5 [1.4] weeks) were included in the control group. Treatment with AA and DHA reduced severe ROP compared with the standard of care (16 of 101 [15.8%] in the AA:DHA group vs 35 of 105 [33.3%] in the control group; adjusted relative risk, 0.50 [95% CI, 0.28-0.91]; P = .02). The AA:DHA group had significantly higher fractions of AA and DHA in serum phospholipids compared with controls (overall mean difference in AA:DHA group, 0.82 mol% [95% CI, 0.46-1.18 mol%]; P < .001; overall mean difference in control group, 0.13 mol% [95% CI, 0.01-0.24 mol%]; P = .03). There were no significant differences between the AA:DHA group and the control group in the rates of bronchopulmonary dysplasia (48 of 101 [47.5%] vs 48 of 105 [45.7%]) and of any grade of intraventricular hemorrhage (43 of 101 [42.6%] vs 42 of 105 [40.0%]). In the AA:DHA group and control group, respectively, sepsis occurred in 42 of 101 infants (41.6%) and 53 of 105 infants (50.5%), serious adverse events occurred in 26 of 101 infants (25.7%) and 26 of 105 infants (24.8%), and 16 of 101 infants (15.8%) and 13 of 106 infants (12.3%) died. CONCLUSIONS AND RELEVANCE This study found that, compared with standard of care, enteral AA:DHA supplementation lowered the risk of severe ROP by 50% and showed overall higher serum levels of both AA and DHA. Enteral lipid supplementation with AA:DHA is a novel preventive strategy to decrease severe ROP in extremely preterm infants. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03201588.
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Affiliation(s)
- Ann Hellström
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders K. Nilsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Dirk Wackernagel
- Department of Neonatology, Karolinska University Hospital and Institute, Astrid Lindgrens Children’s Hospital, Stockholm, Sweden
| | - Aldina Pivodic
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mireille Vanpee
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska Univeristy Hospital, Stockholm, Sweden
| | - Ulrika Sjöbom
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Institute of Health Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hellgren
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Boubou Hallberg
- Department of Pediatrics, Institution of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet and Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Domellöf
- Institute of Cinical Science, Department of Pediatrics, Umeå University Hospital, Umeå, Sweden
| | - Susanna Klevebro
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, Sweden
| | - William Hellström
- Institute of Clinical Sciences, Sahlgrenska Academy, Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden
| | - Mats Andersson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna-My Lund
- Region Västra Götaland, Department of Neonatology, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Chatarina Löfqvist
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Institute of Health Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders Elfvin
- Institute of Clinical Sciences, Sahlgrenska Academy, Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Department of Neonatology, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karin Sävman
- Institute of Clinical Sciences, Sahlgrenska Academy, Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Department of Neonatology, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingrid Hansen-Pupp
- Department of Pediatrics, Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, Lund, Sweden
| | - Anna-Lena Hård
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lois E. H. Smith
- Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - David Ley
- Department of Pediatrics, Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, Lund, Sweden
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Carbone BE, Abouleish M, Watters KE, Vogel S, Ribic A, Schroeder OHU, Bader BM, Biederer T. Synaptic Connectivity and Cortical Maturation Are Promoted by the ω-3 Fatty Acid Docosahexaenoic Acid. Cereb Cortex 2021; 30:226-240. [PMID: 31034037 DOI: 10.1093/cercor/bhz083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 02/20/2019] [Accepted: 03/27/2019] [Indexed: 12/14/2022] Open
Abstract
Brain development is likely impacted by micronutrients. This is supported by the effects of the ω-3 fatty acid docosahexaenoic acid (DHA) during early neuronal differentiation, when it increases neurite growth. Aiming to delineate DHA roles in postnatal stages, we selected the visual cortex due to its stereotypic maturation. Immunohistochemistry showed that young mice that received dietary DHA from birth exhibited more abundant presynaptic and postsynaptic specializations. DHA also increased density and size of synapses in a dose-dependent manner in cultured neurons. In addition, dendritic arbors of neurons treated with DHA were more complex. In agreement with improved connectivity, DHA enhanced physiological parameters of network maturation in vitro, including bursting strength and oscillatory behavior. Aiming to analyze functional maturation of the cortex, we performed in vivo electrophysiological recordings from awake mice to measure responses to patterned visual inputs. Dietary DHA robustly promoted the developmental increase in visual acuity, without altering light sensitivity. The visual acuity of DHA-supplemented animals continued to improve even after their cortex had matured and DHA abolished the acuity plateau. Our findings show that the ω-3 fatty acid DHA promotes synaptic connectivity and cortical processing. These results provide evidence that micronutrients can support the maturation of neuronal networks.
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Affiliation(s)
- Beatrice E Carbone
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, USA
| | - Malik Abouleish
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, USA
| | - Katherine E Watters
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, USA
| | - Seth Vogel
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, USA
| | - Adema Ribic
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, USA
| | | | | | - Thomas Biederer
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, USA
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Maternal and child fatty acid desaturase genotype as determinants of cord blood long-chain PUFA (LCPUFA) concentrations in the Seychelles Child Development Study. Br J Nutr 2021; 126:1687-1697. [PMID: 33526157 DOI: 10.1017/s0007114521000441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Optimal maternal long-chain PUFA (LCPUFA) status is essential for the developing fetus. The fatty acid desaturase (FADS) genes are involved in the endogenous synthesis of LCPUFA. The minor allele of various FADS SNP have been associated with increased maternal concentrations of the precursors linoleic acid (LA) and α-linolenic acid (ALA), and lower concentrations of arachidonic acid (AA) and DHA. There is limited research on the influence of FADS genotype on cord PUFA status. The current study investigated the influence of maternal and child genetic variation in FADS genotype on cord blood PUFA status in a high fish-eating cohort. Cord blood samples (n 1088) collected from the Seychelles Child Development Study (SCDS) Nutrition Cohort 2 (NC2) were analysed for total serum PUFA. Of those with cord PUFA data available, maternal (n 1062) and child (n 916), FADS1 (rs174537 and rs174561), FADS2 (rs174575), and FADS1-FADS2 (rs3834458) were determined. Regression analysis determined that maternal minor allele homozygosity was associated with lower cord blood concentrations of DHA and the sum of EPA + DHA. Lower cord blood AA concentrations were observed in children who were minor allele homozygous for rs3834458 (β = 0·075; P = 0·037). Children who were minor allele carriers for rs174537, rs174561, rs174575 and rs3834458 had a lower cord blood AA:LA ratio (P < 0·05 for all). Both maternal and child FADS genotype were associated with cord LCPUFA concentrations, and therefore, the influence of FADS genotype was observed despite the high intake of preformed dietary LCPUFA from fish in this population.
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Hill NS, Cormack BE, Little BS, Bloomfield FH. Growth and Clinical Outcome in Very Low-Birth-Weight Infants After the Introduction of a Multicomponent Intravenous Lipid Emulsion. JPEN J Parenter Enteral Nutr 2020; 44:1318-1327. [PMID: 31989691 DOI: 10.1002/jpen.1750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 10/18/2019] [Accepted: 11/05/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Very low-birth-weight (VLBW; birth weight < 1500 g) infants are often dependent on intravenous nutrition after birth. Conventional soy-based intravenous lipid emulsions (Soy LE) are associated with inflammatory and metabolic complications that may be harmful to preterm infants. Evidence to support any clinical benefit associated with newer multicomponent emulsions (Mixed LE), remains inconsistent and unsubstantiated in appropriate studies. This retrospective study aimed to determine whether growth and clinical outcomes differed between VLBW infants given Mixed LE vs Soy LE at Auckland City Hospital. METHODS Data were collected on nutrition, growth, and neonatal morbidities for the first 4 weeks after birth. Outcomes were compared between 2 lipid cohorts, Soy LE (February 2013 - August 2014) and Mixed LE (August 2014 - December 2015), using univariate and multivariate analysis. RESULTS 207 infants (Soy LE, 105 vs Mixed LE, 102) were included in the study. Significantly fewer infants in the Mixed LE cohort developed any stage retinopathy of prematurity (Soy LE 59% vs Mixed LE 39%, P = .005) or intraventricular hemorrhage (Soy LE 27% vs Mixed LE 15%, P = .03) during their admission. Mixed LE was also associated with significantly lower mean (P = .01), minimum (P = .03), and maximum (P = .04) total bilirubin concentrations across the first 4 weeks after birth. There was no difference in growth velocity or weight, length, and head circumference z-score change. CONCLUSION SMOFlipid may represent a favorable alternative to conventional lipid emulsions in neonatal parenteral nutrition regimens; however, long-term effects should be further evaluated.
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Affiliation(s)
| | - Barbara E Cormack
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Newborn Services, Auckland City Hospital, Auckland, New Zealand
| | | | - Frank H Bloomfield
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Newborn Services, Auckland City Hospital, Auckland, New Zealand
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Hossain S, Hussain J, Bhowmick S, Sarkar M, Basunia M, Al Mamun A, Tanabe Y, Matsuzaki K, Hashimoto M, Shido O. Docosahexaenoic Acid (DHA, C22:6, ω-3) Composition of Milk and Mammary Gland Tissues of Lactating Mother Rats Is Severely Affected by Lead (Pb) Exposure. Biol Trace Elem Res 2020; 195:525-534. [PMID: 31463761 DOI: 10.1007/s12011-019-01878-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/19/2019] [Indexed: 12/13/2022]
Abstract
Docosahexaenoic acid (DHA, C22:6, ω-3), an ω-3 polyunsaturated fatty acid (PUFA), is critical for brain growth, development, and cognitive ability. It is consumed by offspring via milk during lactation. However, the toxic heavy metal lead (Pb) readily passes into the mammary glands of mother animals and then to offspring through milk. Here, we investigated whether DHA composition of milk and mammary gland tissues is affected by Pb exposure. Mother rats were exposed to Pb via drinking water (0.1%). The fatty acid profile and levels of reduced glutathione (GSH), lipid peroxide (LPO), and pro-inflammatory TNF-α in milk and mammary tissues were measured. Levels of DHA and antioxidant GSH decreased (P < 0.05), while LPO and TNF-α levels increased (P < 0.05) both in milk and mammary tissues. Our results suggest that toxic Pb exposure can upset the level of milk DHA, which may affect brain growth and development, and hence cognitive ability in adulthood and later life.
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Affiliation(s)
- Shahdat Hossain
- Department of Biochemistry & Molecular Biology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
| | - Jakir Hussain
- Department of Biochemistry & Molecular Biology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Sujan Bhowmick
- Department of Biochemistry & Molecular Biology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Marzan Sarkar
- Department of Biochemistry & Molecular Biology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Mafroz Basunia
- Department of Biochemistry & Molecular Biology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Abdullah Al Mamun
- Department of Environmental Physiology, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Yoko Tanabe
- Department of Environmental Physiology, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Kentaro Matsuzaki
- Department of Environmental Physiology, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Michio Hashimoto
- Department of Environmental Physiology, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Osamu Shido
- Department of Environmental Physiology, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
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9
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Wu WC, Lin HC, Liao WL, Tsai YY, Chen AC, Chen HC, Lin HY, Liao LN, Chao PM. FADS Genetic Variants in Taiwanese Modify Association of DHA Intake and Its Proportions in Human Milk. Nutrients 2020; 12:nu12020543. [PMID: 32093185 PMCID: PMC7071481 DOI: 10.3390/nu12020543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 12/13/2022] Open
Abstract
Our objective was to determine how docosahexaenoic acid (DHA) proportions in human milk are modulated by maternal FADS gene variants and dietary intake in Taiwanese women. Inclusion criteria included being healthy, 20–40 y old, having had a full-term baby that they intended to breast feed for at least 1 month, and willingness to participate in this study. Intake of DHA was assessed by food frequency questionnaire and fatty acids were analyzed in human milk samples collected 3–4 weeks postpartum. Based on multiple linear regression of data from 164 mothers that completed this study, there was 0.28% (FA%) reduction in milk DHA in high versus low genetic risk (stratified by whether minor allele numbers were ≥ 3 in rs1535 and rs174448) and 0.45% reduction in low versus high intake (stratified by whether DHA intake reached 200 mg/d). There was a significant gene–diet interaction; mothers with low genetic risk only had high milk DHA proportions with high DHA intake, whereas for mothers with high genetic risk, dietary effects were quite limited. Therefore, for FADS single nucleotide polymorphism in Taiwanese women, increasing DHA intake did not correct low milk DHA proportions in those with a high-risk genotype. Diet only conferred benefits to those with a low-risk genotype. Trial registration: This trial was retrospectively registered (Feb 12, 2019) in ClinicalTrials.gov (No. NCT03842891, https://clinicaltrials.gov/ct2/show/NCT03842891).
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Affiliation(s)
- Wen-Chieh Wu
- PhD Program for Health Science and Industry, China Medical University, Taichung 404, Taiwan;
| | - Hung-Chih Lin
- Division of Neonatology, Children’s Hospital, China Medical University, Taichung 404, Taiwan; (H.-C.L.); (H.-Y.L.)
- Asia University Hospital, Asia University, Taichung 413, Taiwan
- School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Wen-Ling Liao
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404, Taiwan;
- Center for Personalized Medicine, China Medical University Hospital, Taichung 404, Taiwan
| | | | - An-Chyi Chen
- Division of Pediatric Hepatology and Gastroenterology, Children’s Hospital, China Medical University, Taichung 404, Taiwan;
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | | | - Hsiang-Yu Lin
- Division of Neonatology, Children’s Hospital, China Medical University, Taichung 404, Taiwan; (H.-C.L.); (H.-Y.L.)
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Li-Na Liao
- Department of Public Health, China Medical University, Taichung 404, Taiwan
- Correspondence: (L.-N.L.); (P.-M.C.); Tel.: (+886)-4-22053366 (ext. 7509) (P.-M.C.); Fax: (+886)-4-22062891 (P.-M.C.)
| | - Pei-Min Chao
- PhD Program for Health Science and Industry, China Medical University, Taichung 404, Taiwan;
- Department of Nutrition, China Medical University, Taichung 404, Taiwan
- Correspondence: (L.-N.L.); (P.-M.C.); Tel.: (+886)-4-22053366 (ext. 7509) (P.-M.C.); Fax: (+886)-4-22062891 (P.-M.C.)
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10
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Hsiao WT, Su HM, Su KP, Chen SH, Wu HP, You YL, Fu RH, Chao PM. Deficiency or activation of peroxisome proliferator-activated receptor α reduces the tissue concentrations of endogenously synthesized docosahexaenoic acid in C57BL/6J mice. Nutr Res Pract 2019; 13:286-294. [PMID: 31388404 PMCID: PMC6669072 DOI: 10.4162/nrp.2019.13.4.286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/12/2019] [Accepted: 04/02/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND/OBJECTIVES Docosahexaenoic acid (DHA), an n-3 long chain polyunsaturated fatty acid (LCPUFA), is acquired by dietary intake or the in vivo conversion of α-linolenic acid. Many enzymes participating in LCPUFA synthesis are regulated by peroxisome proliferator-activated receptor alpha (PPARα). Therefore, it was hypothesized that the tissue accretion of endogenously synthesized DHA could be modified by PPARα. MATERIALS/METHODS The tissue DHA concentrations and mRNA levels of genes participating in DHA biosynthesis were compared among PPARα homozygous (KO), heterozygous (HZ), and wild type (WT) mice (Exp I), and between WT mice treated with clofibrate (PPARα agonist) or those not treated (Exp II). In ExpII, the expression levels of the proteins associated with DHA function in the brain cortex and retina were also measured. An n3-PUFA depleted/replenished regimen was applied to mitigate the confounding effects of maternal DHA. RESULTS PPARα ablation reduced the hepatic Acox, Fads1, and Fads2 mRNA levels, as well as the DHA concentration in the liver, but not in the brain cortex. In contrast, PPARα activation increased hepatic Acox, Fads1, Fads2 and Elovl5 mRNA levels, but reduced the DHA concentrations in the liver, retina, and phospholipid of brain cortex, and decreased mRNA and protein levels of the brain-derived neurotrophic factor in brain cortex. CONCLUSIONS LCPUFA enzyme expression was altered by PPARα. Either PPARα deficiency or activation-decreased tissue DHA concentration is a stimulus for further studies to determine the functional significance.
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Affiliation(s)
- Wen-Ting Hsiao
- Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan
| | - Hui-Min Su
- Graduate Institute of Physiology, National Taiwan University, Taipei 100, Taiwan
| | - Kuan-Pin Su
- Department of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
| | - Szu-Han Chen
- Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan
| | - Hai-Ping Wu
- Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan
| | - Yi-Ling You
- Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan
| | - Ru-Huei Fu
- Graduate Institute of Immunology, China Medical University, Taichung 404, Taiwan
| | - Pei-Min Chao
- Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan
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11
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Thakkar SK, De Castro CA, Beauport L, Tolsa JF, Fischer Fumeaux CJ, Affolter M, Giuffrida F. Temporal Progression of Fatty Acids in Preterm and Term Human Milk of Mothers from Switzerland. Nutrients 2019; 11:nu11010112. [PMID: 30626044 PMCID: PMC6356418 DOI: 10.3390/nu11010112] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/18/2018] [Accepted: 12/25/2018] [Indexed: 01/20/2023] Open
Abstract
We longitudinally compared fatty acids (FA) from human milk (HM) of mothers delivering term and preterm infants. HM was collected for 4 months postpartum at 12 time points for preterm and for 2 months postpartum at 8 time points for term group. Samples were collected from the first feed of the morning, and single breast was fully expressed. FA were analyzed by gas chromatography coupled with flame ionization detector. Oleic, palmitic and linoleic acids were the most abundant FA across lactation and in both groups. Preterm colostrum contained significantly (p < 0.05) higher 8:0, 10:0, 12:0, sum medium chain fatty acids (MCFA), 18:3 n-3 FA compared to term counterparts. Preterm mature milk contained significantly higher 12:0, 14:0, 18:2 n-6, sum saturated fatty acids (SFA), and sum MCFA. We did not observe any significant differences between the preterm and term groups for docosahexaenoic acid, arachidonic acid and eicosapentaenoic acid at any stage of lactation. Overall, preterm milk was higher for SFA with a major contribution from MCFA and higher in 18:2 n-6. These observational differences needs to be studied further for their implications on preterm developmental outcomes and on fortification strategies of either mothers’ own milk or donor human milk.
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Affiliation(s)
- Sagar K Thakkar
- Nestlé Institute of Health Sciences, Nestlé Research, Lausanne 1000, Switzerland.
| | | | - Lydie Beauport
- Clinic of Neonatology, Department Woman Mother Child, University Hospital of Lausanne, Lausanne 1011, Switzerland.
| | - Jean-François Tolsa
- Clinic of Neonatology, Department Woman Mother Child, University Hospital of Lausanne, Lausanne 1011, Switzerland.
| | - Céline J Fischer Fumeaux
- Clinic of Neonatology, Department Woman Mother Child, University Hospital of Lausanne, Lausanne 1011, Switzerland.
| | - Michael Affolter
- Nestlé Institute of Food Safety & Analytical Science, Nestlé Research, Lausanne 1000, Switzerland.
| | - Francesca Giuffrida
- Nestlé Institute of Food Safety & Analytical Science, Nestlé Research, Lausanne 1000, Switzerland.
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12
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Cimatti AG, Martini S, Munarini A, Zioutas M, Vitali F, Aceti A, Mantovani V, Faldella G, Corvaglia L. Maternal Supplementation With Krill Oil During Breastfeeding and Long-Chain Polyunsaturated Fatty Acids (LCPUFAs) Composition of Human Milk: A Feasibility Study. Front Pediatr 2018; 6:407. [PMID: 30622936 PMCID: PMC6308297 DOI: 10.3389/fped.2018.00407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 12/07/2018] [Indexed: 01/27/2023] Open
Abstract
Background: Docosahexaenoic acid (DHA) is a major constituent of neuronal and retinal membranes and plays a crucial role in brain and visual development within the first months of life. Dietary intakes are fundamental to provide neonates with adequate DHA supply; hence, maternal supplementation might represent a useful strategy to implement DHA contents in breast milk (BM), with possible benefits on neonatal neurodevelopment. Antarctic krill is a small crustacean rich in highly available phospholipid-bound DHA. This pilot study aimed to evaluate whether maternal supplementation with krill oil during breastfeeding increases long-chain polyunsaturated fatty acids (LCPUFAs) BM contents. Methods: Mothers of infants admitted to the Neonatal Intensive Care Unit were enrolled in this open, randomized-controlled study between 4 and 6 weeks after delivery and randomly allocated in 2 groups. Group 1 received an oral krill oil-based supplement providing 250 mg/day of DHA and 70 mg/day of eicosapentaenoic acid (EPA) for 30 days; group 2 served as control. BM samples from both groups were collected at baseline (T0) and day 30 (T1) and underwent a qualitative analysis of LCPUFAs composition by gas chromatography/mass spectrometry. Results: Sixteen breastfeeding women were included. Of these, 8 received krill-oil supplementation and 8 were randomized to the control group. Baseline percentage values of DHA (%DHA), arachidonic acid (%AA), and EPA (%EPA) did not differ between groups. A significant increase in %DHA (T0: median 0.23% [IQR 0.19;0.38], T1:0.42% [0.32;0.49], p 0.012) and %EPA (T0: median 0.10% [IQR 0.04;0.11], T1:0.11% [0.04;0.15], p 0.036) and a significant reduction in %AA (T0: median 0.48% [IQR 0.42;0.75], T1:0.43% [0.38;0.61], p 0.017) between T0 and T1 occurred in Group 1, whereas no difference was seen in Group 2. Consistently, a significant between-group difference was observed in percentage changes from baseline of DHA (Δ%DHA, group 1: median 64.2% [IQR 27.5;134.6], group 2: -7.8% [-12.1;-3.13], p 0.025) and EPA (Δ%EPA, group 1: median 39% [IQR 15.7;73.4]; group 2: -25.62% [-32.7;-3.4], p 0.035). Conclusions: Oral krill oil supplementation effectively increases DHA and EPA contents in BM. Potential benefits of this strategy on brain and visual development in breastfed preterm neonates deserve further evaluation in targeted studies. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03583502.
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Affiliation(s)
- Anna Giulia Cimatti
- Neonatal Intensive Care Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Silvia Martini
- Neonatal Intensive Care Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alessandra Munarini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Department of Clinical Medicine, Center of Applied Biochemical Research, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Maximilano Zioutas
- Pediatric Endocrinology, Department of Pediatrics, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Francesca Vitali
- Neonatal Intensive Care Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Arianna Aceti
- Neonatal Intensive Care Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Vilma Mantovani
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Department of Clinical Medicine, Center of Applied Biochemical Research, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Giacomo Faldella
- Neonatal Intensive Care Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Luigi Corvaglia
- Neonatal Intensive Care Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
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13
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Smith SL, Rouse CA. Docosahexaenoic acid and the preterm infant. Matern Health Neonatol Perinatol 2017; 3:22. [PMID: 29238605 PMCID: PMC5725938 DOI: 10.1186/s40748-017-0061-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/24/2017] [Indexed: 12/20/2022] Open
Abstract
Docosahexaenoic acid (DHA) is a long chain poly-unsaturated fatty acid (LCPUFA) that has a role in the cognitive and visual development, as well as in the immune function of newborns. Premature infants are typically deficient in DHA for several reasons, to include fetal accretion of DHA that typically occurs during the third trimester. These premature infants are reliant on enteral sources of DHA, most commonly through breast milk. The DHA content in breast milk varies in direct correlation with maternal DHA intake and mothers consuming a Western diet typically have lower levels of DHA in their breast milk. Maternal DHA supplementation and direct supplementation of DHA to the infant has been tried successfully but there are still conflicting results on the optimal dosage and method of delivery of DHA to the infant. This has led to inconsistent results in trials evaluating the effects of DHA supplementation to the preterm infant in terms of cognitive and immunological outcomes. While short-term benefits have been seen in several studies, long-term benefits are not consistent. Future studies continue to be needed to optimize DHA intake in our premature infants.
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Affiliation(s)
- Stephanie L Smith
- Uniformed Services University of Health Sciences, 4301 Jones Bridge, Bethesda, MD 20814 USA
| | - Christopher A Rouse
- Uniformed Services University of Health Sciences, 4301 Jones Bridge, Bethesda, MD 20814 USA.,Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20814 USA
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14
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Abstract
EPA and DHA appear to be the most important n-3 fatty acids, but roles for n-3 docosapentaenoic acid are now also emerging. Intakes of EPA and DHA are usually low, typically below those recommended. Increased intakes result in higher concentrations of EPA and DHA in blood lipids, cells and tissues. Increased content of EPA and DHA modifies the structure of cell membranes and the function of membrane proteins. EPA and DHA modulate the production of lipid mediators and through effects on cell signalling can alter the patterns of gene expression. Through these mechanisms, EPA and DHA alter cell and tissue responsiveness in a way that often results in more optimal conditions for growth, development and maintenance of health. DHA has vital roles in brain and eye development and function. EPA and DHA have a wide range of physiological roles, which are linked to certain health or clinical benefits, particularly related to CVD, cancer, inflammation and neurocognitive function. The benefits of EPA and DHA are evident throughout the life course. Future research will include better identification of the determinants of variation of responses to increased intake of EPA and DHA; more in-depth dose-response studies of the effects of EPA and DHA; clearer identification of the specific roles of EPA, docosapentaenoic acid and DHA; testing strategies to enhance delivery of n-3 fatty acids to the bloodstream; and exploration of sustainable alternatives to fish-derived very long-chain n-3 fatty acids.
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15
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Abstract
Improving maternal and child nutrition is central to global development goals and reducing the noncommunicable disease burden. Although the process of becoming malnourished starts in utero, the consequences of poor nutrition extend across the life cycle and into future generations. The global nutrition targets for 2025 include reducing infant and young child growth faltering, halting the increase of overweight children, improving breastfeeding practices, and reducing maternal anemia. In this review, we address nutritional assessment, discuss nonnutritive factors that affect growth, and endorse the evidence-based interventions that should be scaled up to improve maternal and child nutrition.
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16
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Turner JM, Sauvé Y, Suh M, Wales PW, Wizzard P, Goruk S, Field CJ. A Third-Generation Lipid Emulsion that Contains n-3 Long-Chain PUFAs Preserves Retinal Function in Parenterally Fed Neonatal Piglets. J Nutr 2016; 146:2260-2266. [PMID: 27733528 DOI: 10.3945/jn.116.237669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/12/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Preterm neonates and those with intestinal failure require prolonged parenteral nutrition (PN) during a critical time of early central nervous system maturation. Conventional lipid emulsions fed to preterm neonates lack n-3 (ω-3) long-chain polyunsaturated fatty acids (LC-PUFAs; >20 carbon chain in length). Recently, fish oil lipid emulsions have been developed that provide both n-6 (ω-6) and n-3 LC-PUFAs, precursors of very long-chain PUFAs (VLC-PUFAs; >24 carbon chain in length). OBJECTIVE Our objective was to determine the effect of fish oil lipid on retinal function in neonatal piglets fed total PN with the use of the lipid emulsions available in clinical practice. We hypothesized that fish oil-containing parenteral lipid would preserve retinal function more than conventional parenteral lipid. METHODS Male neonatal piglets (2-5 d of age) were fed isonitrogenous (16 g · kg-1 · d-1), isocaloric (1.1 MJ · kg-1 · d-1) PN that varied only in the lipid emulsion: Intralipid or SMOFlipid at 10 g · kg-1 · d-1 (n = 8/group). Retinal function was assessed after 14 d of treatment by recording electroretinograms under various light intensity conditions. Retinas were then harvested for histology and to determine fatty acid composition. RESULTS Electroretinogram intensity response curves showed greater photoreceptor a-wave amplitude in piglets fed SMOFlipid than in those fed Intralipid (percentage), for postsynaptic depolarizing bipolar cell b-waves (percentage) and for flicker electroretinogram amplitudes (percentage) (P < 0.05). Compared with those fed Intralipid, SMOFlipid-fed piglets had greater retinal total n-3 LC-PUFAs (15.7% compared with 18.4%; P = 0.04) and n-3 VLC-PUFAs (0.9% compared with 1.5%; P = 0.02), whereas Intralipid-fed piglets had greater total n-6 LC-PUFAs (13.1% compared with 10.5%; P < 0.01) and n-6 VLC-PUFAs (0.7% compared with 0.5%; P = 0.01). Histologically, retinas were indistinguishable between groups. CONCLUSIONS In a neonatal piglet model of PN feeding, the inclusion of fish oil-based n-3 LC-PUFAs in the lipid emulsion leads to their accretion and endogenous elongation to VLC-PUFAs in the retina, which is associated with better retinal function.
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Affiliation(s)
| | - Yves Sauvé
- Department of Ophthalmology and Visual Sciences, and.,Department of Physiology, University of Alberta, Edmonton, Canada
| | - Miyoung Suh
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada
| | - Paul W Wales
- Department of Pediatrics.,Department of Pediatric Surgery, Hospital for Sick Children, Toronto, Canada; and.,Research Institute, University of Toronto, Toronto, Canada
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17
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Elkin RG, Ying Y, Fan Y, Harvatine KJ. Influence of feeding stearidonic acid (18:4n-3)-enriched soybean oil, as compared to conventional soybean oil, on tissue deposition of very long-chain omega-3 fatty acids in meat-type chickens. Anim Feed Sci Technol 2016. [DOI: 10.1016/j.anifeedsci.2016.04.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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18
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An updated review of worldwide levels of docosahexaenoic and arachidonic acid in human breast milk by region. Public Health Nutr 2016; 19:2675-87. [PMID: 27056340 DOI: 10.1017/s1368980016000707] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE We aimed to evaluate the DHA and arachidonic acid (AA) levels in human breast milk worldwide by country, region and socio-economic status. DESIGN Descriptive review conducted on English publications reporting breast-milk DHA and AA levels. SETTING We systematically searched and identified eligible literature in PubMed from January 1980 to July 2015. Data on breast-milk DHA and AA levels from women who had given birth to term infants were included. SUBJECTS Seventy-eight studies from forty-one countries were included with 4163 breast-milk samples of 3746 individuals. RESULTS Worldwide mean levels of DHA and AA in breast milk were 0·37 (sd 0·11) % and 0·55 (sd 0·14) % of total fatty acids, respectively. The breast-milk DHA levels from women with accessibility to marine foods were significantly higher than those from women without accessibility (0·35 (sd 0·20) % v. 0·25 (sd 0·14) %, P<0·05). Data from the Asian region showed the highest DHA concentration but much lower AA concentration in breast milk compared with all other regions, independent of accessibility to marine foods. Comparison was made among Canada, Poland and Japan - three typical countries (each with sample size of more than 100 women) from different regions but all with high income and similar accessibility to fish/marine foods. CONCLUSIONS The current review provides an update on worldwide variation in breast-milk DHA and AA levels and underlines the need for future population- or region-specific investigations.
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19
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De Velasco PC, Sandre PC, Tavares Do Carmo MG, Faria-Melibeu AC, Campello-Costa P, Ferraz AC, Andrade Da Costa BLS, Serfaty CA. A critical period for omega-3 nutritional supplementation in the development of the rodent visual system. Brain Res 2015; 1615:106-115. [PMID: 25916576 DOI: 10.1016/j.brainres.2015.04.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/12/2015] [Accepted: 04/18/2015] [Indexed: 10/23/2022]
Abstract
Retinocollicular connections form precise topographical maps that are normally completed through the selective elimination of misplaced axons and the stabilization of topographically ordered axon terminals during early development. Omega-3 fatty acids, acquired exclusively through the diet, and its main metabolite, docosahexaenoic acid (DHA), are involved in brain development and synaptic maturation. We have previously shown that the nutritional restriction of omega-3/DHA results in abnormal retinocollicular topographical fine-tuning. Therefore, we studied the role of omega-3 fatty acids nutritional supplementation and the developmental time windows during which this postnatal supplementation would restore normal topographical maps in the visual system. Female rats and their litters were chronically fed with either control (soy oil) or restricted omega-3 (coconut oil) diets. Fish oil supplementation was introduced between either postnatal day (PND) 7-13, PND7-28 or PND21-42. At PND13, PND28 or PND42, animals received an anterograde eye injection of a neuronal tracer to visualize retinocollicular axons. Confirming previous observations we found that an omega-3/DHA deficiency resulted in an abnormally high innervation density of retinal axons at the visual layers of the superior colliculus (SC). Although a short-term fish oil supplementation between PND7-13 could not restore normal retinocollicular topography, an extended treatment between PND7-28 completely recovered normal innervation densities of retinotectal axons. However, a late onset supplementation protocol, between PND28-42, was no longer effective in the restoration of the abnormal topographical pattern induced by an early omega-3 nutritional malnutrition. The results suggest a critical period for omega3/DHA dietary intake for the proper development of visual topographical maps.
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Affiliation(s)
- P C De Velasco
- Departamento de Neurobiologia, Universidade Federal Fluminense, Niterói, Brazil; Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Brazil
| | - P C Sandre
- Departamento de Neurobiologia, Universidade Federal Fluminense, Niterói, Brazil
| | - M G Tavares Do Carmo
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Brazil
| | - A C Faria-Melibeu
- Departamento de Neurobiologia, Universidade Federal Fluminense, Niterói, Brazil
| | - P Campello-Costa
- Departamento de Neurobiologia, Universidade Federal Fluminense, Niterói, Brazil
| | - A C Ferraz
- Departamento de Fisiologia, Universidade Federal do Paraná, Curitiba, Curitiba, Brazil
| | | | - C A Serfaty
- Departamento de Neurobiologia, Universidade Federal Fluminense, Niterói, Brazil.
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20
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Molloy CS, Anderson PJ, Anderson VA, Doyle LW. The long-term outcome of extremely preterm (<28 weeks’ gestational age) infants with and without severe retinopathy of prematurity. J Neuropsychol 2015; 10:276-94. [DOI: 10.1111/jnp.12069] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/24/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Carly S. Molloy
- Murdoch Childrens Research Institute; Melbourne Victoria Australia
| | - Peter J. Anderson
- Murdoch Childrens Research Institute; Melbourne Victoria Australia
- University of Melbourne; Victoria Australia
- Royal Women's Hospital; Melbourne Victoria Australia
| | - Vicki A. Anderson
- Murdoch Childrens Research Institute; Melbourne Victoria Australia
- University of Melbourne; Victoria Australia
- Royal Children's Hospital; Melbourne Victoria Australia
| | - Lex W. Doyle
- Murdoch Childrens Research Institute; Melbourne Victoria Australia
- University of Melbourne; Victoria Australia
- Royal Women's Hospital; Melbourne Victoria Australia
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21
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Elkin RG, Ying Y, Harvatine KJ. Feeding laying hens stearidonic acid-enriched soybean oil, as compared to flaxseed oil, more efficiently enriches eggs with very long-chain n-3 polyunsaturated fatty acids. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2015; 63:2789-97. [PMID: 25756744 DOI: 10.1021/jf505185u] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The desaturation of α-linolenic acid (ALA) to stearidonic acid (SDA) is considered to be rate-limiting for the hepatic conversion of ALA to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in humans, rodents, and chickens. Thus, we hypothesized that feeding laying hens SDA, as a component of the oil derived from the genetic modification of the soybean, would bypass this inefficient metabolic step and result in the enrichment of eggs with EPA and DHA at amounts comparable to that achieved by direct supplementation of hens' diet with these very long-chain (VLC) n-3 polyunsaturated fatty acids (PUFAs). In a 28-d study, laying hens incorporated 0.132 mg, 0.041 mg, or 0.075 mg of VLC n-3 PUFAs into egg yolk for each milligram of ingested dietary ALA derived primarily from conventional soybean oil (CON), dietary ALA derived primarily from flaxseed oil (FLAX), or dietary SDA derived from SDA-enriched soybean oil, respectively. Moreover, the amounts of total yolk VLC n-3 PUFAs in eggs from hens fed the CON (51 mg), FLAX (91 mg), or SDA (125 mg) oils were markedly less than the 305 mg found in eggs from fish oil-fed hens. Unexpectedly, SDA appeared to be more readily incorporated into adipose tissue than into egg yolk. Since egg yolk FAs typically reflect the hens' dietary pattern, these tissue-specific differences suggest the existence of an alternate pathway for the hepatic secretion and transport of SDA in the laying hen.
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Affiliation(s)
- Robert G Elkin
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Yun Ying
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Kevin J Harvatine
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
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Affiliation(s)
- Philip C. Calder
- Human Development and Health Academic Unit, Faculty of Medicine; University of Southampton; Southampton United Kingdom
- NIHR Southampton Biomedical Research Centre; University Hospital Southampton NHS Foundation Trust and University of Southampton; Southampton United Kingdom
- Department of Biological Sciences; Faculty of Science, King Abdulaziz University; Jeddah Saudi Arabia
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23
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Cartier C, Muckle G, Jacobson SW, Jacobson JL, Dewailly É, Ayotte P, Chevrier C, Saint-Amour D. Prenatal and 5-year p,p′-DDE exposures are associated with altered sensory processing in school-aged children in Nunavik: A visual evoked potential study. Neurotoxicology 2014; 44:8-16. [DOI: 10.1016/j.neuro.2014.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 04/26/2014] [Accepted: 04/26/2014] [Indexed: 12/27/2022]
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24
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Lin W, Wu FW, Yue L, Du QG, Tian L, Wang ZX. Combination of Urea Complexation and Molecular Distillation to Purify DHA and EPA from Sardine Oil Ethyl Esters. J AM OIL CHEM SOC 2014. [DOI: 10.1007/s11746-013-2402-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Beken S, Dilli D, Fettah ND, Kabataş EU, Zenciroğlu A, Okumuş N. The influence of fish-oil lipid emulsions on retinopathy of prematurity in very low birth weight infants: a randomized controlled trial. Early Hum Dev 2014; 90:27-31. [PMID: 24314586 DOI: 10.1016/j.earlhumdev.2013.11.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/07/2013] [Accepted: 11/16/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the effect of two lipid emulsions on the development of retinopathy of prematurity in very low birth weight infants. DESIGN Randomized controlled study. PATIENTS AND METHODS Eighty very low birth weight infants receiving parenteral nutrition from the first day of life were evaluated. One of the two lipid emulsions were used in the study infants: Group 1 (n=40) received fish-oil based lipid emulsion (SmofLipid®) and Group 2 (n=40) soybean oil based lipid emulsion (Intralipid®). MAIN OUTCOME MEASURES The development of retinopathy of prematurity and the need for laser photocoagulation were assessed. RESULTS The maternal and perinatal characteristics were similar in both groups. The median (range) duration of parenteral nutrition [14days (10-28) vs 14 (10-21)] and hospitalization [34days (20-64) vs 34 (21-53)] did not differ between the groups. Laboratory data including complete blood count, triglyceride level, liver and kidney function tests recorded before and after parenteral nutrition also did not differ between the two groups. In Group 1, two patients (5.0%) and in Group 2, 13 patients (32.5%) were diagnosed with retinopathy of prematurity (OR: 9.1, 95% CI 1.9-43.8, p=0.004). One patient in each group needed laser photocoagulation, without significant difference. Multivariate analysis showed that only receiving fish-oil emulsion in parenteral nutrition decreased the risk of development of retinopathy of prematurity [OR: 0.76, 95% CI (0.06-0.911), p=0.04]. CONCLUSIONS Premature infants with very low birth weight receiving an intravenous fat emulsion containing fish oil developed less retinopathy of prematurity.
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Affiliation(s)
- Serdar Beken
- Neonatal Intensive Care Unit, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey.
| | - Dilek Dilli
- Neonatal Intensive Care Unit, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Nurdan Dinlen Fettah
- Neonatal Intensive Care Unit, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Emrah Utku Kabataş
- Pediatric Ophthalmology Unit, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Ayşegül Zenciroğlu
- Neonatal Intensive Care Unit, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Nurullah Okumuş
- Neonatal Intensive Care Unit, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
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26
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Heaton AE, Meldrum SJ, Foster JK, Prescott SL, Simmer K. Does docosahexaenoic acid supplementation in term infants enhance neurocognitive functioning in infancy? Front Hum Neurosci 2013; 7:774. [PMID: 24312040 PMCID: PMC3834239 DOI: 10.3389/fnhum.2013.00774] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 10/27/2013] [Indexed: 01/06/2023] Open
Abstract
The proposal that dietary docosahexaenoic acid (DHA) enhances neurocognitive functioning in term infants is controversial. Theoretical evidence, laboratory research and human epidemiological studies have convincingly demonstrated that DHA deficiency can negatively impact neurocognitive development. However, the results from randomized controlled trials (RCTs) of DHA supplementation in human term-born infants have been inconsistent. This article will (i) discuss the role of DHA in the human diet, (ii) explore the physiological mechanisms by which DHA plausibly influences neurocognitive capacity, and (iii) seek to characterize the optimal intake of DHA during infancy for neurocognitive functioning, based on existing research that has been undertaken in developed countries (specifically, within Australia). The major observational studies and RCTs that have examined dietary DHA in human infants and animals are presented, and we consider suggestions that DHA requirements vary across individuals according to genetic profile. It is important that the current evidence concerning DHA supplementation is carefully evaluated so that appropriate recommendations can be made and future directions of research can be strategically planned.
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Affiliation(s)
- Alexandra E. Heaton
- School of Paediatrics and Child Health, University of Western AustraliaPerth, WA, Australia
| | - Suzanne J. Meldrum
- School of Paediatrics and Child Health, University of Western AustraliaPerth, WA, Australia
| | - Jonathan K. Foster
- School of Paediatrics and Child Health, University of Western AustraliaPerth, WA, Australia
- School of Psychology and Speech Pathology, Curtin Health Innovation Research Institute, Curtin UniversityPerth, WA, Australia
- Neurosciences Unit, Western Australia Department of HealthPerth, WA, Australia
- Telethon Institute for Child Health ResearchPerth, WA, Australia
| | - Susan L. Prescott
- School of Paediatrics and Child Health, University of Western AustraliaPerth, WA, Australia
- Telethon Institute for Child Health ResearchPerth, WA, Australia
| | - Karen Simmer
- School of Paediatrics and Child Health, University of Western AustraliaPerth, WA, Australia
- Telethon Institute for Child Health ResearchPerth, WA, Australia
- Centre for Neonatal Research and Education, University of Western AustraliaPerth, WA, Australia
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