Visual acuity and blood lipids in term infants fed human milk or formulae

This multicenter, parallel group study determined plasma phospholipid and red blood cell (RBC) phosphatidylcholine and phosphatidylethanolamine fatty acids, plasma cholesterol, apo A-1 and B, growth and visual acuity (using the acuity card procedure) in term infants fed from birth to 90 d of age with formula containing palm-olein, high oleic sunflower, coconut and soy oil (22.2% 16∶0, 36.2% 18∶1, 18% 18∶2n−6, 1.9% 18∶3n−3) (n=59) or coconut and soy oil (10.3% 16∶0 18∶6% 18∶1, 34.2% 18∶2n−6, 4.7% 18∶3n−3) (n=57) or breast-fed (n=56) with no formula supplementation. Different centers in North America were included to overcome potential bias due to differences in n−6 or n−3 fatty acids at birth or in breast-fed infants that might occur in a single-site study. Plasma and RBC phospholipid docosahexaenoic acid (DHA, 22∶6n−3) and arachidonic acid (AA, 20∶4n−6), cholesterol and apo B were significantly lower in the formula- than breast-fed infants. There were no differences in looking acuity or growth among the breast-fed and formula-fed infants. No significant relations were found between DHA and looking acuity, or AA and growth within or among any of the infant groups. This study provides no evidence to suggest the formula provided inadequate n−6 or n−3 fatty acids for growth and looking acuity for the first 3 mon after birth.     

Maternal fish oil supplementation in lactation: Effect on visual acuity and n−3 fatty acid content of infant erythrocytes

Studies on formula-fed infants indicate a beneficial effect of dietary DHA on visual acuity. Cross-sectional studies have shown an association between breast-milk DHA levels and visual acuity in breast-fed infants. The objective in this study was to evaluate the biochemical and functional effects of fish oil (FO) supplements in lactating mothers. In this double-blinded randomized trial, Danish mothers with habitual fish intake below the 50th percentile of the Danish National Birth Cohort were randomized to microencapsulated FO [1.3 g/d long-chain n−3 FA (n−3 LCPUFA)] or olive oil (OO). The intervention started within a week after delivery and lasted 4 mon. Mothers with habitual high fish intake and their infants were included as a reference group. Ninety-seven infants completed the trial (44 OO-group, 53 FO-group) and 47 reference infants were followed up. The primary outcome measures were: DHA content of milk samples (0, 2, and 4 mon postnatal) and of infant red blood cell (RBC) membranes (4 mon postnatal), and infant visual acuity (measured by swept visual evoked potential at 2 and 4 mon of age). FO supplementation gave rise to a threefold increase in the DHA content of the 4-mon milk samples (P<0.001). DHA in infant RBC reflected milk contents (r=0.564, P<0.001) and was increased by almost 50% (P<0.001). Infant visual acuity was not significantly different in the randomized groups but was positively associated at 4 mon with infant RBC-DHA (P=0.004, multiple regression). We concluded that maternal FO supplementation during lactation did not enhance visual acuity of the infants who completed the intervention. However, the results showed that infants with higher RBC levels of n−3 LCPUFA had a better visual acuity at 4 mon of age, suggesting that n−3 LCPUFA may influence visual maturation.     

Blood phospholipid fatty acid analysis of adults with and without attention deficit/hyperactivity disorder

Several psychiatric disorders, including juvenile Attention Deficit/Hyperactivity Disorder (ADHD), have been associated with abnormalities of certain long-chain PUFA (LCPUFA). Despite this reported association, the FA levels of patients with the adult form of ADHD have not previously been evaluated. In this study we measured the total blood phospholipid FA concentrations in 35 control subjects and 37 adults with ADHD symptoms to determine whether adults with ADHD symptoms would show abnormalities of FA relative to control subjects. In the serum phospholipids, adults with ADHD symptoms had significantly lower levels of total saturated, total polyunsaturated, and total omega-6 (n−6) FA, as well as the omega-3 (n−3) LCPUFA DHA (22∶6n−3), and significantly higher levels of total monounsaturated FA and the n−3 LCPUFA docosapentaenoic acid (22∶5n−3). In the erythrocyte membrane phospholipids, adults with ADHD symptoms had significantly lower levels of total PUFA, total n−3 FA, and DHA, and significantly higher levels of total saturated FA. Neither serum nor erythrocyte membrane phospholipid DHA was related to ADHD symptom severity (as assessed by the Amen questionnaire) in ADHD subjects. Although the exact cause of these variations is unknown, both environmental and genetic factors may be involved.     

The effect of α-linolenic acid and linoleic acid on the growth and development of formula-fed infants: A systematic review and meta-analysis of randomized controlled trials

This systematic review and meta-analysis aimed to evaluate the effect of modifying 18-carbon PUFA [18-C PUFA: α-linolenic acid (ALA, 18∶3n−3) and linoleic acid (LA, 18∶2n−6)] in the diets of term and preterm infants on DHA (22∶6n−3) status, growth, and developmental outcomes. Only randomized controlled trials (RCT) involving formula-fed term and preterm infants, in which the 18-C PUFA composition of the formula was changed and growth or developmental outcomes were measured, were included. Differences were presented as control (standard formula) and treatment (18-C PUFA-supplemented formula). Primary analyses for term infants were 4 and 12 mon and for preterm infants 37–42 and 57 wk postmenstrual age. Five RCT involving term infants and three RCT involving preterm infants were included in the systematic review. Infants fed ALA-supplemented formula had significantly higher plasma and erythrocyte phospholipid DHA levels than control infants. There was no effect of ALA supplementation on the growth of preterm infants. In term infants, ALA supplementation was associated with increased weight and length at 12 mon, which was at least 4 mon after the end of dietary intervention. Developmental indices of term infants did not differ between groups. There was a transient improvement in the retinal function of preterm infants fed ALA-supplemented diets compared with controls. The findings suggest that ALA-supplemented diets improve the DHA status of infants. Further studies are needed to provide convincing evidence regarding the effects of ALA supplementation of formula on infant growth and development.     

Relationships between the fatty acid composition of muscle and erythrocyte membrane phospholipid in young children and the effect of type of infant feeding

Muscle membrane fatty acid (FA) composition is linked to insulin action. The aims of this study were to compare the FA composition of muscle and erythrocyte membrane phospholipid in young children; to investigate the effect of diet on these lipid compositions; and to investigate differential incorporation of FA into muscle, erythrocyte and adipose tissue membrane phospholipid, and adipose tissue triglyceride. Skeletal muscle biopsies and fasting blood samples were taken from 61 normally nourished children (15 males and 16 females), less than 2 yr old (means ±SE, 0.80±0.06 yr), undergoing elective surgery. Adipose tissue samples were taken from 15 children. There were significant positive correlations between muscle and erythrocyte docosahexaenoic acid (DHA) (r=0.44, P<0.0001), total n−3 polyunsaturated fatty acids (PUFA) (r=0.39, P=0.002), and the n−6/n−3 PUFA ratio (r=0.39, P=0.002). Adipose tissue triglyceride had lower levels of long-chain PUFA, especially DHA, than muscle and erythrocytes (0.46±0.18% vs. 2.44±0.26% and 3.17±0.27%). Breast-fed infants had higher levels of DHA than an age-matched group of formulafed infants in both muscle (3.91±0.21% vs. 1.94±0.18%) and erythrocytes (3.81±0.10% vs. 2.65±0.23%). The results of this study show that (i) erythrocyte FA composition is a reasonable index of muscle DHA, total n−3 PUFA, and the n−6/n−3 PUFA ratio; (ii) breast feeding has a potent effect on the FA composition of all these tissues; and (iii) there is a wide range in long-chain PUFA levels in muscle, erythrocytes, and adipose tissue.     

Dietary intake of essential and long-chain polyunsaturated fatty acids in pregnancy

The dietary intake of EFA and long-chain PUFA (LCPUFA) by women with (n=14) and without (n=31) gestational diabetes mellitus (GDM) was determined by repeated 24-h recalls. Women with GDM consumed significantly more energy as fat compared with women who had uncomplicated pregnancies; absolute dietary fat did not differ. Dietary n−3 LCPUFA was substantially lower than the current recommendation for pregnancy, whereas intake of saturated FA (SFA) exceeded it. We conclude that replacing dietary sources of SFA with those of EFA and LCPUFA, especially n−3 LCPUFA, would benefit the dietary fat profiles of all pregnant women.     

Blood lipid docosahexaenoic and arachidonic acid in term gestation infants fed formulas with high docosahexaenoic acid,low eicosapentaenoic acid fish oil

The effect of fish oil high in docosahexaenoic acid (22∶6n−3) and low in eicosapentaenoic acid (20∶5n−3) in formula on blood lipids and growth of full-term infants was studied. Infants were fed formula with about 15% oleic acid (18∶1), 32% linoleic acid (18∶2n−6), 4.9% linolenic acid (18∶3n−3) and 0, 0.10 or 0.22% 22∶6n−3, or 35% 18∶1, 20% 18∶2n−6, 2.1% 18∶3n−3 and 0, 0.11 or 0.24% 22∶6n−3 from 3 d to 16 wk of age (n=16, 18, 17, 21, 17, 16, respectively). The formulae had <0.1% 20∶5n−3 and no arachidonic acid (20∶4n−6). Breast-fed infants (n=26) were also studied. Plasma phospholipid and red blood cell (RBC) phosphatidylcholine (PC) and phosphatidylethanolamine (PE) fatty acids were determined at 3 d and 4, 8, and 16 wk of age. These longitudinal analyses showed differences in blood lipid 22∶6n−3 between breast-fed and formula-fed infants depending on the feeding duration. At 16 wk, infants fed formula with 0.10, 0.11% 22∶6n−3, or 0.22% 22∶6n−3 had similar 22∶6n−3 levels in the plasma phospholipid and RBC PC and PE compared with breast-fed infants and higher 22∶6n−3 than infants fed formula without 22∶6n−3. Formula with 0.24% 22∶6n−3, however, resulted in higher plasma phospholipid 22∶6n−3 than in breast-fed infants at 16, but not 4 or 8 wk of age. Plasma and RBC phospholipid 20∶4n−6 was lower in formula-fed than breast-fed infants, but no differences in growth were found. Higher blood lipid C₂₀ and C₂₂ n−6 and n−3 fatty acids in infants fed formula with 20% 18∶2n−6 and 2.4% 18∶3n−3 compared with 32% 18∶2n−6 and 4.9% 18∶3n−3 show the increase in blood lipid 22∶6n−3 in response to dietary 22∶6n−3 depending on other fatty acids in the formula.     

Fish oil supplementation of lactating mothers affects cytokine production in 2 1/2-year-old children

n−3 PUFA influence immune functioning and may affect the cytokine phenotype during development. To examine whether maternal fish oil supplementation during lactation could modify later immune responses in children, 122 lactating Danish mothers with a fish intake below the population median were randomized to groups supplemented for the first 4 mon of lactation with 4.5 g/d of fish oil (equivalent to 1.5 g/d of n−3 long-chain PUFA) or olive oil. Fifty-three mothers with a fish intake in the highest quartile of the population were also included. The FA composition of erythrocyte membranes was measured at 4 mon and at 2 1/2 yr. Plasma immunoglobulin E (IgE) levels and cytokine production in lipopolysaccharide-stimulated whole-blood cultures were determined at 2 1/2 yr. Erythrocyte n−3 PUFA at 4 mon were higher in infants from the fish oil group compared with the olive oil group (P<0.001) but were no longer different at 2 1/2 yr. The median production of lipopolysaccharide-induced interferon γ(IFN-γ) in the fish oil group was fourfold higher than that in the olive oil group (P=0.034), whereas interleukin-10 (IL-10) production was similar. The IFN-γ/IL-10 ratio was twofold higher in the fish oil group (P=0.019) and was positively correlated with 20∶5n−3/20∶4n−6 in erythrocytes at 4 mon (P=0.050). The percentages of atopic children and plasma IgE were not different in the two groups, but the study was not designed to look at atopy. Cytokine responses and erythrocyte FA composition in children of mothers with a high fish intake were intermediate in comparison with those in the randomized groups. Fish oil supplementation during lactation resulted in increased in vitro IFN-γ production in the children 2 yr after the supplementation was given, which may reflect a faster maturation of the immune system.     

A randomized controlled trial of the effect of fish oil supplementation in late pregnancy and early lactation on the n−3 fatty acid content in human breast milk

The aim of this research was to investigate the effect of fish oil supplementation, in the third trimester of pregnancy and early lactation period of healthy pregnant Danish women. Forty-four pregnant women were randomly allocated to fish oil supplementation (1.3 g EPA and 0.9 g DHA per day) from week 30 of gestation (FO-group) or to a control regimen (olive oil or no oil; controls). The FO-group was randomly subdivided into women stopping fish oil supplementation at delivery [FO(pregn)], and women continuing supplementation for an, additional 30 d [FO(pregn/lact)]. Thirty-six women agreed to collect milk samples at days 4, 16, and 30 postpartum. The FA composition of the milk samples was determined by GLC. At days 4, 16, and 30 in lactation, FO(pregn/lact) women (n=12) had, respectively 2.3 (P=0.001), 4.1 (P=0.001), and 3.3 (P=0.001) times higher mean contents of LCPUFA(n−3) in their breast milk compared with controls (n=13), and 1.7 (P=0.005), 2.8 (P=0.001), and 2.8 (P=0.001), times higher LCPUFA(n−3) contents, respectively, at these days compared with FO(pregn) women (n=11). The latter group did not differ significantly from controls with regard to LCPUFA(n−3) content in the breast milk. Similar results were obtained when analyzing separately for effects on the milk content of DHA. Dietary supplementation with 2.7 g LCPUFA(n−3) per day from week 30 of gestation and onward more than tripled the LCPUFA(n−3) content in early breast milk; supplementation limited to pregnancy only was much less effective.     

Infant cerebellar gray and white matter fatty acids in relation to age and diet

There is little evidence as to the fatty acid composition of the cerebellum in infancy and it remains uncertain whether milk diet can influence its composition. We therefore examined cerebellar gray and white matter of infants less than 6 mon old who had died unexpectedly. The fatty acid content of 33 gray and 21 white matter specimens from infants born at term and 6 gray and 5 white matter specimens from pretern infants was assessed by gas chromatographic/mass spectrometric analysis. Infants were grouped according to whether they had received human or manufactured formula milk. Whereas cerebellar cortex docosahexaenoic acid (DHA, 22∶6n−3) concentrations were significantly lower (P<0.01) in the formula-fed than breast-fed infants, no differences existed between the term (n=10) and preterm (n=5) Scientific Milk Adaptation (SMA) formula-fed infants. Cerebellar white matter DHA concentrations were similarly lower (P<0.01) in the SMA formula-fed infants (n=8) than in an age-matched breast-fed group. Low concentrations of cerebellar white matter lignoceric (24∶0) and nervonic acid (24∶1n−9) in two 7-wk-old preterm infants appeared to correlated with postgestational rather than chronological age. Dietary long-chain polyunsaturated fatty acids particularly DHA, are probably essential for normal development of the infant cerebellum.     

Liver desaturase activities and FA composition in monkeys. Effect of a low-protein diet

The aim of the present study was to measure Δ9-, Δ6-, and Δ5-desaturase activities in liver microsomes, as well as phospholipid FA composition of liver and erythrocytes in monkeys fed a control or low-protein diet during the postweaning period. Ten Saimiri sciureus boliviensis (Cebidae) of both sexes were employed; at 12 mon of age they were separated into two groups fed ad libitum on a control or a low-protein diet for 24 mon. Saimiri sciureus had active Δ9, Δ6, and Δ5 liver desaturase enzymes, and these activities were influenced by the diet. A low-protein diet produced a significant reduction in Δ5-desaturation capacity, an increase in Δ9-desaturase activity, and no change in Δ6-desaturase activity (P<0.05). These changes, evoked by protein deprivation, were reflected in the liver phospholipid FA composition. Increases in the proportion of saturated FA and in monounsaturated oleic acid (18∶1n−9) and a decrease in the proportion of PUFA of the n−6 and n−3 series were produced in the animals fed a low-protein diet (P<0.0001). Differences between the two dietary groups were less pronounced in the FA composition of erythrocyte phospholipids. The authors are members of the Carrera del Investigador del Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina.     

Influence of long-chain polyunsaturated fatty acids on infant cognitive function

Long-chain polyunsaturated fatty acids (LCPUFA) are important for normal visual and cortical development. In a previous study of the effects of LCPUFA on cognitive function of term infants at the age of 3 mon, we indicated that infants with evidence of reduced growth parameters at birth and impaired attention control as manifested by a late peak fixation during infant habituation assessment may benefit from LCPUFA supplementation. The aim of this prospective study was to determine whether LCPUFA supplementation and late peak fixation are related to means-end problem-solving ability in these same infants at the age of 9 mon. Term infants (58) were randomized to one of two formulas containing either LCPUFA or no LCPUFA and completed 4 mon of feeding with their formula. Cognitive function was assessed at 3 mon of age by measures of infant habituation. Infants (20 LCPUFA and 20 no-LCPUFA) completed the problem-solving assessment at 9 mon. The no-LCPUFA group had lower scores on both measures of intention and number of solutions, but neither of these differences was significant. Analysis of covariance for the effects of group and peak fixation, covaried with gestation and birth weight, showed that the number of solutions was significantly reduced in the late peak-fixation infants receiving no LCPUFA (P<0.02). Intention scores tended to be reduced in this group (P<0.06). The late peak-fixation infants who received LCPUFA had solution and intention scores similar to early peak-fixation infants receiving LCPUFA or no LCPUFA. These findings suggest that in term infants who have reduced growth parameters at birth and who show evidence of impaired attention control, information processing and problem-solving ability in infancy may be enhanced by LCPUFA supplementation. Based on a presentation at the AOCS Meeting on PUFA in Infant Nutrition: Consensus and Controversies, Barcelona, November 7–9, 1996.     

Low erucic acid canola oil does not induce heart triglyceride accumulation in neonatal pigs fed formula

Canola oil is not approved for use in infant formula largely because of concerns over possible accumulation of triglyceride in heart as a result of the small amounts of erucic acid (22∶1n−9) in the oil. Therefore, the concentration and composition of heart triglyceride were determined in piglets fed from birth for 10 (n=4–6) or 18 (n=6) d with formula containing about 50% energy fat as 100% canola oil (0.5% 22∶1n−9) or 100% soybean oil, or 26% canola oil or soy oil (blend) with palm, high-oleic sunflower and coconut oil, providing amounts of 16∶0 and 18∶1 closer to milk, or a mix of soy, high-oleic sunflower and flaxseed oils with C₁₆ and C₁₈ fatty acids similar to canola oil but without 22∶1. Biochemical analysis found no differences in heart triglyceride concentrations among the groups at 10 or 18 d. Assessment of heart triglycerides using Oil Red O staining in select treatments confirmed no differences between 10-d-old piglets fed formula with 100% canola oil (n=4), 100% soy oil (n=4), or the soy oil blend (n=2). Levels of 22∶1n−9 in heart triglyceride and phospholipid, however, were higher (P<0.01) in piglets fed 100% canola oil or the canola oil blend, with higher levels found in triglycerides compared with phospholipids. The modest accumulation of 22∶1n−9 associated with feeding canola oil was not associated with biochemical evidence of heart triglyceride accumulation at 10 and 18 d.     

Fluctuations in human milk long-chain PUFA levels in relation to dietary fish intake

Within the Danish population, milk DHA (22∶6n−3) levels vary by more than a factor of 10. This paper deals with fluctuations in the milk content of 22∶6n−3 and other long-chain PUFA (LCPUFA) and the acute effects of fish meals and fish oil supplements on milk levels of LCPUFA. Twelve fish-eating mothers with 4-mon-old infants provided one blood and one adipose tissue sample, and seven consecutive morning hindmilk samples with dietary records from the previous days. Another 12 lactating women were given fish oil (2–8 g) for breakfast and delivered 6–12 milk samples during the following 24 h. The mean milk 22∶6n−3 content of the fish-eating mothers was 0.57±0.28 FA% (=percentage of total area of FAME peaks in GLC) and the day-to-day variation (SD/mean) within the individual was 35±17%. Mean milk 22∶6n−3 content on mornings with no fish the day before was 0.42±0.15 FA%; this was increased by 82±17% (n=9, P=0.05) if the mother had eaten fatty fish. Fish oil resulted in a twofold increase in milk 22∶6n−3 levels, which peaked after 10 h and lasted for 24 h. The EPA content of milk was also increased by fish meals and fish oil supplements, but these had no effect on the level of arachidonic acid. The study showed that diurnal and day-to-day fluctuations in levels of milk n−3 LCPUFA are large, which makes it difficult to assess the 22∶6n−3 intake of breast-fed infants from a single milk sample. In studies of the functional outcome of dietary 22∶6n−3 in breast-fed infants it is suggested also to use a measure of maternal 22∶6n−3 status.     

Fatty acid profile of buccal cheek cell phospholipids as an index for dietary intake of docosahexaenoic acid in preterm infants

Cheek cells (buccal epithelia) were utilized as a noninvasive index of fatty acid status in a study of the effects of n−3 long chain polyunsaturated fatty acid supplementation on visual function in preterm infants. The fatty acid profile of cheek cell phospholipids was directly correlated with the dietary docosahexenoic acid (DHA) intake of infants receiving: (i) primarily human milk; (ii) n−3 fatty acid-deficient, corn oil-based, commercial formula (CO); (iii) α-linolenic acid-enriched, soy oilbased, commercial formula; or (iv) experimental formula enriched with soy and marine oils providing a DHA level equivalent to that in human milk. In a subset of infants with complete cheek cell fatty acid profiles and visual function assessments, preterm infants at both 36 wk (n=63) and 57 wk (n=45) postconceptional age had significantly (P<0.0005) reduced cheek cell phospholipid DHA levels in the n−3-dificient, CO-fed group compared to the other diet groups. The DHA content in cheek cell phospholipids was highly correlated (P<0.0005) with that of both red blood cell lipids and plasma phospholipids at the 36-and 57-wk time points. The DHA content in cheek cell lipids of infants at 36 wk was significantly correlated with electroretinographic responses (r=−0.29; P<0.03) and visual acuity (r=−0.31; P<0.02) as measured by visual-evoked potentials (VEP). Cheek cell DHA was highly correlated (r=−0.57; P<0.0005) with VEP acuity at the 57-wk time point. These results suggest that the fatty acid profile of cheek cells is a valid index of essential fatty acid status, can be monitored frequently, and is associated with functional parameters in infants.     

A significant inverse relationship between concentrations of plasma homocysteine and phospholipid docosahexaenoic acid in healthy male subjects

The aim of this study was to investigate the possibility of a relationship between plasma homocysteine (Hcy) and phospholipid FA (PUFA) in healthy Australian males. One hundred thirty six healthy male subjects aged 20–55 yr were recruited from the Melbourne metropolitan area. Each volunteer completed a semiquantitative food frequency questionnaire and gave a blood sample. Plasma Hcy concentrations were determined by an established HPLC method; the plasma phospholipid FA were determined by standard methods. Plasma Hcy concentration was significantly negatively correlated with plasma phospholipid concentration of the PUFA 20∶5n−3 (r=−0.226, P=0.009), 22∶5n−3 (r=−0.182, P=0.036), 22∶6n−3 (r=−0.286, P=0.001), total n−3 (r=−0.270, P=0.002) and the ratio n−3/n−6 PUFA (r=−0.265, P=0.002), and significantly positively correlated with 20∶4n−6 (r=0.180, P=0.037). In the partial correlation analysis, after controlling for serum vitamin B₁₂ and folate concentration, plasma Hcy was significantly negatively correlated with the plasma phospholipid concentration of 22∶6n−3 (r=−0.205, P=0.019), total n−3 (r=−0.182, P=0.038) and the ratio n−3/n−6 PUFA (r=−0.174, P=0.048). Evidence indicates that an increased concentration of n−3 PUFA in tissues has a beneficial effect on cardiovascular health. Our findings provide further evidence that increased consumption of dietary n−3 PUFA increases the concentration of n−3 PUFA in plasma phospholipid, which is associated with a protective effect on cardiovascular diseases and lower plasma Hcy levels. The mechanism that might explain the association between plasma 22∶6n−3 and Hcy levels is not clear.     

n-3 long-chain FA decrease serum levels of TG and remnant-like particle-cholesterol in humans

A large number of papers have reported that administration of n−3 FA reduced serum TG concentrations in hypertriglyceridemic patients. However, few studies have examined the effect of n−3 FA on serum concentrations of remnant-like particle (RLP) cholesterol. Volunteers (n=41) whose serum TG concentrations were 100–300 mg/dL were recruited and randomly assigned to either an n−3 FA group or a control group with stratification by sex, age, and serum TG level in a double-blind manner. The subjects in the n−3 FA group were administered 125 ml of fermented soybean milk with fish oil containing 600 mg of EPA and 260 mg of DHA/d for 12 wk. The controls consumed control soybean milk with olive oil. Fasting blood samples were obtained before the start of administration and at 4, 8 and 12 wk. EPA concentrations in red blood cells increased significantly in all but one subject in the n−3 FA group, with no significant changes in the control group. TG levels decreased more in the n−3 FA group than in the control group at weeks 4 (P<0.05), 8 (P<0.01), and 12 (P<0.05) with their baseline as covariate. RLP cholesterol levels decreased more in the n−3 FA group than in the control at weeks 8 (P<0.01) and 12 (P<0.05) with their baseline as covariate. The groups did not differ in the other lipid levels. It is likely that n−3 long-chain FA may exert anti-atherosclerotic effects by lowering serum TG and RLP-cholesterol levels even at the dose of 860 mg/d.     

Effect of fish oil on the fatty acid composition of human milk and maternal and infant erythrocytes

To examine the effect of fish oil supplementation on the fatty acid (FA) composition of human milk and maternal and infant erythrocytes, five lactating women were supplemented with 6 g of fish oil daily for 21d. Usual maternal diets contained 1,147 mg of total n−3 FA, with 120 mg from very long-chain (>C₁₈) n−3 FA. Supplementation increased dietary levels to 3,092 mg of total n−3 FA and 2,006 mg of very long-chain n−3 FA. Milk samples were collected daily, prior to fish oil ingestion, and at 4-h intervals on days 1, 7, 14 and 21. Milk n−3 FA content increased within 8 h and reached steady state levels within one week. The n−6 fatty acid content decreased. Erythrocyte eicosapentaenoic acid content increased from 0.24% to 1.4% (P<0.01) in mothers and from 0.11% to 0.70% (P<0.05) in infants. Docosapentaenoic acid increased from 1.4% to 2.2% (P<0.05) in mothers and from 0.30% to 0.78% (P<0.01) in infants. There was no significant change in docosahexaenoic acid or n−6 fatty acid content. Maternal platelet aggregation responses were variable. No differences in milk or plasma tocopherol levels were noted. Based on a paper presented at the Symposium on Milk Lipids held at the AOCS Annual Meeting, Baltimore, MD, April 1990.     

Long-chain PUFA supplementation improves PUFA profile in infants with cholestasis

Long-chain PUFA (LCP) deficiency is a frequent complication in cholestatic infants. We investigated the effects of LCP-supplemented formula on EFA status in infants with cholestasis. Twenty-three infants with cholestasis (biliary atresia after surgery, 8; intrahepatic cholestasis, 15) aged 1.9 to 4.9 mon (median 3.1 mon) were randomized to receive commercial infant formulas either without LCP or with LCP from egg phospholipids for 1 mon. Liver tests, nutrient intakes, and plasma phospholipid FA (%w/w) were determined at baseline and after intervention. At baseline, patients had high serum direct bilirubin levels (5.9 ± 3.0 mg/dL; mean ± SD), they were malnourished (body fat mass: 40 ± 13% of normal) and presented with PUFA deficiency [plasma phospholipid PUFA: 28.43%w/w (26.56–30.53) in patients vs. 37.02%w/w (34.53–39.58) in controls; median (1st–3rd quartile)] with elevated Mead acid and palmitoleic acid. LCP-supplemented (n=11 and-nonsupplemented groups (n=12) did not differ in age, indicators of liver function, and EFA status at baseline. After the intervention, LCP-supplemented infants had higher levels of arachidonic acid [7.2 (5.9–8.8) vs. 4.2 (3.0–5.3) %w/w; P<0.001] and DHA [2.8 (2.2–3.2) vs. 1.6 (1.0–2.1) %w/w; P<0.05], accompanied by increased [BARS concentration: 1.9 (1.4–2.2) vs. 1.3 (1.1–1.6) nmol/mL; P<0.05]. We concluded that LCP-supplemented formulae improve LCP status of infants with severe cholestasis but may enhance lipid peroxidation.     

Mice raised on milk transgenically enriched with n−3 PUFA have increased brain docosahexaenoic acid

The brain contains high levels of the long-chain n−3 FA DHA(22∶6n−3), mainly in the gray matter and synaptosomes. Adequate intake of DHA is crucial for optimal nervous system function, particularly in infants. Supplementation of infant formulas with DHA at levels similar to human breast milk is recommended for biochemical and functional benefits to neonates. We generated transgenic mice that produce elevated levels of n−3 PUFA in their milk by expressing the Caenorhabditis elegans n−3 FA desaturase under the control of a lactation-induced goat beta-casein promoter. To examine the postnatal effects of consuming the n−3-enriched milk, we compared the growth and brain and plasma FA composition of mouse pups raised on milk from transgenic dams with those observed for pups raised on milk from nontransgenic dams. A significant decrease in arachidonic acid (ARA, 20∶4n−6) and concomitant increases in n−3 PUFA were observed in the phospholipid fraction of transgenic mouse milk. The n−6∶n−3 FA ratios were 4.7 and 34.5 for the transgenic and control milk phospholipid fractions, respectively. DHA and DPA (22∶5n−6) comprised 15.1% and 2.8% of brain FA from weanling mice nursed on transgenic dams, as compared with 6.9% and 9.2% for weanling mice nursed on control dams, respectively. This transgenic mouse model offers a unique approach to disassociate the effects and fetal programming resulting from a high n−6∶n−3 FA ratio gestational environment from the postnatal nutritional effects of providing milk with differing n−6∶n−3 FA ratios.