1
|
Embleton ND, Jennifer Moltu S, Lapillonne A, van den Akker CHP, Carnielli V, Fusch C, Gerasimidis K, van Goudoever JB, Haiden N, Iacobelli S, Johnson MJ, Meyer S, Mihatsch W, de Pipaon MS, Rigo J, Zachariassen G, Bronsky J, Indrio F, Köglmeier J, de Koning B, Norsa L, Verduci E, Domellöf M. Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts. J Pediatr Gastroenterol Nutr 2023; 76:248-268. [PMID: 36705703 DOI: 10.1097/mpg.0000000000003642] [Citation(s) in RCA: 67] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To review the current literature and develop consensus conclusions and recommendations on nutrient intakes and nutritional practice in preterm infants with birthweight <1800 g. METHODS The European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee of Nutrition (CoN) led a process that included CoN members and invited experts. Invited experts with specific expertise were chosen to represent as broad a geographical spread as possible. A list of topics was developed, and individual leads were assigned to topics along with other members, who reviewed the current literature. A single face-to-face meeting was held in February 2020. Provisional conclusions and recommendations were developed between 2020 and 2021, and these were voted on electronically by all members of the working group between 2021 and 2022. Where >90% consensus was not achieved, online discussion meetings were held, along with further voting until agreement was reached. RESULTS In general, there is a lack of strong evidence for most nutrients and topics. The summary paper is supported by additional supplementary digital content that provide a fuller explanation of the literature and relevant physiology: introduction and overview; human milk reference data; intakes of water, protein, energy, lipid, carbohydrate, electrolytes, minerals, trace elements, water soluble vitamins, and fat soluble vitamins; feeding mode including mineral enteral feeding, feed advancement, management of gastric residuals, gastric tube placement and bolus or continuous feeding; growth; breastmilk buccal colostrum, donor human milk, and risks of cytomegalovirus infection; hydrolyzed protein and osmolality; supplemental bionutrients; and use of breastmilk fortifier. CONCLUSIONS We provide updated ESPGHAN CoN consensus-based conclusions and recommendations on nutrient intakes and nutritional management for preterm infants.
Collapse
Affiliation(s)
| | | | | | - Chris H P van den Akker
- the Department of Pediatrics - Neonatology, Amsterdam UMC - Emma Children's Hospital, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Virgilio Carnielli
- Polytechnic University of Marche and Division of Neonatology, Ospedali Riuniti, Ancona, Ancona, Italy
| | - Christoph Fusch
- the Department of Pediatrics, Nuremberg General Hospital, Paracelsus Medical School, Nuremberg, Germany
- the Division of Neonatology, Department of Pediatrics, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Konstantinos Gerasimidis
- the Human Nutrition, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Johannes B van Goudoever
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Nadja Haiden
- the Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Silvia Iacobelli
- the Réanimation Néonatale et Pédiatrique, Néonatologie - CHU La Réunion, Saint-Pierre, France
| | - Mark J Johnson
- the Department of Neonatal Medicine, University Hospital Southampton NHS Trust, Southampton, UK
- the National Institute for Health Research Biomedical Research Centre Southampton, University Hospital Southampton NHS Trust and University of Southampton, Southampton, UK
| | - Sascha Meyer
- the Department of General Paediatrics and Neonatology, University Hospital of Saarland, Homburg, Germany
| | - Walter Mihatsch
- the Department of Pediatrics, Ulm University, Ulm, Germany
- the Department of Health Management, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Miguel Saenz de Pipaon
- the Department of Pediatrics-Neonatology, La Paz University Hospital, Autonoma University of Madrid, Madrid, Spain
| | - Jacques Rigo
- the Neonatal Unit, University of Liège, CHR Citadelle, Liège, Belgium
| | - Gitte Zachariassen
- H.C. Andersen Children's Hospital, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Jiri Bronsky
- the Department of Paediatrics, University Hospital Motol, Prague, Czech Republic
| | - Flavia Indrio
- the Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Jutta Köglmeier
- the Department of Paediatric Gastroenterology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Barbara de Koning
- the Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Lorenzo Norsa
- the Paediatric Hepatology, Gastroenterology and Transplantation, ASST Papa Giovanni XXIIII, Bergamo, Italy
| | - Elvira Verduci
- the Department of Health Sciences, University of Milan, Milan, Italy
- the Department of Paediatrics, Ospedale dei Bambini Vittore Buzzi, Milan, Italy
| | - Magnus Domellöf
- the Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden
| |
Collapse
|
2
|
Kiełbasa A, Buszewski B, Gadzała-Kopciuch R. A novel non-derivatization HPLC/UV method for the determination of some n-3 free fatty acids in breast milk matrix. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
3
|
Khalid W, Gill P, Arshad MS, Ali A, Ranjha MMAN, Mukhtar S, Afzal F, Maqbool Z. Functional behavior of DHA and EPA in the formation of babies brain at different stages of age, and protect from different brain-related diseases. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2022. [DOI: 10.1080/10942912.2022.2070642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Waseem Khalid
- Department of Food Science, Government College University, Faisalabad, Pakistan
| | - Poonam Gill
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | | | - Anwar Ali
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, China
| | | | - Shanza Mukhtar
- Department of Nutrition and Dietetics, The University of Faisalabad, Pakistan
| | - Fareed Afzal
- Department of Food Science, Government College University, Faisalabad, Pakistan
| | - Zahra Maqbool
- Department of Food Science, Government College University, Faisalabad, Pakistan
| |
Collapse
|
4
|
Kiełbasa A, Gadzała-Kopciuch R, Buszewski B. Cytokines-Biogenesis and Their Role in Human Breast Milk and Determination. Int J Mol Sci 2021; 22:6238. [PMID: 34207900 PMCID: PMC8229712 DOI: 10.3390/ijms22126238] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 12/13/2022] Open
Abstract
Cytokines play a huge role in many biological processes. Their production, release and interactions are subject to a very complex mechanism. Cytokines are produced by all types of cells, they function very differently and they are characterized by synergism in action, antagonism, and aggregation activity, opposing action of one cytokine, overlapping activity, induction of another cytokine, inhibition of cytokine synthesis at the mRNA level as well as autoregulation-stimulation or inhibition of own production. The predominance of pro-inflammatory cytokines leads to a systemic inflammatory response, and anti-inflammatory-to an anti-inflammatory response. They regulate the organism's immune response and protect it against sudden disturbances in homeostasis. The synthesis and activity of cytokines are influenced by the central nervous system through the endocrine system (pituitary gland, adrenal glands).
Collapse
Affiliation(s)
- Anna Kiełbasa
- Department of Environmental Chemistry and Bioanalysis, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, ul. Gagarina 7, 87-100 Toruń, Poland; (A.K.); (B.B.)
| | - Renata Gadzała-Kopciuch
- Department of Environmental Chemistry and Bioanalysis, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, ul. Gagarina 7, 87-100 Toruń, Poland; (A.K.); (B.B.)
- Interdisciplinary Centre of Modern Technologies, Group for Separation and Bioanalytical Methods (Bio-Sep) Nicolaus Copernicus University in Toruń, ul. Wileńska 4, 87-100 Toruń, Poland
| | - Bogusław Buszewski
- Department of Environmental Chemistry and Bioanalysis, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, ul. Gagarina 7, 87-100 Toruń, Poland; (A.K.); (B.B.)
- Interdisciplinary Centre of Modern Technologies, Group for Separation and Bioanalytical Methods (Bio-Sep) Nicolaus Copernicus University in Toruń, ul. Wileńska 4, 87-100 Toruń, Poland
| |
Collapse
|
5
|
Picó C, Reis F, Egas C, Mathias P, Matafome P. Lactation as a programming window for metabolic syndrome. Eur J Clin Invest 2021; 51:e13482. [PMID: 33350459 DOI: 10.1111/eci.13482] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022]
Abstract
The concept of developmental origins of health and disease (DOHaD) was initially supported by the low birth weight and higher risk of developing cardiovascular disease in adult life, caused by nutrition restriction during foetal development. However, other programming windows have been recognized in the last years, namely lactation, infancy, adolescence and even preconception. Although the concept has been developed in order to study the impact of foetal calorie restriction in adult life, it is now recognized that maternal overweight during programming windows is also harmful to the offspring. This article explores and summarizes the current knowledge about the impact of maternal obesity and obesogenic diets during lactation in the metabolic programming towards the development of metabolic syndrome in the adult life. The impact of maternal obesity and obesogenic diets in milk quality is discussed, including the alterations in specific micro and macronutrients, as well as the impact of such alterations in the development of metabolic syndrome-associated features in the newborn, such as insulin resistance and adiposity. Moreover, the impact of milk quality and formula feeding in infants' gut microbiota, immune system maturation and in the nutrient-sensing mechanisms, namely those related to gut hormones and leptin, are also discussed under the current knowledge.
Collapse
Affiliation(s)
- Catalina Picó
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics and Obesity), University of the Balearic Islands, Palma (Mallorca), Spain.,Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma (Mallorca), Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Palma (Mallorca), Spain
| | - Flávio Reis
- Faculty of Medicine, Institute of Pharmacology & Experimental Therapeutics and Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Conceição Egas
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Center of Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
| | | | - Paulo Matafome
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,Faculty of Medicine, Institute of Physiology and Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Department of Complementary Sciences, Instituto Politécnico de Coimbra, Coimbra Health School (ESTeSC), Coimbra, Portugal
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Jagodic M, Snoj Tratnik J, Potočnik D, Mazej D, Ogrinc N, Horvat M. Dietary habits of Slovenian inland and coastal primiparous women and fatty acid composition of their human milk samples. Food Chem Toxicol 2020; 141:111299. [PMID: 32283198 DOI: 10.1016/j.fct.2020.111299] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 03/18/2020] [Accepted: 03/20/2020] [Indexed: 10/24/2022]
Abstract
The quantity and composition of fatty acids (FAs) in milk can influence an infant's growth and development through maternal diet. Therefore, associations between maternal diet and FA composition in 74 mature human milk samples were investigated. This study aimed to obtain FA patterns in mature milk arising from different dietary habits in two geographically different areas in Slovenia: Koper (KP), a coastal area, and Pomurje (MS), an inland area. The results revealed statistically significant differences in the dietary intake of game, freshwater fish, and fresh and frozen seafood between the study areas. Among the mean percentages of 35 individual FAs in milk, 19 were higher in KP and 16 were higher in MS. In KP, despite the higher intake of fresh seafood, the levels of saturated and monounsaturated FAs were higher and the levels of PUFAs, ω-3, and ω-6 were lower compared to those in MS. The ω-6:ω-3 ratio did not differ significantly between the study areas. This finding was not expected and indicates a discrepancy between the measured and self-reported data - the latter lack reliable data on dietary supplements. Therefore, determination of FA profile is important as a promising biomarker of dietary intake in environmental health studies.
Collapse
Affiliation(s)
- Marta Jagodic
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova cesta 39, 1000, Ljubljana, Slovenia.
| | - Janja Snoj Tratnik
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova cesta 39, 1000, Ljubljana, Slovenia.
| | - Doris Potočnik
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova cesta 39, 1000, Ljubljana, Slovenia.
| | - Darja Mazej
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia.
| | - Nives Ogrinc
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova cesta 39, 1000, Ljubljana, Slovenia.
| | - Milena Horvat
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova cesta 39, 1000, Ljubljana, Slovenia.
| |
Collapse
|
8
|
He Y, Wu T, Sun H, Sun P, Liu B, Luo M, Chen F. Comparison of fatty acid composition and positional distribution of microalgae triacylglycerols for human milk fat substitutes. ALGAL RES 2019. [DOI: 10.1016/j.algal.2018.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
9
|
Juber BA, Jackson KH, Johnson KB, Harris WS, Baack ML. Breast milk DHA levels may increase after informing women: a community-based cohort study from South Dakota USA. Int Breastfeed J 2017; 12:7. [PMID: 28149321 PMCID: PMC5273852 DOI: 10.1186/s13006-016-0099-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Docosahexaenoic acid (DHA), an omega-3 fatty acid found in breast milk, has many health benefits for both mother and baby. A 2007 meta-analysis found U.S. women had breast milk DHA levels (0.20% of total fatty acids) below the worldwide mean (0.32%). In 2008, international dietary recommendations were made for pregnant and lactating women to consume 200 mg of DHA per day. This community-based study aimed to define current milk DHA levels from upper Midwest USA lactating mothers and to determine if providing information about their own level along with dietary recommendations would incite changes to increase breast milk DHA content. METHODS New mothers attending lactation classes or using hospital pumping rooms in Sioux Falls, South Dakota, USA participated by providing one drop of breast milk on a card for fatty acid analysis at baseline and 1 month after initial reporting. DHA levels were analyzed by gas chromatography. Mothers received a report of their own breast milk level along with dietary recommendations on DHA intake for lactating women. Median baseline and follow-up DHA levels were determined and differences were compared by Wilcoxon signed-rank test. RESULTS At baseline, breast milk DHA content (n = 84) was highly variable (range 0.05 to 0.73%) with a median of 0.18% (IQR, 0.13, 0.28; mean ± SD, 0.22 ± 0.13%), well below the worldwide average (0.32%). Women who reported taking DHA supplements (n = 43) had higher levels than those who did not (0.23% vs. 0.15%, P < 0.0001). In a subset of 60 mothers who submitted a second sample, median breast milk DHA content increased from 0.19 to 0.22% (P < 0.01). CONCLUSIONS Findings suggest that providing nursing mothers with their breast milk DHA level and education about DHA intake while breastfeeding motivates change to increase DHA levels.
Collapse
Affiliation(s)
- Brian A Juber
- Sanford School of Medicine, University of South Dakota, 1400 W. 22nd St., Sioux Falls, SD 57105 USA
| | | | - Kristopher B Johnson
- Sanford Research, Children's Health Research Center, 2301 E. 60th Street North, Sioux Falls, SD 57104 USA
| | - William S Harris
- OmegaQuant Analytics, LLC, 5009 W. 12th St, Ste 8, Sioux Falls, SD 57106 USA.,Sanford Research, Children's Health Research Center, 2301 E. 60th Street North, Sioux Falls, SD 57104 USA
| | - Michelle L Baack
- Sanford Research, Children's Health Research Center, 2301 E. 60th Street North, Sioux Falls, SD 57104 USA.,Boekelheide Neonatal Intensive Care Unit, Sanford Children's Hospital, 1600 W. 22nd St., PO Box 5039, Sioux Falls, SD USA
| |
Collapse
|
10
|
Abstract
Docosahexaenoic acid (DHA) is the predominant omega-3 (n-3) polyunsaturated fatty acid (PUFA) found in the brain and can affect neurological function by modulating signal transduction pathways, neurotransmission, neurogenesis, myelination, membrane receptor function, synaptic plasticity, neuroinflammation, membrane integrity and membrane organization. DHA is rapidly accumulated in the brain during gestation and early infancy, and the availability of DHA via transfer from maternal stores impacts the degree of DHA incorporation into neural tissues. The consumption of DHA leads to many positive physiological and behavioral effects, including those on cognition. Advanced cognitive function is uniquely human, and the optimal development and aging of cognitive abilities has profound impacts on quality of life, productivity, and advancement of society in general. However, the modern diet typically lacks appreciable amounts of DHA. Therefore, in modern populations, maintaining optimal levels of DHA in the brain throughout the lifespan likely requires obtaining preformed DHA via dietary or supplemental sources. In this review, we examine the role of DHA in optimal cognition during development, adulthood, and aging with a focus on human evidence and putative mechanisms of action.
Collapse
|
11
|
Weiser MJ, Butt CM, Mohajeri MH. Docosahexaenoic Acid and Cognition throughout the Lifespan. Nutrients 2016; 8:99. [PMID: 26901223 PMCID: PMC4772061 DOI: 10.3390/nu8020099] [Citation(s) in RCA: 229] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 01/26/2016] [Accepted: 01/28/2016] [Indexed: 12/30/2022] Open
Abstract
Docosahexaenoic acid (DHA) is the predominant omega-3 (n-3) polyunsaturated fatty acid (PUFA) found in the brain and can affect neurological function by modulating signal transduction pathways, neurotransmission, neurogenesis, myelination, membrane receptor function, synaptic plasticity, neuroinflammation, membrane integrity and membrane organization. DHA is rapidly accumulated in the brain during gestation and early infancy, and the availability of DHA via transfer from maternal stores impacts the degree of DHA incorporation into neural tissues. The consumption of DHA leads to many positive physiological and behavioral effects, including those on cognition. Advanced cognitive function is uniquely human, and the optimal development and aging of cognitive abilities has profound impacts on quality of life, productivity, and advancement of society in general. However, the modern diet typically lacks appreciable amounts of DHA. Therefore, in modern populations, maintaining optimal levels of DHA in the brain throughout the lifespan likely requires obtaining preformed DHA via dietary or supplemental sources. In this review, we examine the role of DHA in optimal cognition during development, adulthood, and aging with a focus on human evidence and putative mechanisms of action.
Collapse
Affiliation(s)
- Michael J Weiser
- DSM Nutritional Products, R&D Human Nutrition and Health, Boulder, CO, USA.
| | - Christopher M Butt
- DSM Nutritional Products, R&D Human Nutrition and Health, Boulder, CO, USA.
| | - M Hasan Mohajeri
- DSM Nutritional Products, R&D Human Nutrition and Health, Basel, Switzerland.
| |
Collapse
|
12
|
Jackson KH, Polreis J, Sanborn L, Chaima D, Harris WS. Analysis of breast milk fatty acid composition using dried milk samples. Int Breastfeed J 2016; 11:1. [PMID: 26813701 PMCID: PMC4727292 DOI: 10.1186/s13006-016-0060-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/18/2016] [Indexed: 02/07/2023] Open
Abstract
Background The effect of breast milk fatty acid (FA) composition, particularly levels of docosahexaenoic acid (DHA), on infant health outcomes is unclear. Part of the reason for this is difficulties in collecting, storing and shipping milk samples to the laboratory. Here we report the validation of a dried milk spot (DMS) system to measure FA composition to help overcome these obstacles. Milk FA were measured by gas chromatography and reported as percent of total FA; the FA of primary interest in this study were DHA and industrially produced trans FA (iTFA). Experiments were carried out using pooled milk samples from US (n = 5) and Malawian women (n = 50). Experiments compared liquid vs. DMS samples (n = 55), assessed stability of FA composition under different storage conditions (n = 5), and compared the results from two different labs using the same methods (n = 5). Results Both % DHA and % iTFA levels in liquid and DMS samples were strongly correlated (R2 = 0.99 and 0.99, respectively, P < 0.0001). The % DHA in DMS samples was stable for up to four weeks at room temperature and up to three years at -80 °C; only slight deviations from the acceptable range of variability (±15 %) occurred in the 4 °C and -20 °C conditions for % DHA. The % iTFA was stable under all conditions. All % DHA and % iTFA were within 15 % of the referent when analyzed in two laboratories. Conclusions Valid FA composition values can be obtained from DMS samples using this robust collection and transport system which should facilitate studies of the role of milk FA composition in infant development. Electronic supplementary material The online version of this article (doi:10.1186/s13006-016-0060-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | | | | | - David Chaima
- Department of Microbiology, University of Malawi, College of Medicine, Blantyre, Malawi
| | - William S Harris
- OmegaQuant Analytics LLC, Sioux Falls, SD USA ; Sanford School of Medicine, University of South Dakota, Sioux Falls, SD USA
| |
Collapse
|
13
|
Essential role of docosahexaenoic acid towards development of a smarter brain. Neurochem Int 2015; 89:51-62. [DOI: 10.1016/j.neuint.2015.08.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 08/18/2015] [Accepted: 08/26/2015] [Indexed: 01/25/2023]
|
14
|
Lassandro C, Banderali G, Radaelli G, Borghi E, Moretti F, Verduci E. Docosahexaenoic Acid Levels in Blood and Metabolic Syndrome in Obese Children: Is There a Link? Int J Mol Sci 2015; 16:19989-20000. [PMID: 26307979 PMCID: PMC4581336 DOI: 10.3390/ijms160819989] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 07/21/2015] [Accepted: 08/18/2015] [Indexed: 12/13/2022] Open
Abstract
Prevalence of metabolic syndrome is increasing in the pediatric population. Considering the different existing criteria to define metabolic syndrome, the use of the International Diabetes Federation (IDF) criteria has been suggested in children. Docosahexaenoic acid (DHA) has been associated with beneficial effects on health. The evidence about the relationship of DHA status in blood and components of the metabolic syndrome is unclear. This review discusses the possible association between DHA content in plasma and erythrocytes and components of the metabolic syndrome included in the IDF criteria (obesity, alteration of glucose metabolism, blood lipid profile, and blood pressure) and non-alcoholic fatty liver disease in obese children. The current evidence is inconsistent and no definitive conclusion can be drawn in the pediatric population. Well-designed longitudinal and powered trials need to clarify the possible association between blood DHA status and metabolic syndrome.
Collapse
Affiliation(s)
- Carlotta Lassandro
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
| | - Giuseppe Banderali
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
| | - Giovanni Radaelli
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
| | - Elisa Borghi
- Microbiology Unit, Department of Health Sciences, University of Milan, I-20142 Milan, Italy.
| | - Francesca Moretti
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
| | - Elvira Verduci
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
| |
Collapse
|
15
|
Khan NA, Raine LB, Donovan SM, Hillman CH. IV. The cognitive implications of obesity and nutrition in childhood. Monogr Soc Res Child Dev 2015; 79:51-71. [PMID: 25387415 DOI: 10.1111/mono.12130] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The prevalence of childhood obesity in the United States has tripled since the 1980s and is strongly linked to the early onset of several metabolic diseases. Recent studies indicate that lower cognitive function may be another complication of childhood obesity. This review considers the research to date on the role of obesity and nutrition on childhood cognition and brain health. Although a handful of studies point to a maladaptive relationship between obesity and aspects of cognitive control, remarkably little is known regarding the impact of fat mass on brain development and cognitive function. Further, missing from the literature is the role of nutrition in the obesity-cognition interaction. Nutrition may directly or indirectly influence cognitive performance via several pathways including provision of key substrates for optimal brain health, modulation of gut microbiota, and alterations in systemic energy balance. However, in the absence of malnutrition, the functional benefits of specific nutrient intake on particular cognitive domains are not well characterized. Here, we examine the literature linking childhood obesity and cognition while considering the effects of nutritional intake. Possible mechanisms for these relationships are discussed and suggestions are made for future study topics. Although childhood obesity prevalence rates in some developed countries have recently stabilized, significant disparities remain among groups based on sex and socioeconomic status. Given that the elevated prevalence of pediatric overweight and obesity may persist for the foreseeable future, it is crucial to develop a comprehensive understanding of the influence of obesity and nutrition on cognition and brain health in the pediatric population.
Collapse
|
16
|
Delgado‐Noguera MF, Calvache JA, Bonfill Cosp X, Kotanidou EP, Galli‐Tsinopoulou A. Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development. Cochrane Database Syst Rev 2015; 2015:CD007901. [PMID: 26171898 PMCID: PMC9759098 DOI: 10.1002/14651858.cd007901.pub3] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Long chain polyunsaturated fatty acids (LCPUFA), especially docosahexaenoic acid (DHA), are the most abundant fatty acids in the brain and are necessary for growth and maturation of an infant's brain and retina. LCPUFAs are named "essential" because they cannot be synthesised efficiently by the human body and come from maternal diet. It remains controversial whether LCPUFA supplementation to breastfeeding mothers is beneficial for the development of their infants. OBJECTIVES To assess the effectiveness and safety of supplementation with LCPUFA in breastfeeding mothers in the cognitive and physical development of their infants as well as safety for the mother and infant. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (6 August 2014), CENTRAL (Cochrane Library 2014, Issue 8), PubMed (1966 to August 2014), EMBASE (1974 to August 2014), LILACS (1982 to August 2014), Google Scholar (August 2014) and reference lists of published narrative and systematic reviews. SELECTION CRITERIA Randomised controlled trials or cluster-randomised controlled trials evaluating the effects of LCPUFA supplementation on breastfeeding mothers (including the pregnancy period) and their infants. DATA COLLECTION AND ANALYSIS Two review authors independently assessed eligibility and trial quality, performed data extraction and evaluated data accuracy. MAIN RESULTS We included eight randomised controlled trials involving 1567 women. All the studies were performed in high-income countries. The longest follow-up was seven years.We report the results from the longest follow-up time point from included studies. Overall, there was moderate quality evidence as assessed using the GRADE approach from these studies for the following outcomes measured beyond 24 months age of children: language development and child weight. There was low-quality evidence for the outcomes: Intelligence or solving problems ability, psychomotor development, child attention, and child visual acuity.We found no significant difference in children's neurodevelopment at long-term follow-up beyond 24 months: language development (standardised mean difference (SMD) -0.27, 95% confidence interval (CI) -0.56 to 0.02; two trials, 187 participants); intelligence or problem-solving ability (three trials, 238 participants; SMD 0.00, 95% CI -0.36 to 0.36); psychomotor development (SMD -0.11, 95% CI -0.48 to 0.26; one trial, 113 participants); motor development (SMD -0.23, 95% CI -0.60 to 0.14; one trial, 115 participants), or in general movements (risk ratio, RR, 1.12, 95% CI 0.58 to 2.14; one trial, 77 participants; at 12 weeks of life). However, child attention scores were better at five years of age in the group of children whose mothers had received supplementation with fatty acids (mean difference (MD) 4.70, 95% CI 1.30 to 8.10; one study, 110 participants)). In working memory and inhibitory control, we found no significant difference (MD -0.02 95% CI -0.07 to 0.03 one trial, 63 participants); the neurological optimality score did not present any difference (P value: 0.55).For child visual acuity, there was no significant difference (SMD 0.33, 95% CI -0.04 to 0.71; one trial, 111 participants).For growth, there were no significant differences in length (MD -0.39 cm, 95% CI -1.37 to 0.60; four trials, 441 participants), weight (MD 0.13 kg, 95% CI -0.49 to 0.74; four trials, 441 participants), and head circumference (MD 0.15 cm, 95% CI -0.27 to 0.58; three trials, 298 participants). Child fat mass and fat mass distribution did not differ between the intervention and control group (MD 2.10, 95% CI -0.48 to 4.68; one trial, 115 participants, MD -0.50, 95% CI -1.69 to 0.69; one trial, 165 participants, respectively).One study (117 infants) reported a significant difference in infant allergy at short-term follow-up (risk ratio (RR) 0.13, 95% CI 0.02 to 0.95), but not at medium-term follow-up (RR 0.52, 95% CI 0.17 to 1.59).We found no significant difference in two trials evaluating postpartum depression. Data were not possible to be pooled due to differences in the describing of the outcome. One study (89 women) did not find any significant difference between the LCPUFA supplementation and the control group at four weeks postpartum (MD 1.00, 95%CI -1.72 to 3.72).No adverse effects were reported. AUTHORS' CONCLUSIONS Based on the available evidence, LCPUFA supplementation did not appear to improve children's neurodevelopment, visual acuity or growth. In child attention at five years of age, weak evidence was found (one study) favouring the supplementation. Currently, there is inconclusive evidence to support or refute the practice of giving LCPUFA supplementation to breastfeeding mothers in order to improve neurodevelopment or visual acuity.
Collapse
Affiliation(s)
- Mario F Delgado‐Noguera
- Facultad Ciencias de la Salud, Universidad del Cauca, ColombiaDepartamento de PediatriaHospital Universitario San JoseDepartamento de PediatríaPopayanCaucaColombiaNA
| | - Jose Andres Calvache
- Universidad del Cauca, Colombia. Erasmus University Medical Centre Rotterdam, The Netherlands.Departamento de Anestesiología, Universidad del Cauca, Colombia. Department of Anesthesiology, Erasmus University Medical Centre Rotterdam, The Netherlands.Cra 2 16N‐142, tercer pisoHospital Universitario San JosePopayanColombia
| | - Xavier Bonfill Cosp
- CIBER Epidemiología y Salud Pública (CIBERESP) ‐ Universitat Autònoma de BarcelonaIberoamerican Cochrane Centre ‐ Biomedical Research Institute Sant Pau (IIB Sant Pau)Sant Antoni Maria Claret, 167Pavilion 18 (D‐13)BarcelonaCataloniaSpain08025
| | - Eleni P Kotanidou
- Medical School, Aristotle University of Thessaloniki4th Department of PaediatricsPapageorgiou General Hospital, Ring Road Nea EfkarpiaThessalonikiGreeceGR56403
| | - Assimina Galli‐Tsinopoulou
- Medical School, Aristotle University of Thessaloniki4th Department of PaediatricsPapageorgiou General Hospital, Ring Road Nea EfkarpiaThessalonikiGreeceGR56403
| | | |
Collapse
|
17
|
Berseth CL, Harris CL, Wampler JL, Hoffman DR, Diersen-Schade DA. Liquid human milk fortifier significantly improves docosahexaenoic and arachidonic acid status in preterm infants. Prostaglandins Leukot Essent Fatty Acids 2014; 91:97-103. [PMID: 24863250 DOI: 10.1016/j.plefa.2014.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/18/2014] [Accepted: 03/20/2014] [Indexed: 10/25/2022]
Abstract
We report the fatty acid composition of mother׳s own human milk from one of the largest US cohorts of lactating mothers of preterm infants. Milk fatty acid data were used as a proxy for intake at enrollment in infants (n=150) who received human milk with a powder human milk fortifier (HMF; Control) or liquid HMF [LHMF; provided additional 12mg docosahexaenoic acid (DHA), 20mg arachidonic acid (ARA)/100mL human milk]. Mothers provided milk samples (n=129) and reported maternal DHA consumption (n=128). Infant blood samples were drawn at study completion (Study Day 28). Human milk and infant PPL fatty acids were analyzed using capillary column gas chromatography. DHA and ARA were within ranges previously published for US term and preterm human milk. Compared to Control HMF (providing no DHA or ARA), human milk fortified with LHMF significantly increased infant PPL DHA and ARA and improved preterm infant DHA and ARA status.
Collapse
Affiliation(s)
- C L Berseth
- Department of Medical Affairs, Clinical Research, Mead Johnson Nutrition, 2400 West Lloyd Expy, Evansville, IN 47721, USA
| | - C L Harris
- Department of Medical Affairs, Clinical Research, Mead Johnson Nutrition, 2400 West Lloyd Expy, Evansville, IN 47721, USA
| | - J L Wampler
- Department of Medical Affairs, Clinical Research, Mead Johnson Nutrition, 2400 West Lloyd Expy, Evansville, IN 47721, USA.
| | - D R Hoffman
- Retina Foundation of the Southwest, 9900 North Central Expressway, Dallas, TX 75231, USA
| | - D A Diersen-Schade
- College of Human Ecology, Division of Nutritional Sciences, Cornell University, Savage Hall, Ithaca, NY 14853, USA
| |
Collapse
|
18
|
Innis SM. Impact of maternal diet on human milk composition and neurological development of infants. Am J Clin Nutr 2014; 99:734S-41S. [PMID: 24500153 DOI: 10.3945/ajcn.113.072595] [Citation(s) in RCA: 224] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Maternal nutrition has little or no effect on many nutrients in human milk; for others, human milk may not be designed as a primary nutritional source for the infant; and for a few, maternal nutrition can lead to substantial variations in human milk quality. Human milk fatty acids are among the nutrients that show extreme sensitivity to maternal nutrition and are implicated in neurological development. Extensive development occurs in the infant brain, with growth from ∼ 350 g at birth to 925 g at 1 y, with this growth including extensive dendritic and axonal arborization. Transfer of n-6 (omega-6) and n-3 (omega-3) fatty acids from the maternal diet into human milk occurs with little interconversion of 18:2n-6 to 20:4n-6 or 18:3n-3 to docosahexaenoic acid (DHA) and little evidence of mammary gland regulation to maintain individual fatty acids constant with varying maternal fatty acid nutrition. DHA has gained attention because of its high concentrations and roles in the brain and retina. Studies addressing DHA intakes by lactating women or human milk amounts of DHA at levels above those typical in the United States and Canada on infant outcomes are inconsistent. However, separating effects of the fatty acid supply in gestation or in the weaning diet from effects on neurodevelopment solely due to human milk fatty acids is complex, particularly when neurodevelopment is assessed after the period of exclusive human milk feeding. Information on infant fatty acid intakes, including milk volume consumed and energy density, will aid in understanding of the human milk fatty acids that best support neurological development.
Collapse
Affiliation(s)
- Sheila M Innis
- Nutrition and Metabolism Research Program, Child and Family Research Institute, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| |
Collapse
|
19
|
Holub B, Mutch DM, Pierce GN, Rodriguez-Leyva D, Aliani M, Innis S, Yan W, Lamarche B, Couture P, Ma DWL. Proceedings from the 2013 Canadian Nutrition Society Conference on Advances in Dietary Fats and Nutrition. Appl Physiol Nutr Metab 2014; 39:754-62. [PMID: 24749841 DOI: 10.1139/apnm-2013-0418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The science of lipid research continues to rapidly evolve and change. New knowledge enhances our understanding and perspectives on the role of lipids in health and nutrition. However, new knowledge also challenges currently held opinions. The following are the proceedings of the 2013 Canadian Nutrition Society Conference on the Advances in Dietary Fats and Nutrition. Content experts presented state-of-the-art information regarding our understanding of fish oil and plant-based n-3 polyunsaturated fatty acids, nutrigenomics, pediatrics, regulatory affairs, and trans fats. These important contributions aim to provide clarity on the latest advances and opinions regarding the role of different types of fats in health.
Collapse
Affiliation(s)
- Bruce Holub
- a Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, ON N1G 2W1, Canada
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Dangat K, Kilari A, Mehendale S, Lalwani S, Joshi S. Preeclampsia alters milk neurotrophins and long chain polyunsaturated fatty acids. Int J Dev Neurosci 2013; 33:115-21. [PMID: 24374257 DOI: 10.1016/j.ijdevneu.2013.12.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 12/06/2013] [Accepted: 12/17/2013] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine the levels of breast milk neurotrophins 1.5, 3.5, and 6 months of lactation and long chain polyunsaturated fatty acids (LCPUFA) at day 3, 1.5, 2.5, 3.5 and 6 months of lactation in mothers with preeclampsia and compare them with normotensive women. Their associations with growth parameters in children are also examined. METHODS Women with preeclampsia (n=101) and normotensive women (n=144) with singleton pregnancies were recruited for this study. Milk samples were collected and anthropometry was recorded at the first 6 months. The LCPUFA composition of milk samples was analyzed by using gas chromatography at all time points and neurotrophins were analyzed at 1.5, 3.5 and 6 months by Emax Immuno Assay System using Promega kits. RESULTS Milk DHA levels were higher at day 3 (9.5%), and 1.5 (23%) and 3.5 (40%) months in mothers with preeclampsia as compared to controls. Milk nerve growth factor (NGF) levels were lower in preeclampsia group as compared to control group at 1.5 (20%) and 3.5 months (27.7%). Milk brain derived neurotrophic factor (BDNF) levels were lower at 1.5 months (10.5%) in the preeclampsia group as compared to control group. CONCLUSION The present study suggests that there is a differential regulation of DHA and neurotrophins in breast milk in preeclampsia and are associated with growth parameters of children. Future studies should explore the associations between milk LCPUFA, neurotrophins with neurodevelopment in children.
Collapse
Affiliation(s)
- Kamini Dangat
- Department of Nutritional Medicine, Interactive Research School for Health Affairs, Bharati Vidyapeeth University, Pune 411043, India
| | - Anitha Kilari
- Department of Nutritional Medicine, Interactive Research School for Health Affairs, Bharati Vidyapeeth University, Pune 411043, India
| | - Savita Mehendale
- Department of Obstetrics and Gynecology, Bharati Medical College and Hospital, Bharati Vidyapeeth University, Pune 411043, India
| | - Sanjay Lalwani
- Department of Pediatrics, Bharati Medical College and Hospital, Bharati Vidyapeeth University, Pune 411043, India
| | - Sadhana Joshi
- Department of Nutritional Medicine, Interactive Research School for Health Affairs, Bharati Vidyapeeth University, Pune 411043, India.
| |
Collapse
|
21
|
Leventakou V, Roumeliotaki T, Koutra K, Vassilaki M, Mantzouranis E, Bitsios P, Kogevinas M, Chatzi L. Breastfeeding duration and cognitive, language and motor development at 18 months of age: Rhea mother-child cohort in Crete, Greece. J Epidemiol Community Health 2013; 69:232-9. [PMID: 24336236 DOI: 10.1136/jech-2013-202500] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Breast feeding duration has been associated with improved cognitive development in children. However, few population-based prospective studies have evaluated dose-response relationships of breastfeeding duration with language and motor development at early ages, and results are discrepant. METHODS The study uses data from the prospective mother-child cohort ('Rhea' study) in Crete, Greece. 540 mother-child pairs were included in the present analysis. Information about parental and child characteristics and breastfeeding practices was obtained by interview-administered questionnaires. Trained psychologists assessed cognitive, language and motor development by using the Bayley Scales of Infant Toddler Development (3rd edition) at the age of 18 months. RESULTS Duration of breast feeding was linearly positively associated with all the Bayley scales, except of gross motor. The association persisted after adjustment for potential confounders with an increase of 0.28 points in the scale of cognitive development (β=0.28; 95% CI 0.01 to 0.55), 0.29 points in the scale of receptive communication (β=0.29; 95% CI 0.04 to 0.54), 0.30 points in the scale of expressive communication (β=0.30; 95% CI 0.04 to 0.57) and 0.29 points in the scale of fine motor development (β=0.29; 95% CI 0.02 to 0.56) per accumulated month of breast feeding. Children who were breast fed longer than 6 months had a 4.44-point increase in the scale of fine motor development (β=4.44; 95% CI 0.06 to 8.82) compared with those never breast fed. CONCLUSIONS Longer duration of breast feeding was associated with increased scores in cognitive, language and motor development at 18 months of age, independently from a wide range of parental and infant characteristics. Additional longitudinal studies and trials are needed to confirm these results.
Collapse
Affiliation(s)
- Vasiliki Leventakou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Katerina Koutra
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete,Heraklion, Crete, Greece
| | - Maria Vassilaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Evangelia Mantzouranis
- Department of Pediatrics, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Panos Bitsios
- Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete,Heraklion, Crete, Greece
| | - Manolis Kogevinas
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain Hospital del Mar Research Institute (IMIM), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain National School of Public Health, Athens, Greece
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| |
Collapse
|
22
|
Impact of fatty acids on human UDP-glucuronosyltransferase 1A1 activity and its expression in neonatal hyperbilirubinemia. Sci Rep 2013; 3:2903. [PMID: 24104695 PMCID: PMC3793218 DOI: 10.1038/srep02903] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 09/20/2013] [Indexed: 02/01/2023] Open
Abstract
While breast milk has been known as a cause of neonatal hyperbilirubinemia, the underlying mechanism of breast milk-induced jaundice has not been clarified. Here, the impact of fatty acids on human UDP-glucuronosyltransferase (UGT) 1A1--the sole enzyme that can metabolize bilirubin--were examined. Oleic acid, linoleic acid, and docosahexaenoic acid (DHA) strongly inhibited UGT1A1 activity. Forty-eight hours after a treatment with a lower concentration of DHA (10 mg/kg), total bilirubin significantly increased in neonatal hUGT1 mice, which are human neonatal jaundice models. In contrast, treatments with higher concentrations of fatty acids (0.1-10 g/kg) resulted in a decrease in serum bilirubin in hUGT1 mice. It was further demonstrated that the treatment with higher concentrations of fatty acids induced UGT1A1, possibly by activation of peroxisome proliferator-activated receptors. Our data indicates that activation of peroxisome proliferator-activated receptors would increase UGT1A1 expression, resulting in reduction of serum bilirubin levels in human infants.
Collapse
|
23
|
|
24
|
Spitzer J, Buettner A. Monitoring aroma changes during human milk storage at −19°C by quantification experiments. Food Res Int 2013. [DOI: 10.1016/j.foodres.2012.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
25
|
Dangat K, Kilari A, Mehendale S, Lalwani S, Joshi S. Higher levels of brain derived neurotrophic factor but similar nerve growth factor in human milk in women with preeclampsia. Int J Dev Neurosci 2013; 31:209-13. [PMID: 23337827 DOI: 10.1016/j.ijdevneu.2012.12.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 11/26/2012] [Accepted: 12/08/2012] [Indexed: 01/16/2023] Open
Abstract
Children born to mothers with preeclampsia have consistently been suggested to be at risk for cognitive and behavioral disorders in later life. Breastfeeding is said to be associated with better neurodevelopment outcomes. Our earlier studies indicated higher levels of docosahexaenoic acid (DHA) in human milk in women with preeclampsia. DHA is known to regulate the expression of neurotrophins and together they play a vital role in neurodevelopment and cognitive performance. The present study examines the levels of maternal plasma and milk neurotrophins [(nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF)] in women with preeclampsia and compares them with normotensive women who served as controls. Singleton pregnant women diagnosed with preeclampsia (n=72) and controls (n=102) were recruited for this study from Bharati Hospital, Pune. Plasma and milk samples were analyzed for NGF and BDNF levels using the Emax Immuno Assay System using promega kits. Maternal plasma NGF and BDNF levels were lower (p<0.01 for both) in women with preeclampsia as compared to the control women. Milk NGF levels were similar while milk BDNF levels were higher (p<0.05) in the preeclampsia group as compared to controls. Plasma NGF levels were positively correlated with milk NGF levels in the control group. Our results indicate the differential regulation of milk NGF and BDNF levels in women with preeclampsia. The present study suggests a role for both NGF and BDNF in human milk for postnatal brain development. Further studies need to examine the associations of DHA and BDNF in human milk with cognition at later ages.
Collapse
Affiliation(s)
- Kamini Dangat
- Department of Nutritional Medicine, Interactive Research School for Health Affairs, Bharati Vidyapeeth University, Pune 411043, India
| | | | | | | | | |
Collapse
|
26
|
Qawasmi A, Landeros-Weisenberger A, Bloch MH. Meta-analysis of LCPUFA supplementation of infant formula and visual acuity. Pediatrics 2013; 131:e262-72. [PMID: 23248232 PMCID: PMC3529943 DOI: 10.1542/peds.2012-0517] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Long-chain polyunsaturated fatty acids (LCPUFAs) are hypothesized to affect visual acuity development in infants. Randomized controlled trials (RCTs) have been conducted to assess whether supplementation of LCPUFAs of infant formulas affects infant visual acuity. This meta-analysis was conducted to evaluate whether LCPUFA supplementation of infant formulas improves infants' visual acuity. METHODS PubMed and PsycInfo were searched for RCTs assessing the efficacy of LCPUFA supplementation of infant formulas on infant visual acuity. RCTs assessing the effects of LCPUFA supplementation on visual acuity (by using either visual evoked potential or behavioral methods) in the first year of life were included in this meta-analysis. Our primary outcome was the mean difference in visual resolution acuity (measured in logarithm of minimum angle of resolution [logMAR]) between supplemented and unsupplemented infants. We also conducted secondary subgroup analyses and meta-regression examining the effects of LCPUFA dose and timing, preterm versus term birth status, and trial methodologic quality. RESULTS Nineteen studies involving 1949 infants were included. We demonstrated a significant benefit of LCPUFA supplementation on infants' visual acuity at 2, 4, and 12 months of age when visual acuity was assessed by using visual evoked potential and at 2 months of age by using behavioral methods. There was significant heterogeneity between trials but no evidence of publication bias. Secondary analysis failed to show any moderating effects on the association between LCPUFA supplementation and visual acuity. CONCLUSIONS Current evidence suggests that LCPUFA supplementation of infant formulas improves infants' visual acuity up to 12 months of age.
Collapse
Affiliation(s)
- Ahmad Qawasmi
- Child Study Center and cDepartment of Psychiatry, Yale University, New Haven, Connecticut 06520, USA.
| | | | - Michael H. Bloch
- Child Study Center and,Department of Psychiatry, Yale University, New Haven, Connecticut; and
| |
Collapse
|
27
|
Pedersen L, Lauritzen L, Brasholt M, Buhl T, Bisgaard H. Polyunsaturated fatty acid content of mother's milk is associated with childhood body composition. Pediatr Res 2012; 72:631-6. [PMID: 23007033 DOI: 10.1038/pr.2012.127] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The consumption of polyunsaturated fatty acids has changed, and the prevalence of adiposity has increased over the past 30 y. A decrease of n-3 polyunsaturated fatty acid content in breast milk has been suggested to be a contributing factor. The objective of this study was to investigate the relationship between docosahexaenoic acid (DHA) content and n-6/n-3 polyunsaturated fatty acid ratio in breast milk, body composition, and timing of adiposity rebound in children. METHODS In the Copenhagen Prospective Study on Asthma in Childhood birth cohort, breast milk fatty acid profile was determined in 281 mothers and BMI development was prospectively followed up to the age of 7 y in 222 children. Age and BMI at adiposity rebound were registered. Furthermore, fat mass determination by dual energy X-ray absorptiometry was performed in 207 children at 6-9 y of age. RESULTS There was a significant association between breast milk DHA and BMI from 2 to 7 y, fat mass, and, for the girls, age at adiposity rebound. No associations were found between the breast milk n-6/n-3 polyunsaturated fatty acid ratio and body composition. CONCLUSION Early intake of DHA may have an effect on body composition. Dietary habits of lactating mothers could contribute to the increased prevalence of obesity in Western societies.
Collapse
Affiliation(s)
- Louise Pedersen
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Naestved Hospital, Copenhagen, Denmark
| | | | | | | | | |
Collapse
|
28
|
Nakatani H, Yasueda T, Oshima K, Okajima T, Nadano D, Flint DJ, Matsuda T. Post-weaning increases in the milk-fat globule EGF-factor VIII on fat globules in mouse milk and in the uptake of the fat globules by HC11 mammary epithelial cells. J Biochem 2012; 153:31-41. [PMID: 23038672 DOI: 10.1093/jb/mvs116] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Milk fat globules (MFGs) secreted by lactating mammary gland are unique lipid surrounded by a phospholipid bi-layer. We report here post-weaning changes in MFG EGF factor VIII (MFG-E8) and annexin V-accessible phosphatidyl-l-serine on the surface of MFGs. The MFG content in milk markedly decreased to about one-half within 2 days after forced weaning, despite a slight increase in milk protein content. Immunofluorescence-staining of MFGs using anti-MFG-E8 and annexin V indicated that MFG-E8 was present on some, but not all, MFGs before weaning, whereas most of MFGs were MFG-E8-positive and annexin V-negative after weaning. Free MFG-E8 with binding activity to phosphatidyl-l-serine was present abundantly in the post-weaning milk, and indeed exhibited binding to MFGs in pre-weaning milk. MFGs were taken up by HC11 mouse mammary epithelial cells in vitro, and those from post-weaning milk were remarkable for such cellular uptake. Moreover, the uptake of MFGs by the cells was inhibited by an anti-MFG-E8 antibody. Taken together, these findings suggest that MFG-E8 plays a critical role in regulation of MFG dynamics after weaning or during the suckling interval through the control of MFG-epithelial cell interaction in lactating mammary glands.
Collapse
Affiliation(s)
- Hajime Nakatani
- Department of Applied Molecular Biosciences, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya 464-8601, Japan
| | | | | | | | | | | | | |
Collapse
|
29
|
Agostoni C, Caroli M. Role of fats in the first two years of life as related to later development of NCDs. Nutr Metab Cardiovasc Dis 2012; 22:775-780. [PMID: 22795296 DOI: 10.1016/j.numecd.2012.05.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 05/05/2012] [Accepted: 05/08/2012] [Indexed: 01/14/2023]
Abstract
AIMS Compared to exclusive breastfeeding, the introduction of solids leads to a reduction of dietary fats. We explore the hypothesis that dietary fats consumed in the 6-24-month period might have later effects on non-communicable disorders and health. DATA SYNTHESIS We have considered studies on dietary fats as substrate for oxidation and energy production, effects on adiposity, blood lipoprotein levels and features of the metabolic syndrome, and the possible influences on brain development and function. Fat oxidation, despite a high initial dietary supply, is greatly suppressed and only gradually increases after birth. There is no evidence of any convincing association between fat intake during the 6-24-month period and later indices of adiposity. Fat quality may affect the blood lipoprotein picture at short-term through the first 12 months of life. In a large Finnish trial, a moderately restricted fat diet started at 7 months, with an increased unsaturated/saturated fat ratio, has shown favourable effects on serum cholesterol values, indices of insulin resistance and endothelial function especially in boys, and had no negative effects until the age of 18 years. The dietary supply of docosahexaenoic acid might affect brain development as well as some features of the metabolic syndrome. CONCLUSIONS In the 6-24-month period, the amount of fat intake does not show associations with later health conditions, and relatively high-fat diets do not seem to be harmful. Fat quality may have later effects on chronic-degenerative processes that need to be explored more in depth.
Collapse
Affiliation(s)
- C Agostoni
- Institute of Pediatrics, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico, University of Milan, Via della Commenda, 9, I-20122 Milan, Italy.
| | | |
Collapse
|
30
|
Urwin HJ, Miles EA, Noakes PS, Kremmyda LS, Vlachava M, Diaper ND, Pérez-Cano FJ, Godfrey KM, Calder PC, Yaqoob P. Salmon consumption during pregnancy alters fatty acid composition and secretory IgA concentration in human breast milk. J Nutr 2012; 142:1603-10. [PMID: 22739373 DOI: 10.3945/jn.112.160804] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Fish oil supplementation during pregnancy alters breast milk composition, but there is little information about the impact of oily fish consumption. We determined whether increased salmon consumption during pregnancy alters breast milk fatty acid composition and immune factors. Women (n = 123) who rarely ate oily fish were randomly assigned to consume their habitual diet or to consume 2 portions of farmed salmon per week from 20 wk of pregnancy until delivery. The salmon provided 3.45 g long-chain (LC) (n-3) PUFA/wk. Breast milk fatty acid composition and immune factors [soluble CD14, transforming growth factor-β (TGFβ)1, TGFβ2, and secretory IgA] were analyzed at 1, 5, 14, and 28 d postpartum (PP). Breast milk from the salmon group had higher proportions of EPA (80%), docosapentaenoic acid (30%), and DHA (90%) on d 5 PP compared with controls (P < 0.01). The LC (n-6) PUFA:LC (n-3) PUFA ratio was lower for the salmon group on all days of PP sampling (P ≤ 0.004), although individual (n-6) PUFA proportions, including arachidonic acid, did not differ. All breast milk immune factors decreased between d 1 and 28 PP (P < 0.001). Breast milk secretory IgA (sIgA) was lower in the salmon group (d 1-28 PP; P = 0.006). Salmon consumption during pregnancy, at the current recommended intakes, increases the LC (n-3) PUFA concentration of breast milk in early lactation, thus improving the supply of these important fatty acids to the breast-fed neonate. The consequence of the lower breast milk concentration of sIgA in the salmon group is not clear.
Collapse
Affiliation(s)
- Heidi J Urwin
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, The University of Reading, Reading, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Qawasmi A, Landeros-Weisenberger A, Leckman JF, Bloch MH. Meta-analysis of long-chain polyunsaturated fatty acid supplementation of formula and infant cognition. Pediatrics 2012; 129:1141-9. [PMID: 22641753 PMCID: PMC3362904 DOI: 10.1542/peds.2011-2127] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Infant formula is supplemented with long-chain polyunsaturated fatty acids (LCPUFAs) because they are hypothesized to improve cognition. Several randomized controlled clinical trials have examined the effect of LCPUFA supplementation of infant formula on cognitive development. We conducted this meta-analysis to examine the efficacy of LCPUFA supplementation of infant formula on early cognitive development. METHODS Two authors searched PubMed, PsychInfo, and Scopus for randomized controlled clinical trials assessing the efficacy of LCPUFA supplementation of infant formulas on cognition. Our analysis was restricted to randomized controlled clinical trials that examined the effect of LCPUFA supplementation on infant cognition using Bayley Scales of Infant Development. Our primary outcome was the weighted mean difference in Bayley Scales of Infant Development score between infants fed formula supplemented with LCPUFA compared with unsupplemented formula. We conducted secondary subgroup analyses and meta-regression to examine the effects of study sample, LCPUFA dose, and trial methodologic quality on measured efficacy of supplementation. RESULTS Twelve trials involving 1802 infants met our inclusion criteria. Our meta-analysis demonstrated no significant effect of LCPUFA supplementation of formula on infant cognition. There was no significant heterogeneity or publication bias between trials. Secondary analysis failed to show any significant effect of LCPUFA dosing or prematurity status on supplementation efficacy. CONCLUSIONS LCPUFA supplementation of infant formulas failed to show any significant effect on improving early infant cognition. Further research is needed to determine if LCPUFA supplementation of infant formula has benefits for later cognitive development or other measures of neurodevelopment.
Collapse
Affiliation(s)
- Ahmad Qawasmi
- Yale Child Study Center and
- Child Institute at Al-Quds University, Jerusalem
| | | | - James F. Leckman
- Yale Child Study Center and
- Department of Psychiatry, Yale University, New Haven, Connecticut; and
| | - Michael H. Bloch
- Yale Child Study Center and
- Department of Psychiatry, Yale University, New Haven, Connecticut; and
| |
Collapse
|
32
|
Chapman DJ, Nommsen-Rivers L. Impact of maternal nutritional status on human milk quality and infant outcomes: an update on key nutrients. Adv Nutr 2012; 3:351-2. [PMID: 22585911 PMCID: PMC3649469 DOI: 10.3945/an.111.001123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
33
|
Guxens M, Mendez MA, Moltó-Puigmartí C, Julvez J, García-Esteban R, Forns J, Ferrer M, Vrijheid M, López-Sabater MC, Sunyer J. Breastfeeding, long-chain polyunsaturated fatty acids in colostrum, and infant mental development. Pediatrics 2011; 128:e880-9. [PMID: 21930546 PMCID: PMC9923846 DOI: 10.1542/peds.2010-1633] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2011] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Breastfeeding has been associated with improved neurodevelopment in children. However, it remains unknown to what extent nutritional advantages of breast milk may explain this relationship. OBJECTIVE We assessed the role of parental psychosocial factors and colostrum long-chain polyunsaturated fatty acid (LC-PUFA) levels in the relationship between breastfeeding and children's neurodevelopment. METHODS A population-based birth cohort was established in the city of Sabadell (Catalonia, Spain) as part of the INMA-INfancia y Medio Ambiente Project. A total of 657 women were recruited during the first trimester of pregnancy. Information about parental characteristics and breastfeeding was obtained by using a questionnaire, and trained psychologists assessed mental and psychomotor development by using the Bayley Scales of Infant Development in 504 children at 14 months of age. RESULTS A high percentage of breastfeeds among all milk feeds accumulated during the first 14 months was positively related with child mental development (0.37 points per month of full breastfeeding [95% confidence interval: 0.06-0.67]). Maternal education, social class, and intelligence quotient only partly explained this association. Children with a longer duration of breastfeeding also exposed to higher ratios between n-3 and n-6 PUFAs in colostrum had significantly higher mental scores than children with low breastfeeding duration exposed to low levels. CONCLUSIONS Greater levels of accumulated breastfeeding during the first year of life were related to higher mental development at 14 months, largely independently from a wide range of parental psychosocial factors. LC-PUFA levels seem to play a beneficial role in children's mental development when breastfeeding levels are high.
Collapse
Affiliation(s)
- Mònica Guxens
- Center for Research in Environmental Epidemiology, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Meldrum S, D'Vaz N, Dunstan J, Mori T, Prescott S. The Infant Fish Oil Supplementation Study (IFOS): Design and research protocol of a double-blind, randomised controlled n−3 LCPUFA intervention trial in term infants. Contemp Clin Trials 2011; 32:771-8. [DOI: 10.1016/j.cct.2011.05.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 05/13/2011] [Accepted: 05/25/2011] [Indexed: 01/11/2023]
|
35
|
Spitzer J, Doucet S, Buettner A. The influence of storage conditions on flavour changes in human milk. Food Qual Prefer 2010. [DOI: 10.1016/j.foodqual.2010.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
36
|
Abstract
Early recognition of the importance of docosahexaenoic acid (DHA) in brain, neural, and visual development, prompted professional bodies to establish dietary recommendations for pregnant women and term and preterm infants. More recent studies show that supplemental DHA can play an important role in reducing the risk for certain age-related diseases. Data from nationwide surveys suggest that the average intake of DHA by US adults is considerably lower than levels suggested by researchers to sustain baseline nutritional status and to achieve the beneficial and protective effects of DHA. The Workshop on DHA as a Required Nutrient provided a forum for scientists to present and debate the research in support of more universal dietary recommendations for DHA as an essential nutrient throughout life.
Collapse
|