van Gool CJ, Thijs C, Henquet CJM et al. Gamma-linolenic acid supplementation for prophylaxis of atopic dermatitis a randomized controlled trial in infants at high familial risk. American Journal of Clinical Nutrition, 2003; 77(4):943-951

Background: Studies suggest that low concentrations of n6 long-chain polyenes in early life are correlated to atopic disease in later life.

Objective: The purpose of the study was to investigate the possible preventive effect of gamma-linolenic acid (GLA) supplementation on the development of atopic dermatitis in infants at risk.

Design: In a double-blind, randomized, placebo-controlled trial, formula-fed infants (n = 118) with a maternal history of atopic disease received borage oil supplement (containing 100 mg GLA) or sunflower oil supplement as a placebo daily for the first 6 mo of life.
Main outcome measures were the incidence of atopic dermatitis in the first year of life (by UK Working Party criteria), the severity of atopic dermatitis (SCORing Atopic Dermatitis; SCORAD), and the total serum immunoglobulin E (IgE) concentration at the age of 1 y.

Results: The intention-to-treat analysis showed a favorable trend for severity of atopic dermatitis associated with GLA supplementation ( ± SD SCORAD: 6.32 ± 5.32) in the GLA-supplemented group as compared with 8.28 ± 6.54 in the placebo group (P = 0.09; P = 0.06 after adjustment for total serum IgE at baseline, age 1 wk), but no significant effects on the other atopic outcomes.

The increase in GLA concentrations in plasma phospholipids between baseline and 3 mo was negatively associated with the severity of atopic dermatitis at 1 y (Spearmans correlation coefficient = -0.233, P = 0.013). There was no significant effect on total serum IgE concentration.

Conclusion: Early supplementation with GLA in children at high familial risk does not prevent the expression of atopy as reflected by total serum IgE, but it tends to alleviate the severity of atopic dermatitis in later infancy in these children.

Gerard Hornstra. Essential fatty acids in mothers and their neonates. Am J Clin Nutr, 2000;71(5):1262S-1269S.

Essential fatty acids (EFAs) and their long-chain polyenes (LCPs) are indispensable for human development and health. Because humans cannot synthesize EFAs and can only ineffectively synthesize LCPs, EFAs need to be consumed as part of the diet.

Consequently, the polyunsaturated fatty acid (PUFA) status of the developing fetus depends on that of its mother, as confirmed by the positive relation between maternal PUFA consumption and neonatal PUFA status.

Pregnancy is associated with a decrease in the biochemical PUFA status, and normalization after delivery is slow. This is particularly true for docosahexaenoic acid (DHA) because, on the basis of the current habitual diet, birth spacing appeared to be insufficient for the maternal DHA status to normalize completely.

Because of the decrease in PUFA status during pregnancy, the neonatal PUFA status may not be optimal. This view is supported by the lower neonatal PUFA status after multiple than after single births.

The neonatal PUFA status can be increased by maternal PUFA supplementation during pregnancy. For optimum results, the supplement should contain both n-6 and n-3 PUFAs.

The PUFA status of preterm neonates is significantly lower than that of term infants, which is a physiologic condition. Because the neonatal DHA status correlates positively with birth weight, birth length, and head circumference, maternal DHA supplementation during pregnancy may improve the prognosis of preterm infants.

In term neonates, maternal linoleic acid consumption correlates negatively with neonatal head circumference. This suggests that the ratio of n-3 to n-6 PUFAs in the maternal diet should be increased.

Consumption of trans unsaturated fatty acids appeared to be associated with lower maternal and neonatal PUFA status. Therefore, it seems prudent to minimize the consumption of trans fatty acids during pregnancy.

Simopoulos AP. Omega-3 fatty acids in health and disease and in growth and development. Am J Clin Nut 1991;54:438-463.

Several sources of information suggest that man evolved on a diet with a ratio of omega 6 to omega 3 fatty acids of approximately 1 whereas today this ratio is approximately 10:1 to 20-25:1, indicating that Western diets are deficient in omega 3 fatty acids compared with the diet on which humans evolved and their genetic patterns were established. Omega-3 fatty acids increase bleeding time; decrease platelet aggregation, blood viscosity, and fibrinogen; and increase erythrocyte deformability, thus decreasing the tendency to thrombus formation.

In no clinical trial, including coronary artery graft surgery, has there been any evidence of increased blood loss due to ingestion of omega 3 fatty acids.

Many studies show that the effects of omega 3 fatty acids on serum lipids depend on the type of patient and whether the amount of saturated fatty acids in the diet is held constant.
In patients with hyperlipidemia, omega 3 fatty acids decrease low-density-lipoprotein (LDL) cholesterol if the saturated fatty acid content is decreased, otherwise there is a slight increase, but at high doses (32 g) they lower LDL cholesterol; furthermore, they consistently lower serum triglycerides in normal subjects and in patients with hypertriglyceridemia whereas the effect on high-density lipoprotein (HDL) varies from no effect to slight increases.

The discrepancies between animal and human studies most likely are due to differences between animal and human metabolism. In clinical trials eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the form of fish oils along with antirheumatic drugs improve joint pain in patients with rheumatoid arthritis; have a beneficial effect in patients with ulcerative colitis; and in combination with drugs, improve the skin lesions, lower the hyperlipidemia from etretinates, and decrease the toxicity of cyclosporin in patients with psoriasis.

In various animal models omega 3 fatty acids decrease the number and size of tumors and increase the time elapsed before appearance of tumors.

Studies with nonhuman primates and human newborns indicate that DHA is essential for the normal functional development of the retina and brain, particularly in premature infants.

Because omega 3 fatty acids are essential in growth and development throughout the life cycle, they should be included in the diets of all humans.

Omega-3 and omega 6 fatty acids are not interconvertible in the human body and are important components of practically all cell membranes.

Whereas cellular proteins are genetically determined, the polyunsaturated fatty acid (PUFA) composition of cell membranes is to a great extent dependent on the dietary intake.

Stene LC, Joner G. Norwegian Childhood Diabetes Study Group. Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes. Am J Clin Nutr, 2003;78:1128-1134.

BACKGROUND: In Norway, cod liver oil is an important source of dietary vitamin D and the long-chain n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid, all of which have biological properties of potential relevance for the prevention of type 1 diabetes.

OBJECTIVE: The main objective was to investigate whether the use of dietary cod liver oil or other vitamin D supplements, either by the mother during pregnancy or by the child during the first year of life, is associated with a lower risk of type 1 diabetes among children.

DESIGN: We designed a nationwide case-control study in Norway with 545 cases of childhood-onset type 1 diabetes and 1668 population control subjects. Families were contacted by mail, and they completed a questionnaire on the frequency of use of cod liver oil and other vitamin D supplements and other relevant factors.

RESULTS: Use of cod liver oil in the first year of life was associated with a significantly lower risk of type 1 diabetes (adjusted odds ratio: 0.74; 95% CI: 0.56, 0.99). Use of other vitamin D supplements during the first year of life and maternal use of cod liver oil or other vitamin D supplements during pregnancy were not associated with type 1 diabetes.

CONCLUSION: Cod liver oil may reduce the risk of type 1 diabetes, perhaps through the antiinflammatory effects of long-chain n-3 fatty acids.

PMID: 14668274

Cohen JT, Bellinger DC, Connor WE, Shaywitz BA. A quantitative analysis of prenatal intake of n-3 polyunsaturated fatty acids and cognitive development. Am J Prev Med, 2005;29(4):366-374.

Although a rich source of n-3 polyunsaturated fatty acids (PUFAs) that may confer multiple health benefits, some fish also contain methyl mercury (MeHg), which may harm the developing fetus.

U.S. government recommendations for women of childbearing age are to modify consumption of high-MeHg fish to reduce MeHg exposure, while recommendations encourage fish consumption among the general population because of the nutritional benefits. The Harvard Center for Risk Analysis convened an expert panel (see acknowledgements) to quantify the net impact of resulting hypothetical changes in fish consumption across the population.

This paper estimates the impact of prenatal n-3 intake on cognitive development. Other papers quantify the negative impact of prenatal exposure to MeHg on cognitive development, and the extent to which fish consumption protects against coronary heart disease mortality and stroke in adults.

This paper aggregates eight randomized controlled trials (RCTs) comparing cognitive development in controls and in children who had received n-3 PUFA supplementation (seven studies of formula supplementation and one study of maternal dietary supplementation).

Our analysis assigns study weights accounting for statistical precision, relevance of three endpoint domains (general intelligence, verbal ability, and motor skills) to prediction of IQ, and age at evaluation.

The study estimates that increasing maternal docosahexaenoic acid (DHA) intake by 100 mg/day increases child IQ by 0.13 points. The paper notes that findings were inconsistent across the RCTs evaluated (although our findings were relatively robust to changes in the weighting scheme used). Also, for seven of the eight studies reviewed, effects are extrapolated from formula supplementation to maternal dietary intake.

Linday LA, Shindledecker RD, Tapia-Mendoza J, Dolitsky JN. Effect of daily cod liver oil and a multivitamin-mineral supplement with selenium on upper respiratory tract pediatric visits by young, inner-city, Latino children: randomized pediatric sites

We studied the effect of daily supplementation with lemon-flavored cod liver oil and a children's multivitamin-mineral supplement containing selenium on the number of pediatric visits by young, inner-city, Latino children from late autumn of 2002 through early spring of 2003.

Two private pediatric offices with similar demographics, located 1.1 miles apart in upper Manhattan, New York City, were randomized to a supplementation site and a medical records control site.

Ninety-four children (47 at each site), 6 months to 5 years of age, were enrolled. The mean age of the supplementation group was 2.03 years (SD, +/- 1.04 years); that of the control group was 2.08 years (SD, +/- 1.10 years).
Children > or = 1 year of age in the supplementation group received 1 teaspoon of lemon-flavored cod liver oil per day and one half-tablet of a children's multivitamin-mineral; the starting dose was halved for children < 1 year of age. The supplements were given from enrollment through May 1, 2003.

The primary outcome measure was the number of upper respiratory tract pediatric visits during the follow-up/supplementation period.

The supplementation group had a statistically significant decrease in the mean number of upper respiratory tract visits over time (p = .042; r = 0.893; y = 0.602 - 0.002x); the medical records control group had no change in this parameter (p = .999; r = 0.0006; y = 0.259 + 1.43 x 10(-6)x).

The supplements were well tolerated; per parental report, 70% of children completed the 5- to 6-month course of cod liver oil. Use of these nutritional supplements was acceptable to the inner-city Latino families and their young children, and was associated with a decrease in upper respiratory tract pediatric visits over time; this approach therefore deserves further research and attention.

Moms and Mercury by Ernie Hood. Fine-Tuning Fish Consumption During Pregnancy. Environmental Health Perspectives, 2005;113:1376-1380.

EHP is a monthly journal of peer-reviewed research and news on the impact of the environment on human health.

Due to ongoing concerns that high mercury intake via fish can cause adverse neurologic effects in the developing fetus, the U.S. Food and Drug Administration now recommends that expectant mothers should limit their consumption of fish to two or fewer meals per week. But pregnant women shouldn't throw the baby out with the bathwater.

A new study by a group of Harvard researchers suggests that this advice, which could result in many pregnant women eliminating fish from their diets altogether, may be denying some babies substantial neurocognitive benefits gained from important nutrients found in fish, such as n-3 polyunsaturated fatty acids.

The scientists sought to determine whether fish consumption during pregnancy is harmful or beneficial to fetal brain development.
To do this, they examined associations of maternal fish consumption during pregnancy, maternal hair mercury levels (a sensitive marker of organic mercury body burden) at delivery, and infant cognition at age 6 months. Study subjects were 135 mother-infant pairs who participated in Project Viva, a prospective pregnancy and child health cohort study in eastern Massachusetts.

The mothers completed questionnaires about fish consumption during their second trimester. That period of time was used to best coordinate temporally with the mercury exposure reflected in maternal hair samples, which were taken at delivery. The questions concerned how much and what categories of fish (canned tuna, dark meat, light meat, shellfish) the women ate.

Mothers consumed an average of 1.2 servings of combined fish categories per week. Their mean hair mercury level was 0.55 part per million (ppm), with 10% of the samples higher than 1.2 ppm, the current U.S. reference dose. Fish consumption was directly correlated with hair mercury levels.

Infant cognition was assessed using a test called visual recognition memory (VRM). In the VRM test, which has been shown to correlate with later IQ, the child is first shown two identical photographs of an infant's face, side by side, at a standardized distance. Then, one of the photos is replaced with a photo of another infant's face.
By tracking the percentage of time the baby looks at each photo, a novelty preference score is derived, reflecting the infant's ability to encode a stimulus into memory, to recognize that stimulus, and to look preferentially at a novel stimulus.

Mean VRM score among the children was 59.8, with a range of 10.9-92.5. After accounting for characteristics such as maternal age and education level, higher fish intake was found to be associated with higher infant cognition, especially after adjusting for mercury levels, which had a dose-dependent negative impact on the infants' cognition.
For each additional weekly serving of fish, the infants' VRM score was 4.0 points higher. Conversely, the researchers found that an increase of 1 ppm in hair mercury was associated with a decrement in VRM score of 7.5 points.

The babies with the highest cognition scores were from mothers who had eaten more than two weekly fish servings but had mercury levels of 1.2 ppm or less.

Although the results may seem contradictory, the authors suggest that the most cognitive benefit is derived by mothers eating fish types with the combination of relatively little mercury and high amounts of beneficial nutrients.
However, since the study assessed maternal fish consumption of four broad categories, there is no information presented on associations with specific types of fish. The researchers say that future studies could incorporate more detailed dietary information to help pregnant women make informed decisions about which fish meals are better or worse for their children's cognition.

Ultimately, the message behind these findings is that pregnant women should continue to eat fish, but should try to choose varieties known to be low in mercury and high in nutrients, such as canned light tuna and sardines.
Finding the most appropriate balance between risk and benefit may be challenging in this situation, but given the strong associations found in the current study, making the right decisions about which fish to eat during pregnancy, and how often, may be even more important than previously suspected.

Stark K, Beblo S, et al. Comparison of bloodstream fatty acid composition from African-American women at gestation, delivery, and postpartum. J Lipid Research, 2005;(46):516-525

Our aim was to examine the docosahexaenoic acid (DHA; 22:6n-3) status of pregnant African-American women reporting to the antenatal clinic at Wayne State University in a longitudinal study design.

Fatty acid compositions of plasma and erythrocyte total lipid extracts were determined and food frequency surveys were administered at 24 weeks of gestation, delivery, and 3 months postpartum for participants (n = 157). DHA (mean ± SD) in the estimated total circulating plasma was similar at gestation (384 ± 162 mg) and delivery (372 ± 155 mg) but was significantly lower at 3 months postpartum (178 ± 81 mg).

The relative weight percentage of DHA and docosapentaenoic acid n-6 (DPAn-6; 22:5n-6) decreased postpartum, whereas their respective metabolic precursors, eicosapentaenoic acid (EPA; 20:5n-3) and arachidonic acid (AA; 20:4n-6), increased. Similar results were found in erythrocytes.

Dietary intake of DHA throughout the study was estimated at 68 ± 75 mg/day. The relative amounts of circulating DHA and DPAn-6 were increased during pregnancy compared with 3 months postpartum, possibly via increased synthesis from EPA and AA.

The low dietary intake and blood levels of DHA in this population compared with others may not support optimal fetal DHA accretion and subsequent neural development.

Foran JA, Good DH, et al. Quantitative Analysis of the Benefits and Risks of Consuming Farmed and Wild Salmon. J. Nutr., 2005;135:2639-2643.

Contaminants in farmed Atlantic and wild Pacific salmon raise important questions about the competing health benefits and risks of fish consumption.

A benefit-risk analysis was conducted to compare quantitatively the cancer and noncancer risks of exposure to organic contaminants in salmon with the (n-3) fatty acid?associated health benefits of salmon consumption.

Recommended levels of (n-3) fatty acid intake, as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may be achieved by consuming farmed or wild salmon while maintaining an acceptable level of noncarcinogenic risk.
However, the recommended level of EPA+DHA intake cannot be achieved solely from farmed or wild salmon while maintaining an acceptable level of carcinogenic risk.

Although the benefit-risk ratio for carcinogens and noncarcinogens is significantly greater for wild Pacific salmon than for farmed Atlantic salmon as a group, the ratio for some subgroups of farmed salmon is on par with the ratio for wild salmon.

This analysis suggests that risk of exposure to contaminants in farmed and wild salmon is partially offset by the fatty acid associated health benefits.

However, young children, women of child-bearing age, pregnant women, and nursing mothers not at significant risk for sudden cardiac death associated with CHD but concerned with health impairments such as reduction in IQ and other cognitive and behavioral effects, can minimize contaminant exposure by choosing the least contaminated wild salmon or by selecting other sources of (n-3) fatty acids.

Clandinin MT, Van Aerde JE, et al. Growth and development of preterm infants fed infant formulas containing docosahexaenoic acid and arachidonic acid. J Peds, 2005;146(4):461-468

Objectives To evaluate safety and benefits of feeding preterm infants formulas containing docosahexaenoic acid (DHA) and arachidonic acid (ARA) until 92 weeks postmenstrual age (PMA), with follow-up to 118 weeks PMA.

Study design This double-blinded study of 361 preterm infants randomized across three formula groups: (1) control, no supplementation; (2) algal-DHA (DHA from algal oil, ARA from fungal oil); and (3) fish-DHA (DHA from fish oil, ARA from fungal oil). Term infants breast-fed 4 months (n=105) were a reference group. Outcomes included growth, tolerance, adverse events, and Bayley development scores.

Results Weight of the algal-DHA group was significantly greater than the control group from 66 to 118 weeks PMA and the fish-DHA group at 118 weeks PMA but did not differ from term infants at 118 weeks PMA. The algal-DHA group was significantly longer than the control group at 48, 79, and 92 weeks PMA and the fish-DHA group at 57, 79, and 92 weeks PMA but did not differ from term infants from 79 to 118 weeks PMA. Supplemented groups had higher Bayley mental and psychomotor development scores at 118 weeks PMA than did the control group. Supplementation did not increase morbidity or adverse events.

Conclusions Feeding formulas with DHA and ARA from algal and fungal oils resulted in enhanced growth. Both supplemented formulas provided better developmental outcomes than unsupplemented formulas.

Pregnant women who eat more of a key fatty acid found in fish give their babies better chances of mature brain development, finds a new study in the September issue of the American Journal of Clinical Nutrition.

The study also found that mothers with more docosahexaenoic acid (DHA) in their blood had babies with heartier sleep patterns in the first 48 hours after delivery compared to those whose mothers consumed less of the compound.

In a report on the study, Healthscoutnews noted that infant sleep patterns are thought to reflect the maturity of a childs nervous system, and have been associated with more rapid development in their first year of life.

The omega-3 fatty acid, DHA, along with another substance, arachidonic acid (AA), are key building blocks in breast milk that contribute to healthy brain and eye development. Infant formula makers, such as Ross Products and Mead Johnson Nutritionals, are beginning to recognize the value of the compounds and have said they will add them to some of their brands.

The two substances are also passed from mother to foetus across the placenta. Some 70 percent of brain cell development takes place during gestation.

In the study, Carol Lammi-Keefe and her colleagues at the University of Connecticut compared DHA levels and newborn sleep patterns in 17 women and their babies. Ten of the women had high blood concentrations of DHA - considered to be more than 3 per cent of their total circulating fatty acids - while seven had less than that amount.

Healthscoutnews noted that Lammi-Keefe's group did not ask the women about their diets. None of the subjects in the study had DHA levels that reflected eating fish more than three times a week, as recommended by many experts. Other foods, like eggs and red meat, contain modest amounts of the nutrient, but cold-water fish such as tuna and mackerel are considered the best source.

Women with low DHA were more likely to be minorities and to have received fewer years of education. They were also five years younger, on average, than those in the high DHA category - 24 versus 29 years, according to the report.

All the babies were delivered vaginally and none of the women had been given drugs known to make newborns lethargic, the researchers said.

Using a motion-sensing pad to measure breathing and movement during sleep cycles, the researchers found babies of women in the low-DHA group had less advanced sleeping patterns than the other infants. They had a greater ratio of "active" to "quiet" sleep, spent more time transitioning between sleeping and waking, and spent less time fully awake than those of women with higher blood levels of the fatty acid.

"As an infant matures, normally you would see the infant spending more time in a wakeful state," Lammi-Keefe said. "Infants born to mothers with more DHA have sleep characteristics of a more mature central nervous system compared with the infants of mothers with lower DHA levels."

June Machover Reinisch, director emerita of the Kinsey Institute and a child development expert, said the findings seemed to echo the importance of breast feeding for optimal infant growth, although she noted that many other factors, from method of delivery and the use of anesthesia during labour to the infant's gender, can influence a newborn's wakefulness.

"We have to be flexible in our definition of development," Machover Reinisch said. "With the child who sleeps not as well at two days, it may be related to the DHA, but it doesn't necessarily mean that there's going to be a problem with that child."

Researchers have correlated newborn sleep states with performance on mental and motor developmental tests at 9 months of age. However, both Lammi-Keefe and Reinisch said there is no way to predict whether a child with less mature sleeping habits in the first week of life will be anything other than healthy.

The researchers are currently organizing a one-year study to investigate dietary intake of DHA in pregnant women.

Source: http://www.nutraingredients.com/news/news.asp?id=5217

Eating oily fish and seeds in pregnancy can boost children's future brain power and social skills, research suggests.

A study of 9,000 mothers and children in Avon suggested those who consumed less of the essential fatty acid Omega-3 had children with lower IQs.

These children also had poorer motor skills and hand-to-eye co-ordination, research in the Economist said.
The Food Standards Agency says pregnant women should consume only one or two portions of oily fish a week.

A team from the National Institutes of Health in the US analysed data from a long-term study done in Avon, UK.


Looking at the effects of Omega-3 intake on 9,000 mothers and their children, the team found mothers with the lowest intake of the essential fatty acid had children with a verbal IQ six points lower than the average.

While those with the highest consumption of mackerel and sardines and other sources of Omega-3 had children, at age three-and-a-half, with the best measures of fine-motor performance, researchers said.

Low intake of the crucial fatty acid also appeared to lead to more problems of social interactions - such as an inability to make friends.

Research leader Dr Joseph Hibbeln said "frightening data" showed 14% of 17-year-olds whose mother had eaten small quantities of Omega -3 during pregnancy demonstrated this sort of behaviour.

This compared with 8% of those born to the group with the highest intake, he said.

Dr Hibbeln said: "The findings of poor social development and poor motor control in children indicate that these children may be on a developmental trajectory towards lifelong disruptive and poorly-socialised behaviour as they grow up."

It's absolutely essential that pregnant women take in enough Omega-3 and that children in early infancy take in enough Omega-3


Professor Jean Golding of Bristol University set up the original research - the Avon Longitudinal Study of Parents and Children -15 years ago to look at the predisposition to disease.

She told the BBC: "The baby's brain needs Omega-3 fatty acids. It doesn't create its own fatty acids so it needs to be something that the mother will eat."

The new research also builds on earlier work in the US which suggests pregnant mothers will develop children with better language and communication skills if they regularly consume oily fish.

Nutritional expert Patrick Holford, director of the Brain Bio Centre, said Omega-3 was key to children's intelligence because the brain is formed of 60% fat - 30% of which is essential fats.

Successive studies have shown clear links between intelligence and consumption of this essential fatty acid, he added.

"It's absolutely essential that pregnant women take in enough Omega-3 and that children in early infancy take in enough Omega-3."

The richest sources of Omega-3 are larger fish which eat other fish, but research shows that the larger the fish the more pollutants, such as mercury, they contain.

For this reason Mr Holford recommends women consume two portions of wild or organic salmon, trout or sardines weekly.

Seeds such as flax, pumpkin and hemp are good sources of Omega-3 for vegetarians, but large quantities need to be consumed to gain the same effect.

This might translate to two tablespoons of seeds daily, Mr Holford said, but women can also use a high quality Omega-3 supplements.

Source: http://news.bbc.co.uk/2/hi/health/4631006.stm

Holman R, Johnson S, Ogburn P. Deficiency of Essential Fatty Acids and Membrane Fluidity During Pregnancy and Lactation. PNAS 1991; 88: 4835-4839.

In a group of 19 normal pregnant women, plasma lipids were extracted, phospholipids were isolated, and the fatty acid (FA) compositions were measured by capillary gas chromatography. Blood samples were taken at 36 wk, at labor, and at 6 wk postpartum. The FA profiles showed deficiencies of 6 and 3 FA ( indicating the length of the terminal saturated chain), the latter more severe, at all three times. Mean melting point (MMP) was calculated for each sample as an index of "fluidity" based upon all FA present. MMP varied linearly with total polyunsaturated FA and with double bond index, current measures of "fluidity" and essential FA status. MMP was elevated 9-11C in plasma phospholipids of women during pregnancy and labor and postpartum. Lactating mothers showed less recovery from the deficiencies than did the nonlactating mothers, but neither approached normal at 6 wk. The changes seen in phospholipid profiles suggest a significant transfer of 3 and 6 polyunsaturated FA from the mother to the fetus. These FA are essential for normal fetal growth and development; their relative deficiency in maternal circulation suggests that dietary supplementation may be indicated.

Helland IB, Saugstad OD, Smith L, et al. Similar effects on infants of n-3 and n-6 fatty acids supplementation in pregnant and lactating women. Pediatrics 2001 Nov;108(5):82-92.

OBJECTIVE: There have been indications that high intake of n-3 long-chain polyunsaturated fatty acids (PUFAs) during pregnancy may increase birth weight and gestational length. In addition, n-3 long-chain PUFAs may be important for the neurobiological development of the infants. High levels of docosahexaenoic acid (DHA, 22:6 n-3) are found in the gray matter of the cerebral cortex and in the retina, and it seems as if the availability of long-chain PUFAs may be limiting cerebral development. The fetus and the newborn are dependent on a high supply from their mothers, either via the placenta or via breast milk. We supplemented pregnant and lactating women with n-3 or n-6 long-chain PUFAs to evaluate the effect on birth weight, gestational length, and infant development.

DESIGN: We performed a double-blind, randomized study recruiting 590 pregnant, healthy, nulli- or primiparous women (19-35 years old) in weeks 17 to 19 of pregnancy. The women were provided 10 mL of either cod liver oil or corn oil daily until 3 months after delivery.

MAIN OUTCOME MEASURES: Primary outcomes were gestational length and birth weight. Electroencephalography (EEG) was done on the second day of life and at 3 months of age. Novelty preference (Fagan test) was used as an indicator of cognitive function at 6 and 9 months of age. The fatty acid pattern in umbilical plasma phospholipids and in breast milk was measured, and dietary assessments were performed, both on the mothers during pregnancy and on the infants at 3 months of age. The growth of the infants was followed up to 1 year of age.

RESULTS: Three hundred forty-one mothers took part in the study until delivery. There were no significant differences in maternal body mass index before pregnancy and at birth, or parity between the 2 groups. Smoking habits and parental education were also similar in the 2 groups. The mean age of the mothers receiving cod liver oil was, by chance, 1 year higher than the age of the mothers receiving corn oil (28.6 [3.4] vs 27.6 [3.2] years). The maternal dietary intake in the 2 groups receiving cod liver oil or corn oil was similar, except for the supplementation. There were no differences in gestational length or birth weight between the cod liver oil group and the corn oil group (279.6 [9.2] vs 279.2 [9.3] days; 3609 [493] vs 3618 [527] g, respectively). Birth length, head circumference, and placental weight were also similar in the 2 groups. The concentrations of the n-3 fatty acids eicosapentaenoic acid (20:5 n-3), docosapentaenoic acid (22:5 n-3), and DHA in umbilical plasma phospholipids were higher in the cod liver oil group compared with the corn oil group (10.8 [7.6] vs 2.5 [1.8] microg/mL, 5.0 [2.6] vs 2.9 [1.3] microg/mL, 55.8 [20.6] vs 45.3 [12.8] microg/mL, respectively).

Neonates with high concentration of DHA in umbilical plasma phospholipids (upper quartile) had longer gestational length than neonates with low concentration (lower quartile; 282.5 [8.5] vs 275.4 [9.3] days). No differences in EEG scores or Fagan scores were found, but neonates with mature EEG (N = 70) had a higher concentration of DHA in umbilical plasma phospholipids than neonates with immature EEG (N = 51) on the second day of life. Dietary information from 251 infants at 3 months of age was collected and 85% of these infants were exclusively breastfed, in addition to 12% who were partly breastfed. The breast milk of mothers supplemented with cod liver oil contained more n-3 long-chain PUFAs and less n-6 long-chain PUFAs than breast milk of mothers supplemented with corn oil. There were no significant differences in infant growth during the first year of life between the 2 groups.

CONCLUSIONS: This study shows neither harmful nor beneficial effects of maternal supplementation of long-chain n-3 PUFAs regarding pregnancy outcome, cognitive development, or growth, as compared with supplementation with n-6 fatty acids. However, it confirms that DHA concentration may be related to gestational length and cerebral maturation of the newborn.

PMID: 11694666