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Cavalcanti MB, Silva IDCGD, Lamarca F, de Castro IRR. Research on commercial milk formulas for young children: A scoping review. MATERNAL & CHILD NUTRITION 2024:e13675. [PMID: 38956436 DOI: 10.1111/mcn.13675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 07/04/2024]
Abstract
A scoping review of publications about commercial milk formulas intended for or consumed by children 12-36 months (CMF 12-36) was conducted. This review aimed to comprehensively map the existing literature, identify key concepts in the field and understand its evolution through time. A total of 3329 articles were screened and 220 were included, published between 1986 and 2024. Most works were published after 2016 (70.0%) and in high-income countries (71.8%). Original studies were the vast majority (81.8%) of publications. Most publications dealt with feeding practices or analysed the composition and/or contamination of specific products (44.1% and 35.9%), but since the late 2000s, publications about marketing, policy, legislation, and consumer perception started to appear. Most published works (65.5%) did not focus exclusively on CMF 12-36 and included formulas for other demographics or other foods. About half of the works (55.5%) did not consider CMF 12-36 to be a breast milk substitute. We found 81 distinct product denominations used to refer to CMF 12-36, Growing Up Milk was the most common (25.9%). CMF industry was involved in 41.8% of all analysed works, and industry participation and funding were not always clearly informed (22.5% lacked a conflict of interest statement, and 25.5% did not present any information about funding). In the last decade, publications about CMF 12-36 have increased in volume and diversified in scope and subject matter. CMF-industry participation has always been and still is present in the field, so possible vested interests should be taken into account when appreciating the literature.
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Affiliation(s)
| | | | - Fernando Lamarca
- Department of Applied Nutrition, Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Serum 25-hydroxyvitamin D and fatty acids in relation to the risk of microbial infections in children: The TRIGR Divia study. Clin Nutr 2022; 41:2729-2739. [PMID: 36368258 DOI: 10.1016/j.clnu.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/03/2022] [Accepted: 10/23/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Nutrient status may affect the risk of microbial infections and play a role in modulating the immune response against such infections. The aim of this study was to determine whether serum 25-hydroxyvitamin D [25(OH)D] and serum fatty acids in infancy are associated with microbial infections by the age of 18 months. METHODS Altogether 576 newborn infants from Trial to Reduce IDDM in the Genetically at Risk (TRIGR) born between 2002 and 2007 were included. The concentration of 25(OH)D vitamin and proportions of 26 fatty acids (presented as % of total fatty acids) were analyzed in cord blood serum and in sera taken at 6, 12, and 18 months of age. The cord blood samples and mean of 6-18-month values were used as exposures. Infections were detected by screening IgG antibodies against 10 microbes using enzyme immunoassay and antibodies against 6 coxsackievirus B serotypes by plaque neutralization assay in serum samples taken at 18 months of age. RESULTS A higher proportion of n-3 polyunsaturated fatty acids (PUFAs) and especially long-chain n-3 PUFAs at birth and at the age of 6-18 months was associated with decreased risk of coxsackievirus B2 infection unadjusted and adjusted for region, case-control status, and maternal type 1 diabetes. Higher proportion of docosapentaenoic acid (DPA, 22:5 n-3) at birth was associated with a decreased risk of respiratory syncytial virus infection. 25(OH)D vitamin concentration was not consistently associated with the risk of infections. When only infected children were included docosahexaenoic acid (DHA, 22:6 n-3) and arachidonic acid (20:4 n-6) proportions were positively associated with IgG antibody levels against influenza A virus. 25(OH)D vitamin concentration showed an inverse association with rotavirus IgG levels among children with rotavirus seropositivity. CONCLUSIONS In young children with increased susceptibility to type 1 diabetes, long-chain n-3 PUFAs may influence the risk of viral infections and immune response against the infections. However, this association may depend on the type of virus suggesting virus-specific effects.
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Zúñiga-Hernández J, Sambra V, Echeverría F, Videla LA, Valenzuela R. N-3 PUFAs and their specialized pro-resolving lipid mediators on airway inflammatory response: beneficial effects in the prevention and treatment of respiratory diseases. Food Funct 2022; 13:4260-4272. [PMID: 35355027 DOI: 10.1039/d1fo03551g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Respiratory diseases include a wide range of pathologies with different clinical manifestations, affecting the normal airways and lung function. An increase in the inflammatory response is considered a characteristic hallmark of these diseases, being also a critical factor for their progression. The n-3 polyunsaturated fatty acids (n-3 PUFAs) eicosapentaenoic acid (C20:4n-3, EPA), docosahexaenoic acid (C22:6n-3, DHA) and their lipid mediators are known to have an inflammation pro-resolution effect. The effects of these n-3 PUFAs in the prevention and treatment of respiratory diseases are beginning to be understood. Consequently, this article aims to analyze the influence of n-3 PUFAs and their lipid mediators on the inflammatory response in respiratory health, emphasizing recent data concerning their beneficial effects in the prevention and possible treatment of different respiratory diseases, particularly asthma, airway allergic syndromes and chronic obstructive pulmonary disease. The review includes studies regarding the effects of EPA, DHA, and their specialized pro-resolving lipid mediators (SPMs) on in vivo and in vitro models of respiratory disease, concluding that EPA and DHA have a positive impact in attenuating the pro-inflammatory response in respiratory diseases, reducing symptoms like nasal congestion, fever and difficulty in breathing. Controversial data reported are probably due to differences in several factors, including the dosages, administration vehicles, and the supplementation times employed, which are aspects that remain to be addressed in future studies.
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Affiliation(s)
| | - Verónica Sambra
- Nutrition Department, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - Francisca Echeverría
- Nutrition Department, Faculty of Medicine, University of Chile, Santiago, Chile. .,Carrera de Nutrición y Dietética, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis A Videla
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Science, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Rodrigo Valenzuela
- Nutrition Department, Faculty of Medicine, University of Chile, Santiago, Chile.
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Brink LR, Chichlowski M, Pastor N, Thimmasandra Narayanappa A, Shah N. In the Age of Viral Pandemic, Can Ingredients Inspired by Human Milk and Infant Nutrition Be Repurposed to Support the Immune System? Nutrients 2021; 13:870. [PMID: 33800961 PMCID: PMC7999376 DOI: 10.3390/nu13030870] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 12/14/2022] Open
Abstract
In 2020, with the advent of a pandemic touching all aspects of global life, there is a renewed interest in nutrition solutions to support the immune system. Infants are vulnerable to infection and breastfeeding has been demonstrated to provide protection. As such, human milk is a great model for sources of functional nutrition ingredients, which may play direct roles in protection against viral diseases. This review aims to summarize the literature around human milk (lactoferrin, milk fat globule membrane, osteopontin, glycerol monolaurate and human milk oligosaccharides) and infant nutrition (polyunsaturated fatty acids, probiotics and postbiotics) inspired ingredients for support against viral infections and the immune system more broadly. We believe that the application of these ingredients can span across all life stages and thus apply to both pediatric and adult nutrition. We highlight the opportunities for further research in this field to help provide tangible nutrition solutions to support one's immune system and fight against infections.
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Affiliation(s)
- Lauren R. Brink
- Medical and Scientific Affairs, Nutrition, Reckitt Benckiser, Evansville, IN 47721, USA; (M.C.); (N.P.)
| | - Maciej Chichlowski
- Medical and Scientific Affairs, Nutrition, Reckitt Benckiser, Evansville, IN 47721, USA; (M.C.); (N.P.)
| | - Nitida Pastor
- Medical and Scientific Affairs, Nutrition, Reckitt Benckiser, Evansville, IN 47721, USA; (M.C.); (N.P.)
| | | | - Neil Shah
- Medical and Scientific Affairs, Nutrition, Reckitt Benckiser, Slough SL1 3UH, UK;
- University College London, Great Ormond Street, London WC1N 3JH, UK
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Patel D, Goruk S, Newell M, Chen G, Richard C, Field CJ. Feeding a Bioactive Oil Enriched in Stearidonic Acid during Early Life Influences Immune System Maturation in Neonatal Sprague-Dawley Rats. J Nutr 2020; 150:606-615. [PMID: 31722423 DOI: 10.1093/jn/nxz255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/09/2019] [Accepted: 09/26/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Long-chain n-3 PUFAs (LCPUFAs) improve immune development and reduce atopic disease risk in infants. Stearidonic acid (SDA) can be a substrate for biosynthesis of n-3 LCPUFAs. OBJECTIVE We aimed to determine the effect of feeding an SDA-enriched diet during suckling and weaning on offspring immunity and ability to develop oral tolerance (OT). METHODS Pregnant Sprague-Dawley rats were randomly assigned to consume either SDA (3 g SDA/100 g fat) or a control (no SDA) diet, 5 d before parturition and through lactation (21 d). For the OT treatment, 10-d-old pups were fed ovalbumin (Ova; 200 μL of 8 mg/mL) or placebo daily for 5 d. At 21 d, pups (both sexes) were weaned to their respective maternal diet until 6 wk of age or killed. Systemic immunization was induced using Ova (in 3-wk-old pups) or Ova + adjuvant (in 6-wk-old pups). The effect of suckling diet (in 3-wk-old pups) or weaning diet (in 6-wk-old pups) and OT treatment on immune function (main outcome) in spleen and blood was compared using 2-factor ANOVA. RESULTS An SDA-enriched maternal diet, compared with the control diet, resulted in higher plasma phospholipid (PL) EPA (15 times higher), docosapentaenoic acid (DPA; 3 times higher), and DHA (1.3 times higher) content in 3-wk-old pups, accompanied by higher B-cell function [plasma ovalbumin-specific IgG1 (Ova-IgG1), 2 times higher] ( P < 0.05). Compared with pups fed a control diet, the splenocytes from these pups had more (23%) helper T (Th) cells (CD3+CD4+) and activated (12%) Th cells (CD4+CD28+) (P < 0.02) than controls. At 6 wk, the SDA group had 30% more CD4+CD25+ splenocytes, and when stimulated ex vivo with LPS, produced less inflammatory IL-6 (50%) and TNF-α (30%) and more immunoregulatory IL-10 (45%) cytokines (P < 0.05) than the control group. The Ova-exposed group had less (30%) plasma Ova-IgG1 than the placebo group. Splenocytes and plasma PLs from the 6-wk-old SDA group had more EPA (2x) and DPA (3.5x) (P < 0.05), but not DHA, than the control group. CONCLUSIONS Feeding SDA during lactation and weaning altered immune responses in directions believed to be beneficial.
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Affiliation(s)
- Dhruvesh Patel
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Susan Goruk
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Marnie Newell
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Guanqun Chen
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Caroline Richard
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Catherine J Field
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
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Beluska-Turkan K, Korczak R, Hartell B, Moskal K, Maukonen J, Alexander DE, Salem N, Harkness L, Ayad W, Szaro J, Zhang K, Siriwardhana N. Nutritional Gaps and Supplementation in the First 1000 Days. Nutrients 2019; 11:E2891. [PMID: 31783636 PMCID: PMC6949907 DOI: 10.3390/nu11122891] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 12/23/2022] Open
Abstract
Optimized nutrition during the first 1000 days (from conception through the 2nd birthday) is critical for healthy development and a healthy life for the newborn. Pregnancy and the postpartum period are accompanied by physiological changes, increased energy needs, and changing requirements in the nutrients critical for optimal growth and development. Infants and toddlers also experience physiological changes and have specific nutritional needs. Food and nutrition experts can provide women of childbearing age with adequate dietary advice to optimize nutrition, as well as guidance on selecting appropriate dietary supplements. Considering the approaching 2020-2025 Dietary Guidelines for Americans (DGA) will be making specific recommendations for children, it is important to provide accurate scientific information to support health influencers in the field of nutrition. The purpose of this review is to summarize the nutrition and supplementation literature for the first 1000 days; to highlight nutritional and knowledge gaps; and to educate nutrition influencers to provide thoughtful guidance to mothers and families. Optimal nutrition during pregnancy through early childhood is critical for supporting a healthy life. Nutrition influencers, such as dietitians, obstetricians/gynecologists, and other relevant health professionals, should continue guiding supplement and food intake and work closely with expectant families and nutrition gatekeepers.
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Affiliation(s)
- Katrina Beluska-Turkan
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Renee Korczak
- Premier Nutrition, LLC, Bernardsville, NJ 07924, USA;
| | - Beth Hartell
- PearTree Nutrition, LLC, Seattle, WA 98115, USA;
| | - Kristin Moskal
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | | | | | - Norman Salem
- DSM Nutritional Products, Columbia, MD 21045, USA;
| | - Laura Harkness
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Wafaa Ayad
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Jacalyn Szaro
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Kelly Zhang
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
| | - Nalin Siriwardhana
- Church & Dwight, Co., Inc., Product Development Nutritional Sciences, Princeton, NJ 08540, USA; (K.B.-T.); (K.M.); (L.H.); (W.A.); (J.S.); (K.Z.)
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Factors associated with plasma n-3 and n-6 polyunsaturated fatty acid levels in Tanzanian infants. Eur J Clin Nutr 2019; 74:97-105. [PMID: 31024091 DOI: 10.1038/s41430-019-0428-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 01/28/2019] [Accepted: 04/03/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES To identify factors associated with plasma polyunsaturated fatty acid (PUFA) levels among 3-month-old Tanzanian infants. SUBJECTS/METHODS Infants (n = 238) and mothers (n = 193) randomly selected from participants in the neonatal vitamin A supplementation randomized controlled trial. A cross-sectional study of maternal-infant pairs at 3 months postpartum. RESULTS All infant total, n-3, n-6, and individual PUFA levels were correlated with maternal levels. Infant plasma n-3 PUFA levels were higher when maternal n-3 PUFA levels were higher (mean difference in infant % fatty acid per unit increase in maternal levels ± standard error: 0.79 ± 0.08; P < 0.01). Infant plasma docosahexaenoic acid (DHA) levels were positively associated with maternal DHA levels (0.77 ± 0.09; P < 0.01) but were lower for twin births (-0.55 ± 0.27; P = 0.03). Greater birth weight in kilograms (1.00 ± 0.43; P = 0.02) and higher maternal n-6 PUFA levels (0.20 ± 0.07; P < 0.01) were positively associated with higher infant n-6 PUFA levels, whereas maternal mono-unsaturated fatty acid (MUFA) levels (-0.26 ± 0.08; P < 0.01), maternal mid upper arm circumference (MUAC) (-0.22 ± 0.11; P = 0.04), and male sex (-0.99 ± 0.45; P = 0.03) were associated with lower infant plasma n-6 PUFA levels. Infant plasma arachidonic acid (AA) levels were positively associated with maternal plasma AA levels (0.38 ± 0.09; P < 0.01), but inversely associated with twin births (-1.37 ± 0.67; P = 0.04). CONCLUSIONS Greater birth weight and higher maternal plasma PUFA levels at 3 months postpartum were significantly associated with higher infant plasma PUFA levels at 3 months age. Twin births, male sex, and higher maternal MUFA levels were associated with lower infant plasma PUFA levels. Nutrition counseling for optimal intake of PUFA-rich foods, to lactating mothers in resource-limited settings may be beneficial for improved infant health.
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Serum fatty acids and progression from dengue fever to dengue haemorrhagic fever/dengue shock syndrome. Br J Nutr 2018; 120:787-796. [PMID: 30105961 DOI: 10.1017/s0007114518002039] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PUFA might modulate inflammatory responses involved in the development of severe dengue. We aimed to examine whether serum PUFA concentrations in patients diagnosed with dengue fever (DF) were related to the risk of progression to dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). A secondary aim was to assess correlations between fatty acids (FA) and inflammatory biomarkers in patients with DF. We conducted a prospective case-control study nested within a cohort of patients who were diagnosed with DF and followed during the acute episode. We compared the distribution of individual FA (% of total FA) at onset of fever between 109 cases who progressed to DHF/DSS and 235 DF non-progressing controls using unconditional logistic regression. We estimated correlations between baseline FA and cytokine concentrations and compared FA concentrations between the acute episode and >1 year post-convalescence in a subgroup. DHA was positively related to progression to DHF/DSS (multivariable adjusted OR (AOR) for DHA in quintile 5 v. 1=5·34, 95 % CI 2·03, 14·1; P trend=0·007). Dihomo-γ-linolenic acid (DGLA) was inversely associated with progression (AOR for quintile 5 v. 1=0·30, 95 % CI 0·13, 0·69; P trend=0·007). Pentadecanoic acid concentrations were inversely related to DHF/DSS. Correlations of PUFA with cytokines at baseline were low. PUFA were lower during the acute episode than in a disease-free period. In conclusion, serum DHA in patients with DF predicts higher odds of progression to DHF/DSS whereas DGLA and pentadecanoic acid predict lower odds.
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Lacombe RS, Kratz RJ, Holub BJ. Directly quantified dietary n-3 fatty acid intakes of Canadian toddlers are lower than current dietary recommendations. Nutr Res 2018; 53:85-91. [DOI: 10.1016/j.nutres.2018.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 02/09/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
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Argaw A, Wondafrash M, Bouckaert KP, Kolsteren P, Lachat C, Belachew T, De Meulenaer B, Huybregts L. Effects of n-3 long-chain PUFA supplementation to lactating mothers and their breastfed children on child growth and morbidity: a 2 × 2 factorial randomized controlled trial in rural Ethiopia. Am J Clin Nutr 2018; 107:454-464. [PMID: 29566189 DOI: 10.1093/ajcn/nqx057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/01/2017] [Indexed: 11/14/2022] Open
Abstract
Background Recurrent infections and inflammation contribute to growth faltering in low-income countries. n-3 (ω-3) Long-chain polyunsaturated fatty-acids (LC-PUFAs) may improve immune maturation, resistance to infections, and growth in young children who are at risk. Objective We evaluated the independent and combined effects of fish oil (500 mg n-3 LC-PUFAs/d) supplementation to lactating mothers and their breastfed children, aged 6-24 mo, on child morbidity, systemic inflammation, and growth in southwest Ethiopia. Design A 4-arm double-blind randomized controlled trial was conducted by enrolling 360 mother-infant pairs with infants 6-12 mo old. Study arms were both the lactating mother and child receiving fish oil intervention (MCI), only the lactating mother receiving fish oil intervention and child receiving placebo control (MI), only the child receiving intervention and mother receiving placebo control (CI), and both mother and child receiving a placebo supplement or control (C). The primary study outcome was linear growth using monthly changes in length-for-age z score. Anthropometric measurements were taken monthly, and hemoglobin, C-reactive protein, and blood LC-PUFAs were measured at baseline and after 6 and 12 mo of follow-up. Weekly morbidity surveillance was conducted throughout the study. Results Fish-oil supplementation significantly increased blood n-3 LC-PUFA concentration (P < 0.01) and decreased the arachidonic acid:(docosahexaenoic acid + eicosapentaenoic acid) ratio (P < 0.001) in all intervention arms. No significant intervention effect was found on linear growth, morbidity, or systemic inflammation. Compared to the control group, a small positive effect on monthly changes in weight-for-length z scores was found in the CI arm (effect size: 0.022/mo; 95% CI: 0.005, 0.039/mo; P = 0.012) and the MCI arm (effect size: 0.018/mo; 95% CI: 0.001, 0.034/mo; P = 0.041). Conclusions n-3 LC-PUFA supplementation of lactating mothers and children did not affect child linear growth and morbidity in a low-income setting. n-3 LC-PUFA supplementation given directly to children modestly increased relative weight gain. This trial was registered at clinicaltrials.gov as NCT01817634.
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Affiliation(s)
- Alemayehu Argaw
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia.,Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Mekitie Wondafrash
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia.,Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Kimberley P Bouckaert
- Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Carl Lachat
- Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Tefera Belachew
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Bruno De Meulenaer
- Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Lieven Huybregts
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC
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Developmental Outcomes at 24 Months of Age in Toddlers Supplemented with Arachidonic Acid and Docosahexaenoic Acid: Results of a Double Blind Randomized, Controlled Trial. Nutrients 2017; 9:nu9090975. [PMID: 28878181 PMCID: PMC5622735 DOI: 10.3390/nu9090975] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 12/27/2022] Open
Abstract
Little is known about arachidonic acid (ARA) and docosahexaenoic acid (DHA) requirements in toddlers. A longitudinal, double blind, controlled trial in toddlers (n = 133) age 13.4 ± 0.9 months (mean ± standard deviation), randomized to receive a DHA (200 mg/day) and ARA (200 mg/day) supplement (supplement) or a corn oil supplement (control) until age 24 months determined effects on neurodevelopment. We found no effect of the supplement on the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) cognitive and language composites and Beery–Buktenica Developmental Test of Visual–Motor Integration (Beery VMI) at age 24 months. Supplemented toddlers had higher RBC phosphatidylcholine (PC), phosphatidylethanolamine (PE), and plasma DHA and ARA compared to placebo toddlers at age 24 months. A positive relationship between RBC PE ARA and Bayley III Cognitive composite (4.55 (0.21–9.00), B (95% CI), p = 0.045) in supplemented boys, but not in control boys, was observed in models adjusted for baseline fatty acid, maternal non-verbal intelligence, and BMI z-score at age 24 months. A similar positive relationship between RBC PE ARA and Bayley III Language composite was observed for supplemented boys (11.52 (5.10–17.94), p < 0.001) and girls (11.19 (4.69–17.68), p = 0.001). These findings suggest that increasing the ARA status in toddlers is associated with better neurodevelopment at age 24 months.
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12
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Carlson SE, Colombo J. Docosahexaenoic Acid and Arachidonic Acid Nutrition in Early Development. Adv Pediatr 2016; 63:453-71. [PMID: 27426911 PMCID: PMC5207030 DOI: 10.1016/j.yapd.2016.04.011] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - John Colombo
- Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA; Department of Psychology, Life Span Institute, 1000 Sunnyside Avenue, University of Kansas, Lawrence, KS 66045, USA
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Collins CT, Gibson RA, Makrides M, McPhee AJ, Sullivan TR, Davis PG, Thio M, Simmer K, Rajadurai VS. The N3RO trial: a randomised controlled trial of docosahexaenoic acid to reduce bronchopulmonary dysplasia in preterm infants < 29 weeks' gestation. BMC Pediatr 2016; 16:72. [PMID: 27250120 PMCID: PMC4896378 DOI: 10.1186/s12887-016-0611-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 05/27/2016] [Indexed: 11/16/2022] Open
Abstract
Background Bronchopulmonary dysplasia (BPD) is a major cause of mortality and long-term respiratory and neurological morbidity in very preterm infants. While survival rates of very preterm infants have increased over the past two decades there has been no decrease in the rate of BPD in surviving infants. Evidence from animal and human studies has suggested potential benefits of docosahexaenoic acid (DHA), an n-3 long chain polyunsaturated fatty acid, in the prevention of chronic lung disease. This randomised controlled trial aims to determine the effectiveness of supplementary DHA in reducing the rate of BPD in infants less than 29 weeks’ gestation. Methods/design This is a multicentre, parallel group, randomised, blinded and controlled trial. Infants born less than 29 weeks’ gestation, within 3 days of first enteral feed and with parent informed consent are eligible to participate. Infants will be randomised to receive an enteral emulsion containing DHA or a control emulsion without DHA. The DHA emulsion will provide 60 mg/kg/day of DHA. The study emulsions will continue to 36 weeks’ postmenstrual age (PMA). The primary outcome is BPD as assessed by the requirement for supplemental oxygen and/or assisted ventilation at 36 weeks’ PMA. Secondary outcomes include the composite of death or BPD; duration of respiratory support and hospitalisation, major neonatal morbidities. The target sample size is 1244 infants (622 per group), which will provide 90 % power to detect a clinically meaningful absolute reduction of 10 % in the incidence of BPD between the DHA and control emulsion (two tailed α =0.05). Discussion DHA supplementation has the potential to reduce respiratory morbidity in very preterm infants. This multicentre trial will provide evidence on whether an enteral DHA supplement reduces BPD in very preterm infants. Trial registration Australia and New Zealand Clinical Trial Registry: ACTRN12612000503820. Registered 09 May 2012.
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Affiliation(s)
- Carmel T Collins
- Women's and Children's Health Research Institute, North Adelaide, South Australia, Australia. .,Healthy Mother's, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. .,Discipline of Paediatrics, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Robert A Gibson
- Healthy Mother's, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Maria Makrides
- Women's and Children's Health Research Institute, North Adelaide, South Australia, Australia.,Healthy Mother's, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,Discipline of Paediatrics, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew J McPhee
- Healthy Mother's, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,Neonatal Services, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Thomas R Sullivan
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Peter G Davis
- Newborn Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.,Clinical Sciences, The Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Marta Thio
- Newborn Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.,Clinical Sciences, The Murdoch Children's Research Institute, Parkville, VIC, Australia.,PIPER-Neonatal Retrieval Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Karen Simmer
- Centre of Neonatal Research and Education, The University of Western Australia, Perth, WA, Australia.,King Edward Memorial Hospital and Princess Margaret Hospital for Children, Subiaco, WA, Australia
| | - Victor S Rajadurai
- Department Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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14
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Kerling EH, Souther LM, Gajewski BJ, Sullivan DK, Georgieff MK, Carlson SE. Reducing Iron Deficiency in 18-36-months-old US Children: Is the Solution Less Calcium? Matern Child Health J 2016; 20:1798-803. [PMID: 26987860 DOI: 10.1007/s10995-016-1982-4] [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: 10/22/2022]
Abstract
Objectives National surveys consistently identify iron deficiency (ID) in US children between 1 and 3 years of age, when the brain is rapidly developing and vulnerable to the effects of ID. However, controversy remains as to how best to recognize and prevent ID in young children, in part because of the multiple potential etiologies. The objective of this project was to assess ID in children and identify potential individual dietary predictors of status. Methods We examined three biomarkers of ID [soluble transferrin receptor (sTfR) and serum ferritin (SF), and body iron (calculated from sTfR and SF)] against parent-provided dietary calcium and iron intake for eight-three 18-36 month old children from middle class families. Results Using literature-based cutoffs, fourteen children (16.9 %) had at least one indicator of ID: low SF(<10 μg/l, 7.2 %), negative body iron (<0 mg/kg, 7.2 %) or elevated sTfR (>8.4 μg/ml, 13.2 %). All children consumed more than the Dietary Reference Intake (DRI) Estimated Average Requirement of 3 mg/d iron. The mean iron intake of children identified with ID approximated the Recommended Dietary Allowance of 7 mg/d. Most children (81 %) consumed above the DRI Adequate Intake of 500 mg/d of calcium. Calcium intakes were generally high and predicted lower body iron (p = 0.0005), lower SF (p = 0.0086) and higher sTfR (p = 0.0176). Conclusions for Practice We found rates of ID similar to US national averages. Dietary calcium intake predicted lower iron status more than deficits in iron intake. Teaching parents to balance calcium and iron intake in toddlers could be a strategy to prevent ID.
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Affiliation(s)
- Elizabeth H Kerling
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Laura M Souther
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Byron J Gajewski
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | | | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
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15
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Pontes MV, Ribeiro TCM, Ribeiro H, de Mattos AP, Almeida IR, Leal VM, Cabral GN, Stolz S, Zhuang W, Scalabrin DMF. Cow's milk-based beverage consumption in 1- to 4-year-olds and allergic manifestations: an RCT. Nutr J 2016; 15:19. [PMID: 26920136 PMCID: PMC4769487 DOI: 10.1186/s12937-016-0138-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/18/2016] [Indexed: 12/31/2022] Open
Abstract
Background Nutrients such as docosahexaenoic acid (DHA), prebiotics and β-glucan have been associated with reduced incidence of respiratory illnesses and allergic manifestations (AM). Our objective was to assess if consumption of a cow’s milk-based beverage with these and other nutrients supports respiratory, gastrointestinal, and skin health in otherwise well-nourished, healthy children. Methods In this double-blind, randomized, controlled trial, healthy children (1–4 years of age) from two daycare centers in Brazil were fed three servings/day of a cow’s milk-based beverage (CMBB; n = 125) containing DHA, the prebiotics polydextrose (PDX) and galactooligosaccharides (GOS), β-glucan, and other key nutrients, or a control cow’s milk-based beverage (control; n = 131) for up to 28 weeks. Occurrence of respiratory infections, diarrheal disease and AM was assessed by study pediatricians and the number of episodes were analyzed with the Cochran-Mantel-Haenszel test and the Andersen-Gill model. Results The CMBB group had fewer episodes of AM, which included allergic rhinitis or conjunctivitis, wheezing, allergic cough, eczema and urticaria, compared to the control group (p = 0.021). The hazard ratio for increased number of episodes of AM was lower in the CMBB group compared to control (HR, 0.64; 95 % CI 0.47–0.89; p = 0.007). There was no difference in the incidence of respiratory infections and diarrheal disease between groups. Conclusion A cow’s milk-based beverage containing DHA, PDX/GOS, and yeast β-glucan, and supplemented with micronutrients, including zinc, vitamin A and iron, when consumed 3 times/day for 28 weeks by healthy 1- to 4-year-old children was associated with fewer episodes of allergic manifestations in the skin and the respiratory tract. Trial registration registration number: NCT01431469
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Affiliation(s)
- M V Pontes
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - T C M Ribeiro
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - H Ribeiro
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - A P de Mattos
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - I R Almeida
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - V M Leal
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - G N Cabral
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - S Stolz
- Mead Johnson Pediatric Nutrition Institute, Evansville, IN, USA.
| | - W Zhuang
- Mead Johnson Pediatric Nutrition Institute, Evansville, IN, USA.
| | - D M F Scalabrin
- Mead Johnson Pediatric Nutrition Institute, Evansville, IN, USA.
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16
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Malan L, Baumgartner J, Zandberg L, Calder PC, Smuts CM. Iron and a mixture of DHA and EPA supplementation, alone and in combination, affect bioactive lipid signalling and morbidity of iron deficient South African school children in a two-by-two randomised controlled trial. Prostaglandins Leukot Essent Fatty Acids 2016; 105:15-25. [PMID: 26869087 DOI: 10.1016/j.plefa.2015.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 11/20/2015] [Accepted: 12/05/2015] [Indexed: 11/17/2022]
Abstract
We recently reported that iron supplementation increased respiratory morbidity in iron deficient South African children. This increase, however, was attenuated when iron was provided in combination with a mixture of DHA/EPA. To explore potential underlying mechanisms, we examined the effects of iron and DHA/EPA, alone and in combination, on plasma lipid-derived immune modulator concentrations and related gene expression in peripheral blood mononuclear cells (PBMC). DHA/EPA decreased inflammatory 12-hydroxyeicosatetraenoic acid and tended to increase anti-inflammatory and pro-resolving 17-hydroxydocosahexaenoic acid (17-HDHA), while iron decreased 17-HDHA. However, in combination with iron, the anti-inflammatory effect of DHA/EPA was maintained. These biochemical changes may explain the prevention of iron-induced respiratory morbidity that we observed when iron was supplemented in combination with DHA/EPA during the 8.5 month randomised controlled trial and might lead to a safer approach of delivering iron supplementation. The study was registered at clinicaltrials.gov as NCT01092377.
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Affiliation(s)
- L Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa.
| | - J Baumgartner
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - L Zandberg
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - P C Calder
- The Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; The NIHR Southampton Biomedical Research Centre in Nutrition, Southampton University Hospital NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - C M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
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17
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Malan L, Baumgartner J, Calder PC, Zimmermann MB, Smuts CM. n-3 Long-chain PUFAs reduce respiratory morbidity caused by iron supplementation in iron-deficient South African schoolchildren: a randomized, double-blind, placebo-controlled intervention. Am J Clin Nutr 2015; 101:668-79. [PMID: 25733652 DOI: 10.3945/ajcn.113.081208] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Although iron supplementation in malaria-free areas mostly reduces infectious morbidity, it can sometimes increase morbidity from infections as a result of the dependence of pathogenic microorganisms on iron. Supplementation with n-3 (ω-3) long-chain polyunsaturated fatty acids (LCPUFAs) improved morbidity in several human studies. However, information on the combined effect of iron and n-3 LCPUFA supplementation on infectious morbidity is limited. OBJECTIVE We determined whether n-3 LCPUFAs and iron supplementation, alone or in combination, affected absenteeism and illness in iron-deficient schoolchildren with low fish intake. DESIGN A total of 321 South African children (aged 6-11 y) with iron deficiency (ID) were randomly divided into 4 groups to receive 1) iron plus placebo, 2) a mixture of docosahexaenoic acid and eicosapentaenoic acid (DHA/EPA) plus placebo, 3) iron plus DHA/EPA, or 4) placebo plus placebo as oral supplements 4 times/wk for 8.5 mo. Morbidity was recorded, and iron-status indexes were measured. The total phospholipid fatty acid composition of peripheral blood mononuclear cell membranes was analyzed in a subsample (n = 130). RESULTS Iron supplementation increased the number of days with illness when all symptoms were considered (B: 0.87; 95% CI: 0.71, 1.03) as well as illness that was specifically caused by respiratory symptoms (B: 1.45; 95% CI: 1.21, 1.70), whereas DHA/EPA reduced the number of days with illness at school (B: -0.96; 95% CI: -1.33, -0.59). The increases caused by iron were reduced to the levels seen in the placebo plus placebo group when iron was provided in combination with DHA/EPA as indicated by significant iron × DHA/EPA interactions (both P < 0.001). CONCLUSION Iron supplementation increased morbidity (mostly respiratory) in iron-deficient South African schoolchildren with low DHA/EPA intake, but when iron was given in combination with DHA/EPA, this effect was prevented.
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Affiliation(s)
- Linda Malan
- From the Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa (LM, CMS, and JB); the Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (PCC), the National Institute for Health Research Biomedical Research Centre in Nutrition, Southampton University Hospital National Health Service Foundation Trust and University of Southampton, Southampton, United Kingdom (PCC); the Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia (PCC); and the Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Eidgenössische Technische Hochschule Zürich, Switzerland (MBZ)
| | - Jeannine Baumgartner
- From the Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa (LM, CMS, and JB); the Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (PCC), the National Institute for Health Research Biomedical Research Centre in Nutrition, Southampton University Hospital National Health Service Foundation Trust and University of Southampton, Southampton, United Kingdom (PCC); the Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia (PCC); and the Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Eidgenössische Technische Hochschule Zürich, Switzerland (MBZ)
| | - Philip C Calder
- From the Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa (LM, CMS, and JB); the Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (PCC), the National Institute for Health Research Biomedical Research Centre in Nutrition, Southampton University Hospital National Health Service Foundation Trust and University of Southampton, Southampton, United Kingdom (PCC); the Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia (PCC); and the Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Eidgenössische Technische Hochschule Zürich, Switzerland (MBZ)
| | - Michael B Zimmermann
- From the Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa (LM, CMS, and JB); the Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (PCC), the National Institute for Health Research Biomedical Research Centre in Nutrition, Southampton University Hospital National Health Service Foundation Trust and University of Southampton, Southampton, United Kingdom (PCC); the Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia (PCC); and the Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Eidgenössische Technische Hochschule Zürich, Switzerland (MBZ)
| | - Cornelius M Smuts
- From the Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa (LM, CMS, and JB); the Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (PCC), the National Institute for Health Research Biomedical Research Centre in Nutrition, Southampton University Hospital National Health Service Foundation Trust and University of Southampton, Southampton, United Kingdom (PCC); the Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia (PCC); and the Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Eidgenössische Technische Hochschule Zürich, Switzerland (MBZ)
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18
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Decsi T, Lohner S. Gaps in Meeting Nutrient Needs in Healthy Toddlers. ANNALS OF NUTRITION AND METABOLISM 2014; 65:22-8. [DOI: 10.1159/000365795] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Lapillonne A, Pastor N, Zhuang W, Scalabrin DMF. Infants fed formula with added long chain polyunsaturated fatty acids have reduced incidence of respiratory illnesses and diarrhea during the first year of life. BMC Pediatr 2014; 14:168. [PMID: 24989353 PMCID: PMC4098921 DOI: 10.1186/1471-2431-14-168] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 06/25/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Long chain polyunsaturated fatty acids (LCPUFAs) may influence the immune system. Our objective was to compare the frequency of common illnesses in infants who received formula with or without added LCPUFAs. METHODS In this observational, multi-center, prospective study, infants consumed formula with 17 mg DHA and 34 mg ARA/100 kcal (n = 233) or with no added DHA or ARA (n = 92). Pediatricians recorded respiratory illnesses, otitis media, eczema, and diarrhea through 1 year of age. RESULTS Infants who consumed formula with DHA/ARA had lower incidence of bronchitis/bronchiolitis (P = 0.004), croup (P = 0.044), nasal congestion (P = 0.001), cough (P = 0.014), and diarrhea requiring medical attention (P = 0.034). The odds ratio (OR) of having at least one episode of bronchitis/bronchiolitis (0.41, 95% CI 0.24, 0.70; P = 0.001), croup (0.23, 95% CI 0.05, 0.97; P = 0.045), nasal congestion (0.37, 95% CI 0.20, 0.66; P = 0.001), cough (0.52, 95% CI 0.32, 0.86; P = 0.011), and diarrhea requiring medical attention (0.51, 95% CI 0.28, 0.92; P = 0.026) was lower in infants fed DHA/ARA. The OR of an increased number of episodes of bronchitis/bronchiolitis, croup, nasal congestion, cough, and diarrhea, as well as the hazard ratio for shorter time to first episode of bronchitis/bronchiolitis, nasal congestion, cough, and diarrhea were also significantly lower in the DHA/ARA group. CONCLUSIONS In healthy infants, formula with DHA/ARA was associated with lower incidence of common respiratory symptoms and illnesses, as well as diarrhea.
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Affiliation(s)
- Alexandre Lapillonne
- Department of Neonatology, APHP Necker Enfants Malades Hospital, Paris Descartes University, Paris, France
| | - Nitida Pastor
- Department of Medical Affairs, Clinical Research, Mead Johnson Nutrition, Evansville, USA
| | - Weihong Zhuang
- Department of Medical Affairs, Clinical Research, Mead Johnson Nutrition, Evansville, USA
| | - Deolinda MF Scalabrin
- Department of Medical Affairs, Clinical Research, Mead Johnson Nutrition, Evansville, USA
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20
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Li F, Jin X, Liu B, Zhuang W, Scalabrin D. Follow-up formula consumption in 3- to 4-year-olds and respiratory infections: an RCT. Pediatrics 2014; 133:e1533-40. [PMID: 24843061 DOI: 10.1542/peds.2013-3598] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Children are vulnerable to diet inadequacies, which may affect immune function. Our objective was to determine if a follow-up formula (FUF) containing DHA, the prebiotics PDX and GOS, and yeast β-glucan affects incidence of respiratory infections and diarrheal disease in healthy children. METHODS In a double-blind, randomized, controlled, prospective trial, 3-4 year old children were fed 3 servings per day of either a FUF with 25 mg DHA, 1.2 g PDX/GOS, and 8.7 mg yeast β-glucan per serving or an unfortified, cow's milk-based beverage (control) for 28 weeks. Fecal and blood samples were collected to assess immune markers and iron/zinc status. Incidence of acute respiratory infections (ARI), diarrheal disease, and antibiotic treatment were obtained from medical records. RESULTS The FUF group had fewer episodes and shorter duration of ARI (mean days [SE]; control = 4.3 [0.2]; FUF = 3.5 [0.2]; P = .007), less antibiotic use (n [%]; control = 21 [14%]; FUF = 8 [5%]; P = .01), and fewer missed days of day care due to illness. No diarrheal disease was diagnosed in either group. The FUF group had higher interleukin-10 and white blood cell count at the end of the study. There were no differences in hemoglobin, serum ferritin and zinc, or fecal secretory immunoglobulin A. CONCLUSIONS Daily consumption of a FUF was associated with fewer episodes and shorter duration of ARI, as well as less antibiotic use. The children who consumed the FUF had increased interleukin-10 and white blood cells, suggesting an antiinflammatory mechanism and/or an increase of effector immune cells.
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Affiliation(s)
- Fei Li
- Developmental and Behavioral Pediatric Department, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China; and
| | - Xingming Jin
- Developmental and Behavioral Pediatric Department, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China; and
| | - Bryan Liu
- Clinical Research, Department of Medical Affairs, Mead Johnson Nutrition, Evansville, Indiana
| | - Weihong Zhuang
- Clinical Research, Department of Medical Affairs, Mead Johnson Nutrition, Evansville, Indiana
| | - Deolinda Scalabrin
- Clinical Research, Department of Medical Affairs, Mead Johnson Nutrition, Evansville, Indiana
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21
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Scientific Opinion on nutrient requirements and dietary intakes of infants and young children in the European Union. EFSA J 2013. [DOI: 10.2903/j.efsa.2013.3408] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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22
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Weiss GA, Troxler H, Klinke G, Rogler D, Braegger C, Hersberger M. High levels of anti-inflammatory and pro-resolving lipid mediators lipoxins and resolvins and declining docosahexaenoic acid levels in human milk during the first month of lactation. Lipids Health Dis 2013; 12:89. [PMID: 23767972 PMCID: PMC3698171 DOI: 10.1186/1476-511x-12-89] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 06/10/2013] [Indexed: 02/07/2023] Open
Abstract
Background The fatty acid mixture of human milk is ideal for the newborn but little is known about its composition in the first few weeks of lactation. Of special interest are the levels of long-chain PUFAs (LCPUFAs), since these are essential for the newborn’s development. Additionally, the LCPUFAs arachidonic acid (AA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are precursors for lipid mediators which regulate inflammation. Methods We determined the composition of 94 human milk samples from 30 mothers over the first month of lactation for fatty acids using GC-MS and quantified lipid mediators using HPLC-MS/MS. Results Over the four weeks period, DHA levels decreased, while levels of γC18:3 and αC18:3 steadily increased. Intriguingly, we found high concentrations of lipid mediators and their hydroxy fatty acid precursors in human milk, including pro-inflammatory leukotriene B4 (LTB4) and anti-inflammatory and pro-resolving lipoxin A4 (LXA4), resolvin D1 (RvD1) and resolvin E1 (RvE1). Lipid mediator levels were stable with the exception of two direct precursors. Conclusions Elevated levels of DHA right after birth might represent higher requirements of the newborn and the high content of anti-inflammatory and pro-resolving lipid mediators and their precursors may indicate their role in neonatal immunity and may be one of the reasons for the advantage of human milk over infant formula.
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Affiliation(s)
- Gisela Adrienne Weiss
- Clinical Chemistry and Biochemistry, Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
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23
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Hageman JHJ, Hooyenga P, Diersen-Schade DA, Scalabrin DMF, Wichers HJ, Birch EE. The impact of dietary long-chain polyunsaturated fatty acids on respiratory illness in infants and children. Curr Allergy Asthma Rep 2012; 12:564-73. [PMID: 23001718 PMCID: PMC3492691 DOI: 10.1007/s11882-012-0304-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Increasing evidence suggests that intake of long-chain polyunsaturated fatty acids (LCPUFA), especially omega-3 LCPUFA, improves respiratory health early in life. This review summarizes publications from 2009 through July 2012 that evaluated effects of fish, fish oil or LCPUFA intake during pregnancy, lactation, and early postnatal years on allergic and infectious respiratory illnesses. Studies during pregnancy found inconsistent effects in offspring: two showed no effects and three showed protective effects of omega-3 LCPUFA on respiratory illnesses or atopic dermatitis. Two studies found that infants fed breast milk with higher omega-3 LCPUFA had reduced allergic manifestations. Earlier introduction of fish improved respiratory health or reduced allergy in four studies. Three randomized controlled trials showed that providing LCPUFA during infancy or childhood reduced allergy and/or respiratory illness while one found no effect. Potential explanations for the variability among studies and possible mechanisms of action for LCPUFA in allergy and respiratory disease are discussed.
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Affiliation(s)
- Jeske H. J. Hageman
- Human Nutrition Department, Wageningen University, Bornse Weilanden 9, 6708 WG Wageningen, the Netherlands
| | - Pieter Hooyenga
- Mead Johnson Nutrition, Middenkampweg 2, 6545 CJ Nijmegen, the Netherlands
| | | | | | - Harry J. Wichers
- Wageningen University Food & Biobased Research, Bornse Weilanden 9, 6708 WG Wageningen, the Netherlands
| | - Eileen E. Birch
- Retina Foundation of the Southwest, 9900 North Central Expressway, Suite 400, Dallas, TX 75231 USA
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24
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Carlson SJ, Fallon EM, Kalish BT, Gura KM, Puder M. The Role of the ω-3 Fatty Acid DHA in the Human Life Cycle. JPEN J Parenter Enteral Nutr 2012. [DOI: 10.1177/0148607112467821] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Kathleen M. Gura
- Department of Pharmacy, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mark Puder
- Department of Surgery and the Vascular Biology Program
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Role of dietary long-chain polyunsaturated fatty acids in infant allergies and respiratory diseases. Clin Dev Immunol 2012; 2012:730568. [PMID: 23049602 PMCID: PMC3461300 DOI: 10.1155/2012/730568] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 08/21/2012] [Accepted: 08/23/2012] [Indexed: 11/21/2022]
Abstract
Maternal nutrition has critical effects on the developing structures and functions of the fetus. Malnutrition during pregnancy can result in low birth weight and small for gestational age babies, increase risk for infection, and impact the immune system. Long-chain polyunsaturated fatty acids (PUFAs) have been reported to have immunomodulatory effects. Decreased consumption of omega-6 PUFAs, in favor of more anti-inflammatory omega-3 PUFAs in modern diets, has demonstrated the potential protective role of omega-3 PUFAs in allergic and respiratory diseases. In this paper, we examine the role of PUFAs consumption during pregnancy and early childhood and its influence on allergy and respiratory diseases. PUFAs act via several mechanisms to modulate immune function. Omega-3 PUFAs may alter the T helper (Th) cell balance by inhibiting cytokine production which in turn inhibits immunoglobulin E synthesis and Th type 2 cell differentiation. PUFAs may further modify cellular membrane, induce eicosanoid metabolism, and alter gene expression. These studies indicate the benefits of omega-3 PUFAs supplementation. Nevertheless, further investigations are warranted to assess the long-term effects of omega-3 PUFAs in preventing other immune-mediated diseases, as well as its effects on the later immunodefense and health status during early growth and development.
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Morse NL. Benefits of docosahexaenoic acid, folic acid, vitamin D and iodine on foetal and infant brain development and function following maternal supplementation during pregnancy and lactation. Nutrients 2012; 4:799-840. [PMID: 22852064 PMCID: PMC3407995 DOI: 10.3390/nu4070799] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 07/09/2012] [Accepted: 07/12/2012] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED Scientific literature is increasingly reporting on dietary deficiencies in many populations of some nutrients critical for foetal and infant brain development and function. PURPOSE To highlight the potential benefits of maternal supplementation with docosahexaenoic acid (DHA) and other important complimentary nutrients, including vitamin D, folic acid and iodine during pregnancy and/or breast feeding for foetal and/or infant brain development and/or function. METHODS English language systematic reviews, meta-analyses, randomised controlled trials, cohort studies, cross-sectional and case-control studies were obtained through searches on MEDLINE and the Cochrane Register of Controlled Trials from January 2000 through to February 2012 and reference lists of retrieved articles. Reports were selected if they included benefits and harms of maternal supplementation of DHA, vitamin D, folic acid or iodine supplementation during pregnancy and/or lactation. RESULTS Maternal DHA intake during pregnancy and/or lactation can prolong high risk pregnancies, increase birth weight, head circumference and birth length, and can enhance visual acuity, hand and eye co-ordination, attention, problem solving and information processing. Vitamin D helps maintain pregnancy and promotes normal skeletal and brain development. Folic acid is necessary for normal foetal spine, brain and skull development. Iodine is essential for thyroid hormone production necessary for normal brain and nervous system development during gestation that impacts childhood function. CONCLUSION Maternal supplementation within recommended safe intakes in populations with dietary deficiencies may prevent many brain and central nervous system malfunctions and even enhance brain development and function in their offspring.
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Affiliation(s)
- Nancy L Morse
- Efamol Ltd., 14 Mole Business Park, Leatherhead KT22 7BA, UK.
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Abstract
The aims of the present study were to review the validity of dietary methods used to measure the usual long chain (LC) omega-3 polyunsaturated fatty acid (n-3 PUFA) intake of a population and to assess the usefulness of different biomarkers of n-3 PUFA in healthy humans. Two systematic literature searches were conducted until May 2011 to update previous systematic reviews. The first literature search aimed to find studies validating the methodology used for measuring the dietary intake of n-3 PUFA. The second search aimed to find human intervention studies in which n-3 PUFA status changed after 2 weeks of n-3 PUFA supplementation. Sixteen studies were identified for inclusion in the first review. Correlation coefficients between fatty acids in subcutaneous fat or blood lipids and dietary intake of n-3 PUFA from different questionnaires were similar. Subcutaneous fat has been reported as the best reference method for some authors, and these studies showed moderate correlation coefficients with no dietary intake method being superior to any other. As for the evaluation of biomarkers of docosahexaenoic acid (DHA, 22 : 6 n-3) and eicosapentaenoic acid (EPA, 20 : 5n-3) status in response to supplementation, the new search reaffirmed and reinforced the evidence supporting that plasma phospholipid DHA, erythrocyte DHA, and platelet DHA were all effective and robust biomarkers of DHA status. Our findings only confirmed earlier studies and did not provide evidence for reaching new conclusions.
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Tyburczy C, Brenna ME, DeMari JA, Kothapalli KSD, Blank BS, Valentine H, McDonough SP, Banavara D, Diersen-Schade DA, Brenna JT. Evaluation of bioequivalency and toxicological effects of three sources of arachidonic acid (ARA) in domestic piglets. Food Chem Toxicol 2011; 49:2320-7. [PMID: 21722692 PMCID: PMC3148427 DOI: 10.1016/j.fct.2011.06.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 06/13/2011] [Accepted: 06/15/2011] [Indexed: 11/29/2022]
Abstract
Arachidonic acid (ARA) and docosahexaenoic acid (DHA) are routinely added to infant formula to support growth and development. We evaluated the bioequivalence and safety of three ARA-rich oils for potential use in infant formula using the neonatal pig model. The primary outcome for bioequivalence was brain accretion of ARA and DHA. Days 3-22 of age, domestic pigs were fed one of three formulas, each containing ARA at ∼0.64% and DHA at ∼0.34% total fatty acids (FA). Control diet ARA was provided by ARASCO and all diets had DHA from DHASCO (Martek Biosciences Corp., Columbia, MD). The experimental diets a1 and a2 provided ARA from Refined Arachidonic acid-rich Oil (RAO; Cargill, Inc., Wuhan, China) and SUNTGA40S (Nissui, Nippon Suisan Kaisha, Ltd., Tokyo, Japan), respectively. Formula intake and growth were similar across all diets, and ARA was bioequivalent across treatments in the brain, retina, heart, liver and day 21 RBC. DHA levels in the brain, retina and heart were unaffected by diet. Liver sections, clinical chemistry, and hematological parameters were normal. We conclude that RAO and SUNTGA40S, when added to formula to supply ∼0.64% ARA are safe and nutritionally bioequivalent to ARASCO in domestic piglets.
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Affiliation(s)
- Cynthia Tyburczy
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA
| | - Margaret E. Brenna
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA
| | - Joseph A. DeMari
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA
| | | | - Bryant S. Blank
- College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Helen Valentine
- College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Sean P. McDonough
- College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | | | | | - J. Thomas Brenna
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA
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Imhoff-Kunsch B, Stein AD, Martorell R, Parra-Cabrera S, Romieu I, Ramakrishnan U. Prenatal docosahexaenoic acid supplementation and infant morbidity: randomized controlled trial. Pediatrics 2011; 128:e505-12. [PMID: 21807696 PMCID: PMC3164093 DOI: 10.1542/peds.2010-1386] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Long-chain polyunsaturated fatty acids such as docosahexaenoic acid (DHA) influence immune function and inflammation; however, the influence of maternal DHA supplementation on infant morbidity is unknown. We investigated the effects of prenatal DHA supplementation on infant morbidity. METHODS In a double-blind randomized controlled trial conducted in Mexico, pregnant women received daily supplementation with 400 mg of DHA or placebo from 18 to 22 weeks' gestation through parturition. In infants aged 1, 3, and 6 months, caregivers reported the occurrence of common illness symptoms in the preceding 15 days. RESULTS Data were available at 1, 3, and 6 months for 849, 834, and 834 infants, respectively. The occurrence of specific illness symptoms did not differ between groups; however, the occurrence of a combined measure of cold symptoms was lower in the DHA group at 1 month (OR: 0.76; 95% CI: 0.58-1.00). At 1 month, the DHA group experienced 26%, 15%, and 30% shorter duration of cough, phlegm, and wheezing, respectively, but 22% longer duration of rash (all P ≤ .01). At 3 months, infants in the DHA group spent 14% less time ill (P < .0001). At 6 months, infants in the DHA group experienced 20%, 13%, 54%, 23%, and 25% shorter duration of fever, nasal secretion, difficulty breathing, rash, and "other illness," respectively, but 74% longer duration of vomiting (all P < .05). CONCLUSIONS DHA supplementation during pregnancy decreased the occurrence of colds in children at 1 month and influenced illness symptom duration at 1, 3, and 6 months.
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Affiliation(s)
- Beth Imhoff-Kunsch
- Nutrition and Health Sciences Program and ,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia; and
| | - Aryeh D. Stein
- Nutrition and Health Sciences Program and ,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia; and
| | - Reynaldo Martorell
- Nutrition and Health Sciences Program and ,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia; and
| | | | - Isabelle Romieu
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Usha Ramakrishnan
- Nutrition and Health Sciences Program and ,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia; and
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Sijben JW, Goedhart AC, Kamphuis PJ, Calder PC, Gottrand F, Koletzko B. Is it prudent to add n-3 long-chain polyunsaturated fatty acids to paediatric enteral tube feeding? Clin Nutr 2011; 30:273-81. [DOI: 10.1016/j.clnu.2010.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 11/10/2010] [Accepted: 11/20/2010] [Indexed: 01/14/2023]
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Lauritzen L, Carlson SE. Maternal fatty acid status during pregnancy and lactation and relation to newborn and infant status. MATERNAL & CHILD NUTRITION 2011; 7 Suppl 2:41-58. [PMID: 21366866 PMCID: PMC6860497 DOI: 10.1111/j.1740-8709.2011.00303.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present review of determinants of infant fatty acid status was undertaken as part of a conference on 'Fatty acid status in early life in low-income countries: determinants and consequences'. Emphasis is placed on the essential fatty acids, and particularly the physiologically important long chain polyunsaturated fatty acids (LCPUFAs) of 20 and 22 carbons. We are unaware of any studies of determinants of infant fatty acid status in populations with a cultural dietary pattern with low amounts of linoleic acid (LA, 18:2n-6) and α-linolenic acid (ALA,18:3n-3). Many reports suggest that there may be adverse health effects related to the increased proportion of LA in relation to ALA, which have occurred worldwide due to the increased availability of vegetable oils high in LA. The issue of dietary n-6 to n-3 balance may apply to infant fatty acid status both during fetal and post-natal life; however, this review focuses on the n-3 and n-6 LCPUFA, in particular, docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6), which are the predominant n-3 and n-6 LCPUFA found in cell membranes. The evidence that these fatty acids are preferentially transferred from maternal to fetal circulation across the placenta, and the sources and mechanisms for this transfer, are reviewed. We also address the sources of DHA and AA for the newborn including human milk DHA and AA and the factors that influence maternal DHA status and consequently the amount of DHA available for transfer to the fetus and infant via human milk.
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Affiliation(s)
- Lotte Lauritzen
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Rolighedsvej 30, Frederiksberg, Denmark.
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