1
|
Abstract
In evaluating vitamin E (VE) nutritional status of preterm infants, it is essential that any data should be compared with those of healthy term infants, and never with those of adults. Moreover, it should be evaluated in terms of gestational age (GA), not birth weight (BW), because placental transfer of most nutrients from mother to fetus is dependent on GA, not BW. Judging from the limited data during the last 75 years, there was no significant correlation between GA and VE concentrations in circulation or in the red blood cells (RBCs), leukocytes, and buccal mucosal cells. In addition, the oxidizability of polyunsaturated fatty acids (PUFAs) in plasma or RBCs, as targets for protection by VE chain-breaking ability, was lower in preterm infants. However, because of the minimal information available about hepatic VE levels, which is considered a key determinant of whole body VE status, the decision on whether VE status of preterm infants is comparable with that of term infants should be postponed. Clinical trials of VE supplementation in preterm infants were repeatedly undertaken to investigate whether VE reduces severity or inhibits development of several diseases specific to preterm infants, namely retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and germinal matrix hemorrhage - intraventricular hemorrhage (GMH-IVH). Most of these trials resulted in a misfire, with a few exceptions for IVH prevention. However, almost all these studies were performed from 1980s to early 1990s, in the pre-surfactant era, and the study populations were composed of mid-preterm infants with GAs of approximately 30 weeks (wks). There is considerable difference in 'preterm infants' between the pre- and post-surfactant eras; modern neonatal medicine mainly treats preterm infants of 28 wks GA or less. Therefore, these results are difficult to apply in modern neonatal care. Before considering new trials of VE supplementation, we should fully understand modern neonatal medicine, especially the recent method of oxygen supplementation. Additionally, a deeper understanding of recent progress in pathophysiology and therapies for possible target diseases is necessary to decide whether VE administration is still worth re-challenging in modern neonatal intensive care units (NICUs). In this review, we present recent concepts and therapeutic trends in ROP, BPD, and GMH-IVH for those unfamiliar with neonatal medicine. Numerous studies have reported the possible involvement of reactive oxygen species (ROS)-induced damage in relation to supplemental oxygen use, inflammation, and immature antioxidant defense in the development of both BPD and ROP. Various antioxidants effectively prevented the exacerbation of BPD and ROP in animal models. In the future, VE should be re-attempted as a complementary factor in combination with various therapies for BPD, ROP, and GMH-IVH. Because VE is a natural and safe supplement, we are certain that it will attract attention again in preterm medicine.
Collapse
Affiliation(s)
- Tohru Ogihara
- Division of Neonatology, Department of Pediatrics, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
| | - Makoto Mino
- Division of Neonatology, Department of Pediatrics, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| |
Collapse
|
2
|
Perretta L, Ouldibbat L, Hagadorn JI, Brumberg HL. High versus low medium chain triglyceride content of formula for promoting short-term growth of preterm infants. Cochrane Database Syst Rev 2021; 2:CD002777. [PMID: 33620090 PMCID: PMC8094384 DOI: 10.1002/14651858.cd002777.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In-hospital growth of preterm infants remains a challenge in clinical practice. The high nutrient demands of preterm infants often lead to growth faltering. For preterm infants who cannot be fed maternal or donor breast milk or may require supplementation, preterm formulas with fat in the form of medium chain triglycerides (MCTs) or long chain triglycerides (LCTs) may be chosen to support nutrient utilization and to improve growth. MCTs are easily accessible to the preterm infant with an immature digestive system, and LCTs are beneficial for central nervous system development and visual function. Both have been incorporated into preterm formulas in varying amounts, but their effects on the preterm infant's short-term growth remain unclear. This is an update of a review originally published in 2002, then in 2007. OBJECTIVES To determine the effects of formula containing high as opposed to low MCTs on early growth in preterm infants fed a diet consisting primarily of formula. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 8), in the Cochrane Library; Ovid MEDLINE Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily, and Ovid MEDLINE(R); MEDLINE via PubMed for the previous year; and Cumulative Index to Nursing and Allied Health Literature (CINAHL), on 16 September 2020. We also searched clinical trials databases and the reference lists of retrieved articles for randomized controlled trials (RCTs) and quasi-RCTs. SELECTION CRITERIA We included all randomized and quasi-randomized trials comparing the effects of feeding high versus low MCT formula (for a minimum of five days) on the short-term growth of preterm (< 37 weeks' gestation) infants. We defined high MCT formula as 30% or more by weight, and low MCT formula as less than 30% by weight. The infants must be on full enteral diets, and the allocated formula must be the predominant source of nutrition. DATA COLLECTION AND ANALYSIS The review authors assessed each study's quality and extracted data on growth parameters as well as adverse effects from included studies. All data used in analysis were continuous; therefore, mean differences with 95% confidence intervals were reported. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS We identified 10 eligible trials (253 infants) and extracted relevant growth data from 7 of these trials (136 infants). These studies were found to provide evidence of very low to low certainty. Risk of bias was noted, as few studies described specific methods for random sequence generation, allocation concealment, or blinding. We found no evidence of differences in short-term growth parameters when high and low MCT formulas were compared. As compared to low MCT formula, preterm infants fed high MCT formula showed little to no difference in weight gain velocity (g/kg/d) during the intervention, with a typical mean difference (MD) of -0.21 g/kg/d (95% confidence interval (CI) -1.24 to 0.83; 6 studies, 118 infants; low-certainty evidence). The analysis for weight gain (g/d) did not show evidence of differences, with an MD of 0.00 g/d (95% CI -5.93 to 5.93; 1 study, 18 infants; very low-certainty evidence), finding an average weight gain of 20 ± 5.9 versus 20 ± 6.9 g/d for high and low MCT groups, respectively. We found that length gain showed no difference between low and high MCT formulas, with a typical MD of 0.10 cm/week (95% CI -0.09 to 0.29; 3 studies, 61 infants; very low-certainty evidence). Head circumference gain also showed little to no difference during the intervention period, with an MD of -0.04 cm/week (95% CI -0.17 to 0.09; 3 studies, 61 infants; low-certainty evidence). Two studies reported skinfold thickness with different measurement definitions, and evidence was insufficient to determine if there was a difference (2 studies, 32 infants; very low-certainty evidence). There are conflicting data (5 studies) as to formula tolerance, with 4 studies reporting narrative results of no observed clinical difference and 1 study reporting higher incidence of signs of gastrointestinal intolerance in high MCT formula groups. There is no evidence of effect on the incidence of necrotizing enterocolitis (NEC), based on small numbers in two trials. Review authors found no studies addressing long-term growth parameters or neurodevelopmental outcomes. AUTHORS' CONCLUSIONS We found evidence of very low to low certainty suggesting no differences among short-term growth data for infants fed low versus high MCT formulas. Due to lack of evidence and uncertainty, neither formula type could be concluded to improve short-term growth outcomes or have fewer adverse effects. Further studies are necessary because the results from included studies are imprecise due to small numbers and do not address important long-term outcomes. Additional research should aim to clarify effects on formula tolerance and on long-term growth and neurodevelopmental outcomes, and should include larger study populations to better evaluate effect on NEC incidence.
Collapse
Affiliation(s)
- Laura Perretta
- Division of Newborn Medicine, New York Medical College-Westchester Medical Center, Valhalla, NY, USA
| | - Laila Ouldibbat
- Clinical Nutrition, Westchester Medical Center/Maria Fareri Children's Hospital, Valhalla, NY, USA
| | - James I Hagadorn
- Division of Neonatology, Connecticut Children's, Hartford, CT, USA
| | - Heather L Brumberg
- Division of Newborn Medicine, New York Medical College-Westchester Medical Center, Valhalla, NY, USA
| |
Collapse
|
3
|
Olmos MAM, Vázquez MJM, Gorría MJM, González PP, Martínez IO, Chimeno IM, González EP, Bobo MTI, Núñez JEC. Effect of Parenteral Nutrition on Nutrition Status After Bariatric Surgery for Morbid Obesity. JPEN J Parenter Enteral Nutr 2017; 29:445-50. [PMID: 16224039 DOI: 10.1177/0148607105029006445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To evaluate the influence of nutrition support (parenteral nutrition [PN] vs no parenteral nutrition [nPN]) on nutrition outcome, complications, and hospital stay after bariatric surgery (BS). METHODS Sixty-seven consecutive BS patients (17 gastric bypass and 50 biliopancreatic diversion). The first 38 received PN and the next 29 did not (nPN) during the fasting postoperative (PO) period. In both groups, after fasting, a progressive oral diet was introduced. Data related to nutrition status, perioperative complications, and postsurgical hospital stay were compared. RESULTS Sixty-seven patients (58 women), mean age 39.4 +/- 11.0 years, body mass index (BMI) 50.7 +/- 6.1 kg/m(2), were included. Thirty-eight patients received PN during 8.7 +/- 2.6 days. Ingestion was initiated at a median 8 PO days in PN vs 6.5 PO days in nPN (p < .04). No significant differences between groups were found in age, final fasting serum albumin (SA), and 30 days postoperative SA, with a similar weight loss. Nonsignificant differences were found in non-catheter-related infectious complications, being mainly urinary tract infections. Catheter-related infections were present in 21.1% in the PN group and 13.8% in the nPN (p = .33). Median hospital stay after surgery was 14 +/- 10 days in PN and 12 +/- 10 days in nPN (p = .003). CONCLUSIONS (1) Nutrition status after BS PO and 30 days postsurgery was no different between PN and nPN. (2) Postsurgery hospital stay was significantly decreased in the nPN group, without a greater incidence of complications. (3) According to nutrition outcome, PN seems unnecessary at the perioperative period in BS unless there are other postsurgical complications.
Collapse
Affiliation(s)
- M A Martínez Olmos
- Endocrinology and Nutrition, Hospital do Meixoeiro, Complejo Hospitalario Universitario de Vigo, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Schindler T, Sinn JKH, Osborn DA. Polyunsaturated fatty acid supplementation in infancy for the prevention of allergy. Cochrane Database Syst Rev 2016; 10:CD010112. [PMID: 27788565 PMCID: PMC6464137 DOI: 10.1002/14651858.cd010112.pub2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Early dietary intakes may influence the development of allergic disease. It is important to determine if dietary polyunsaturated fatty acids (PUFAs) given as supplements or added to infant formula prevent the development of allergy. OBJECTIVES To determine the effect of higher PUFA intake during infancy to prevent allergic disease. SEARCH METHODS We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 9), MEDLINE (1966 to 14 September 2015), EMBASE (1980 to 14 September 2015) and CINAHL (1982 to 14 September 2015). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA Randomised and quasi-randomised controlled trials that compared the use of a PUFA with no PUFA in infants for the prevention of allergy. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials, assessed trial quality and extracted data from the included studies. We used fixed-effect analyses. The treatment effects were expressed as risk ratio (RR) with 95% confidence intervals (CI). We used the GRADE approach to assess the quality of evidence. MAIN RESULTS The search found 17 studies that assessed the effect of higher versus lower intake of PUFAs on allergic outcomes in infants. Only nine studies enrolling 2704 infants reported allergy outcomes that could be used in meta-analyses. Of these, there were methodological concerns for eight.In infants up to two years of age, meta-analyses found no difference in incidence of all allergy (1 study, 323 infants; RR 0.96, 95% CI 0.73 to 1.26; risk difference (RD) -0.02, 95% CI -0.12 to 0.09; heterogeneity not applicable), asthma (3 studies, 1162 infants; RR 1.04, 95% CI 0.80 to 1.35, I2 = 0%; RD 0.01, 95% CI -0.04 to 0.05, I2 = 0%), dermatitis/eczema (7 studies, 1906 infants; RR 0.93, 95% CI 0.82 to 1.06, I2 = 0%; RD -0.02, 95% CI -0.06 to 0.02, I2 = 0%) or food allergy (3 studies, 915 infants; RR 0.81, 95% CI 0.56 to 1.19, I2 = 63%; RD -0.02, 95% CI -0.06 to 0.02, I2 = 74%). There was a reduction in allergic rhinitis (2 studies, 594 infants; RR 0.47, 95% CI 0.23 to 0.96, I2 = 6%; RD -0.04, 95% CI -0.08 to -0.00, I2 = 54%; number needed to treat for an additional beneficial outcome (NNTB) 25, 95% CI 13 to ∞).In children aged two to five years, meta-analysis found no difference in incidence of all allergic disease (2 studies, 154 infants; RR 0.69, 95% CI 0.47 to 1.02, I2 = 43%; RD -0.16, 95% CI -0.31 to -0.00, I2 = 63%; NNTB 6, 95% CI 3 to ∞), asthma (1 study, 89 infants; RR 0.45, 95% CI 0.20 to 1.02; RD -0.20, 95% CI -0.37 to -0.02; heterogeneity not applicable; NNTB 5, 95% CI 3 to 50), dermatitis/eczema (2 studies, 154 infants; RR 0.65, 95% CI 0.34 to 1.24, I2 = 0%; RD -0.09 95% CI -0.22 to 0.04, I2 = 24%) or food allergy (1 study, 65 infants; RR 2.27, 95% CI 0.25 to 20.68; RD 0.05, 95% CI -0.07 to 0.16; heterogeneity not applicable).In children aged two to five years, meta-analysis found no difference in prevalence of all allergic disease (2 studies, 633 infants; RR 0.98, 95% CI 0.81 to 1.19, I2 = 36%; RD -0.01, 95% CI -0.08 to 0.07, I2 = 0%), asthma (2 studies, 635 infants; RR 1.12, 95% CI 0.82 to 1.53, I2 = 0%; RD 0.02, 95% CI -0.04 to 0.09, I2 = 0%), dermatitis/eczema (2 studies, 635 infants; RR 0.81, 95% CI 0.59 to 1.09, I2 = 0%; RD -0.04 95% CI -0.11 to 0.02, I2 = 0%), allergic rhinitis (2 studies, 635 infants; RR 1.02, 95% CI 0.83 to 1.25, I2 = 0%; RD 0.01, 95% CI -0.06 to 0.08, I2 = 0%) or food allergy (1 study, 119 infants; RR 0.27, 95% CI 0.06 to 1.19; RD -0.10, 95% CI -0.20 to -0.00; heterogeneity not applicable; NNTB 10, 95% CI 5 to ∞). AUTHORS' CONCLUSIONS There is no evidence that PUFA supplementation in infancy has an effect on infant or childhood allergy, asthma, dermatitis/eczema or food allergy. However, the quality of evidence was very low. There was insufficient evidence to determine an effect on allergic rhinitis.
Collapse
Affiliation(s)
- Tim Schindler
- Royal Hospital for WomenDepartment of Newborn CareBarker StreetRandwickNSWAustralia2031
| | - John KH Sinn
- Royal North Shore Hospital, The University of SydneyDepartment of NeonatologySt. Leonard'sSydneyNew South WalesAustralia2065
| | - David A Osborn
- University of SydneyCentral Clinical School, Discipline of Obstetrics, Gynaecology and NeonatologySydneyNSWAustralia2050
| | | |
Collapse
|
5
|
Abstract
OBJECTIVES The objective of the present exploratory study was to investigate how the fatty acid (FA) composition of different food sources for preterm infants including breast milk (BM), formula (F), human milk fortifiers (HMFs), and total parenteral nutrition (TPN) impacted preterm infant's plasma FA. The associations between FA content of plasma with antioxidant enzyme activity and cognition were also evaluated. METHODS Thirty-two premature infants were included in the present study. Five different feeds (BM, F, BM + F, BM + HMF, and TPN) were provided. Foods and preterm infant plasma samples were collected at the same time on the same day biweekly where possible. Separation and identification of the plasma and food FA methyl esters were performed by gas-liquid chromatography. Antioxidant enzymes were measured. The Bayley Scale of Infant Development version III was used to evaluate cognition. RESULTS In food sources, BM contained significantly lower stearic acid (C18:0) (P < 0.05), oleic acid (C18:1n9) (P < 0.01), linoleic acid (C18:2n6) (P < 0.01), α-linoleic acid (C18:3n3) (P < 0.01), and arachidonic acid (C20:4n6) (P < 0.05) compared with the F. Palmitic acid (C16:0) was significantly higher (P < 0.05) in the BM + HMF compared with the BM. Stearic acid (C18:0) was significantly higher (P < 0.05) in the BM + F and BM + HMF compared with the BM. In the plasma lauric acid (C12:0) (P < 0.05) and myristic acid (C14:0) (P < 0.001) were higher in the BM-fed babies compared with the F-fed or TPN-recipient groups. Antioxidant enzymes, activities and cognition scores did not differ by feeding groups, however the study may not have been powered to detect these differences. CONCLUSIONS The type, and therefore quality, of fatty acids is an important consideration when selecting what is fed to premature infants because differences in feed fatty acids were seen in some plasma fatty acids in the study.
Collapse
|
6
|
Stimming M, Mesch CM, Kersting M, Kalhoff H, Demmelmair H, Koletzko B, Schmidt A, Böhm V, Libuda L. Vitamin E content and estimated need in German infant and follow-on formulas with and without long-chain polyunsaturated fatty acids (LC-PUFA) enrichment. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2014; 62:10153-10161. [PMID: 25220561 DOI: 10.1021/jf502469b] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Many formulas (FM) for infants are nowadays supplemented with LC-PUFA. Due to the susceptibility of LC-PUFA to peroxidation, a potential risk of oxidative stress must be considered. We analyzed the concentration of unsaturated fatty acids to calculate an estimated vitamin E need and the concentration of vitamin E as an important lipophilic antioxidant in LC-PUFA enriched (FM(+), n = 31) and not enriched (FM(-), n = 29) formulas as well as in breast milk (BM, n = 118). No differences were observed in the ratios of vitamin E content to estimated vitamin E need between FM(+) and FM(-). Ratios were consistently above the minimum value according to European law. FM showed similar or higher ratios than BM, except in a worst-case scenario where BM showed higher ratios than FM(+). Our results indicate adequate vitamin E content relative to unsaturated fatty acid content in present-day commercial formulas. Given that breast milk tends to contain higher ratios of vitamin E content to estimated vitamin E need than LC-PUFA enriched formulas (at least in a worst-case scenario), the potential effects of increasing vitamin E content in LC-PUFA enriched formulas should be explored.
Collapse
Affiliation(s)
- Madlen Stimming
- Research Institute of Child Nutrition (FKE) Dortmund, Rheinische Friedrich-Wilhelms University Bonn , Heinstueck 11, 44225 Dortmund, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Affiliation(s)
- Susan Holmes
- Faculty of Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, CT1 1QT, UK
| |
Collapse
|
8
|
Larqué E, Gil-Campos M, Villada I, Ramírez-Tortosa MC, Cañete R, Gil A. Postprandial plasma adiponectin response is reduced in prepubertal premature pubarche girls. Metabolism 2010; 59:1319-26. [PMID: 20096425 DOI: 10.1016/j.metabol.2009.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 10/20/2009] [Accepted: 12/10/2009] [Indexed: 01/25/2023]
Abstract
The association between premature pubarche (PP) and metabolic syndrome is controversial and not supported by some authors. The aim of this study was to determine insulin resistance syndrome, plasma adiponectin, and fatty acid profile in PP girls to discern potential confounder variables and markers of metabolic disturbances. We studied 22 prepubertal girls with a diagnosis of PP and 20 healthy controls who differed in body mass index (BMI) (19.33 +/- 0.71 vs 17.30 +/- 0.60). We evaluated insulin resistance syndrome components and postprandial response of adiponectin, nonesterified fatty acids, and fatty acid profile after consumption of a standardized breakfast. No lipid disturbances were detected in the PP group. High-density lipoprotein to low-density lipoprotein cholesterol ratio tended to be lower in PP girls (P = .052), but this effect disappeared when data were adjusted for both BMI and age (P = .480). Insulin levels tended to be higher at 2 hours in PP girls, who showed significantly higher C-peptide area under the curve. In contrast, adiponectin at 3 hours after the meal and postprandial adiponectin area under the curve were significantly lower. The PP girls showed significantly higher percentages of eicosapentaenoic acid in total plasma and plasma phospholipids. No differences were found in the postprandial fatty acid clearance rate. In conclusion, PP girls and controls differed in postprandial plasma adiponectin response and in postprandial plasma C-peptide response after both BMI and age adjustment. Cholesterol plasma disturbances were mainly attributable to their higher BMI, although n-3 polyunsaturated fatty acids were higher because of the PP.
Collapse
Affiliation(s)
- Elvira Larqué
- Department of Physiology, Faculty of Biology, University of Murcia, Murcia 30100, Spain
| | | | | | | | | | | |
Collapse
|
9
|
Metabolic Syndrome Affects Fatty Acid Composition of Plasma Lipids in Obese Prepubertal Children. Lipids 2008; 43:723-32. [DOI: 10.1007/s11745-008-3203-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2008] [Accepted: 06/05/2008] [Indexed: 10/21/2022]
|
10
|
Gil-Campos M, Larqué E, Ramírez-Tortosa MC, Linde J, Villada I, Cañete R, Gil A. Changes in plasma fatty acid composition after intake of a standardised breakfast in prepubertal obese children. Br J Nutr 2007; 99:909-17. [PMID: 17903339 DOI: 10.1017/s0007114507831722] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Obese patients typically show a pattern of dyslipidaemia and changes in plasma fatty acid composition reflecting abnormalities in lipoprotein metabolism and dietary habits. Animals and obese adults have been widely studied; however, contradictory results have been published in children. The objective was to assess changes in plasma fatty acid composition in total plasma lipids and plasma lipid fractions in obese prepubertal children compared with those of normal weight and to evaluate changes in postprandial plasma fatty acids during a 3 h period after intake of a standardised breakfast. The study was a case-control study with thirty-four obese and twenty normal-weight prepubertal children (Tanner 1). Anthropometric and metabolic variables and fatty acid concentrations were measured in plasma and its fractions. Liquid chromatography was used to separate lipid fractions and GLC to quantify fatty acids. Plasma total fatty acids (TFA), SFA, MUFA and PUFA concentrations were higher in obese than in control children. Except for 18 : 0, 18 : 3n-3, 20 : 4n-6 and n-3 PUFA, all fatty acids in TAG were also elevated in the obese group. Fatty acids 16 : 1n-7, 18 : 0, 18 : 1n-9, 20 : 2n-6, TFA and MUFA significantly decreased between the 2nd and 3rd hour in normal-weight v. obese children. The concentration of 16 : 1n-7 was positively and the proportion of 20 : 4n-6 inversely associated with a significant increase in risk of obesity. Obese prepubertal children show an altered plasma fatty acid profile and concentrations, mainly related to the TAG fatty acid profile, with a lower clearance of fatty acids v. normal-weight prepubertal children.
Collapse
Affiliation(s)
- M Gil-Campos
- Unit of Paediatric Endocrinology, Reina Sofia University Hospital Córdoba, Spain
| | | | | | | | | | | | | |
Collapse
|
11
|
Bourre JM. [The role of nutritional factors on the structure and function of the brain: an update on dietary requirements]. Rev Neurol (Paris) 2005; 160:767-92. [PMID: 15454864 DOI: 10.1016/s0035-3787(04)71032-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The brain is an organ elaborated and functioning from substances present in the diet. Dietary regulation of blood glucose level (via ingestion of food with a low glycemic index ensuring a low insulin level) improves the quality and duration of intellectual performance, if only because at rest the adult brain consumes 50 p. 100 of dietary carbohydrates, 80 p. 100 of them for energy purposes. The nature of the amino acid composition of dietary proteins contributes to good cerebral function; tryptophan plays a special role. Many indispensable amino acids present in dietary proteins help to elaborate neurotransmitters and neuromodulators. Omega-3 fatty acids provided the first coherent experimental demonstration of the effect of dietary nutrients on the structure and function of the brain. First it was shown that the differentiation and functioning of cultured brain cells requires omega-3 fatty acids. It was then demonstrated that alpha-linolenic acid (ALA) deficiency alters the course of brain development, perturbs the composition and physicochemical properties of brain cell membranes, neurones, oligodendrocytes, and astrocytes (ALA). This leads to physicochemical modifications, induces biochemical and physiological perturbations, and results in neurosensory and behavioral upset. Consequently, the nature of polyunsaturated fatty acids (in particular omega-3) present in formula milks for infants (premature and term) conditions the visual and cerebral abilities, including intellectual abilities. Moreover, dietary omega-3 fatty acids are certainly involved in the prevention of some aspects of cardiovascular disease (including at the level of cerebral vascularization), and in some neuropsychiatric disorders, particularly depression, as well as in dementia, notably Alzheimer's disease. Their deficiency can prevent the satisfactory renewal of membranes and thus accelerate cerebral aging. Iron is necessary to ensure oxygenation, to produce energy in the cerebral parenchyma, and for the synthesis of neurotransmitters. The iodine provided by the thyroid hormone ensures the energy metabolism of the cerebral cells. The absence of iodine during pregnancy induces severe cerebral dysfunction, leading to cretinism. Manganese, copper, and zinc participate in enzymatic mechanisms that protect against free radicals, toxic derivatives of oxygen. The use of glucose by nervous tissue implies the presence of vitamin B1. Vitamin B9 preserves memory during aging, and with vitamin B12 delays the onset of signs of dementia, provided it is administered in a precise clinical window, at the onset of the first symptoms. Vitamins B6 and B12, among others, are directly involved in the synthesis of neurotransmitters. Nerve endings contain the highest concentrations of vitamin C in the human body. Among various vitamin E components, only alpha-tocopherol is involved in nervous membranes. The objective of this update is to give an overview of the effects of dietary nutrients on the structure and certain functions of the brain.
Collapse
Affiliation(s)
- J-M Bourre
- Unité de recherches en Neuro-Pharmaco-Nutrition, INSERM U26, Hôpital Fernand Widal, Paris.
| |
Collapse
|
12
|
Sala-Vila A, Castellote AI, Campoy C, Rivero M, Rodriguez-Palmero M, López-Sabater MC. The source of long-chain PUFA in formula supplements does not affect the fatty acid composition of plasma lipids in full-term infants. J Nutr 2004; 134:868-73. [PMID: 15051839 DOI: 10.1093/jn/134.4.868] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Supplementation of formulas for full-term infants with long-chain (LC) PUFA [arachidonic acid (AA) and docosahexaenoic acid (DHA)] at levels resembling human milk is recommended because they provide biochemical and functional benefits to the neonate. The objective of this work was to determine whether the source of dietary LC-PUFA affects the bioavailability in full-term infants. Treatment groups were as follows: full-term infants were fed from birth to 3 mo breast-milk (n = 11, 0.4 and 0.3 g/100 g total fatty acids as AA and DHA, respectively), formula containing LC-PUFA in the form of egg phospholipids (n = 12), or a formula supplemented with LC-PUFA in the form of triglycerides synthesized by single cells of algal and fungal microorganisms (n = 12). Both formulas provided 0.4 and 0.1 g/100 g total fatty acids as AA and DHA, respectively. We compared the fatty acid compositions of the main plasma lipid fractions (phospholipids, triglycerides, and cholesteryl esters) at birth and 3 mo. At 3 mo, lower levels of nervonic acid (NA), docosapentaenoic (DPA) acid, and DHA were found in all plasma lipid fractions from infants fed formula compared with those in the human milk-fed infants, irrespective of the source of the formula supplement (P < 0.02). These data demonstrate that the form of dietary LC-PUFA (triglycerides or phospholipids) does not influence their bioavailability. Similarly, absorption of LC-PUFA depends mainly on the lipid composition of the diet fed. These results suggest that the levels of NA, DPA, and DHA in formulas for full-term infants should be increased.
Collapse
Affiliation(s)
- Aleix Sala-Vila
- Department Nutrició i Bromatologia, Centre de Referència en Tecnologia dels Aliments (CeRTA), Facultat de Farmàcia, Universitat de Barcelona, 08028 Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
13
|
Ailhaud G, Guesnet P. Fatty acid composition of fats is an early determinant of childhood obesity: a short review and an opinion. Obes Rev 2004; 5:21-6. [PMID: 14969504 DOI: 10.1111/j.1467-789x.2004.00121.x] [Citation(s) in RCA: 141] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The importance of dietary fat in human obesity remains a controversial issue as the prevalence of overweight and obesity has increased despite no dramatic change in the amount of ingested fats over the past few decades. However, qualitative changes (i.e. the fatty acid composition of fats) have been largely disregarded. In this review, we summarize experimental evidence which supports polyunsaturated fatty acids of the omega6 series as being potent promoters of both adipogenesis in vitro and adipose tissue development in vivo during the gestation/lactation period. This conclusion is also supported by epidemiological data from infant studies as well as by the assessment of the fatty acid composition of mature breast milk and formula milk. It is proposed that unnoticed changes in fatty acid composition of ingested fats over the last decades have been important determinants in the increasing prevalence of childhood overweight and obesity.
Collapse
Affiliation(s)
- G Ailhaud
- Institut de Recherche Signalisation, Biologie du Développement et Cancer, Centre de Biochimie, Faculté des Sciences, Parc Valrose, Nice, France.
| | | |
Collapse
|
14
|
Affiliation(s)
- Grzegorz Bartosz
- Department of Molecular Biophysics, University of Lódź, Lódź, Poland
| |
Collapse
|
15
|
CORRESPONDENCE. Clin Nutr 2002. [DOI: 10.1054/clnu.2001.0519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
16
|
Amate L, Gil A, Ramírez M. Dietary long-chain polyunsaturated fatty acids from different sources affect fat and fatty acid excretions in rats. J Nutr 2001; 131:3216-21. [PMID: 11739869 DOI: 10.1093/jn/131.12.3216] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Several sources of long-chain polyunsaturated fatty acids (LCP) have been evaluated for infant-formula supplementation. These sources differ in their chemical structure [triglyceride (TG) or phospholipid (PL)], arrangement of fatty acids on the TG or PL backbone, fatty acid composition and presence of other lipid components. All of these characteristics influence fat digestion, may affect fat and fatty acid absorption, and hence, LCP bioavailability and metabolism in infancy. The main objective of this work was to establish the influence of different dietary LCP sources on overall fat and LCP absorption in early life. We compared fat and fatty acid excretions at weaning in rats fed control diets or diets supplemented with LCP as TG or PL. Two separate experiments were conducted. In Experiment 1, weanling rats were fed for 3 wk a control diet (C1), a diet with TG from tuna and fungal oils (TF-TG) or a diet with PL from pig brain concentrate (PB-PL). In Experiment 2, weanling rats were fed for 3 wk a control diet (C2), a diet containing egg-TG (EG-TG) or a diet containing egg-PL (EG-PL). Fat, mineral and saturated fatty acid excretions in feces were higher in rats fed PB-PL compared with those fed TF-TG diet. In Experiment 2, groups did not differ in fat and mineral excretions. However, the EG-PL group had lower fecal excretions of saturated fatty acids than the C2 and EG-TG groups. The 16:1(n-7), 18:1(n-9), 18:2(n-6) and 22:6(n-3) levels in feces were higher in the EG-TG group than in the EG-PL group. In summary, total fat and LCP excretions differed among rats fed diets supplemented with LCP from different sources.
Collapse
Affiliation(s)
- L Amate
- Research and Development Department, Abbott Laboratories, 18004 Granada, Spain
| | | | | |
Collapse
|