LONG-CHAIN POLYUNSATURATED FATTY ACIDS: THE CASE FOR AND AGAINST THE SUPPLEMENTATION OF INFANT FORMULA
The following paper investigates the role of long-chain polyunsaturated fatty acids (LCPUFAs) and its effects on infants to determine whether or not there is beneficial to supplement LCPUFAs in infant products. A brief introduction to the topic is provided and the key concepts defined, after which thorough analysis of a variety of studies is conducted.
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In neural structure, the specific LCPUFAs, docosahexaenoic acid (DHA) and arachidonic acid (AA) can be found. DHA is a component of neurone membranes and external segments of fotoreceptors in the retina. In the brain, liver and intestine, DHA, an omega-3 (n-3) polyunsaturated fatty acid is biosynthesized in limited amount in the body from essential fatty acids (EFA), alpha-linolenic acid (ALA) by successive desaturation and elongation whereas AA (n-6) is synthesised in the body from EFA precursor, linoleic acid (LA).
Infants are able to synthesize their own DHA and AA from the precursors found in formula [7]. The aim for this paper is to argue that the use of LCP-supplemented infant formula over non-supplemented formula in infants.
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Role of long-chain essential fatty acids in infant development
In the studies shown that LCPUFA influences perception and cognitive functions in infancy. In early infancy, LCPUFA, especially AA affects positively growth and development [7]. The major components of membranes are n-3 and n-6 that play important roles on membrane functions, cell organisation, neuronal growth and development of synaptic processed for neural cell interaction. Moreover, DHA affects positively the neurological development of preterm infants, for instant, mental development for exhibition of anti inflammatory properties [7]. In recent years, the greatest interest is the role of DHA in neural and brain development and function. Dietary n-3 fatty acids are able to affect the retina and visual acuity by influencing their rate of development [5].
Consequences of deficiency
LCPUFA deficiency in children can manifest into a condition known as attention-deficit hyperactivity disorder (ADHD), used to describe children who are inattentive, impulsive and hyperactive [6]. These behaviours may affect school performance, family relations and social interactions with peers. ADHD has been associated with conditions that cause neurological impairment [2]. N-3 fatty acids deficiency leads to impaired neurotransmitter reception in brain and altered neuronal plasticity. In addition, skin changes unresponsive to linoleic acid supplementation, abnormal visual function and peripheral neuropathy would be happened of deficiency of n-3 fatty acids [7]. Unfortunately, the process of synthesis of LCPUFA is unable to infants.
Evidence on reduces heart rate
Based on a double-blind, randomised, controlled, parallel-group perspective trial, 122 term infants were fed one of four formulas varying in their DHA composition from birth to 12 months; three with varying levels of two LCPUFAs (DHA and AA) and one formula with no LCPUFA (control formula), tested at aged of 4, 6 and 9 months and measured the heart rate during the administration of the visual attention task [3]. This trial involved those healthy, term, formula-fed, singleton-birth infants. Infants were fed the study formula for the first 12 months without limits.
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In the result shown, infants’ heart rate change consistently with age, overall, heart rate in beats per minute declined from 146 to 138 to 133 at 4, 6 and 9 months, respectively. The results have shown the positive effects of postnatal DHA supplementation in term infants typically more than 0.20% total fatty acids as DHA. Moreover, lower heart rate was shown consistently for all three supplemented groups, relative to controls. The increased intake of n-3 LCPUFA will affect the reduction or increased of heart rate, however, the effect of lowering heart rate in adult populations is viewed as a positive health outcome and has been suggested to impart positive impacts on affective, cognitive and behavioural outcomes [3].
Evidence of visual acuity
A double-masked, randomised trial found a specific benefit if dietary DHA for retinal maturation and visual acuity development at 2 sites. 343 healthy, term, formula-fed infants were enrolled at 1-9 days of age and were randomly assigned to be fed 1 of the following 4 infant formulas containing equivalent nutrient amounts, except for LCPUFA: control (0% DHA), 0.32% DHA, 0.64% DHA or 0.96% DHA. Visual acuity was measured by visual evoked potentials in 244 infants who completed the 12 months primary outcome examination [1].
The results shown that only 0.32% of total fatty acids of DHA supplementation of infant formula improve visual acuity; however, the higher amounts of DHA supplementation were not associated with additional improvement of visual acuity. There were no significant differences in visual evoked potential visual acuity between 3 amounts of DHA supplementation for either site at any age tested [1].
Evidence from a double-blind randomised controlled trial on infant morbidity
1094 pregnant women were randomly assigned to DHA group or placebo group from 18 to 22 weeks’ gestation through parturition. DHA group received daily supplementation with 400mg of DHA capsules, which was derived from an algal source. Algal-derived DHA supplements have a less distinct taste than fish oil whereas the placebo capsules, which were similar in appearance and taste to the DHA capsules, contained a corn and soy oil blend with no added antioxidants. After all, in infants aged 1, 3 and 6 months, caregivers reported the occurrence of common illness symptoms in the preceding 15 days [4].
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As a result, there was no between-group difference in the number of symptoms experienced; however, the occurrence of a combined measure of cold symptoms was lower in the DHA group at 1 month. At 1 month, the DHA group experienced 26%, 15% and 30% shorter duration of cough, phlegm and wheezing, respectively, but 22% longer duration of rash. At 3 months, infants in the DHA group spent 14% less time ill. At 6 months, infants in the DHA group experienced 20%, 13%, 54%, 23% and 25% shorter duration of fever, nasal secretion, difficulty breathing, rash, and other illness, but 74% longer duration of vomiting. DHA supplementation during pregnancy decreased the occurrence of colds in children at 1 month and influenced illness symptom duration at 1, 3 and 6 months [4].
Recommendation
In this studies, the overall weight of evidence from studies analysed that long-chain polyunsaturated fatty acids supplemented infant formula have significantly beneficial for development of infant. Therefore, they should put into produce and keep on researching in the future. Based on DHA and AA supplemented infant formula can decrease heart rate. Moreover, it provides further benefit on visual acuity for the development of infant. Meanwhile, the rate of infant morbidity will decrease with the consumption of the DHA supplemented. In conclusion, the new products of infant formula that added LCPs ingredient should sell in the market. They can increase the selection of consumers that are not willing to rely on breastfed for infants’ nutrition intake.
