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Controversy in fatty acid balance

J E Van Aerde1, M T Clandinin

  • 1University of Alberta Hospitals, Department of Pediatrics, Edmonton, Canada.

Canadian Journal of Physiology and Pharmacology
|September 1, 1993
PubMed
Summary

Preterm infants may struggle to produce essential long-chain polyunsaturated fatty acids. Specially balanced infant formulas can achieve levels similar to breast milk, supporting infant development.

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Area of Science:

  • Neonatal nutrition
  • Biochemistry
  • Pediatric research

Background:

  • Preterm infants' ability to synthesize crucial C20 and C22 omega-6 and omega-3 fatty acids is uncertain.
  • Standard infant formulas lacking long-chain polyunsaturated fatty acids (LCPUFAs) lead to lower levels of these fatty acids in infant phospholipids compared to breastfed infants.
  • Fish oil supplementation offers only partial improvement, with reduced synthesis and incorporation of arachidonic acid.

Purpose of the Study:

  • To investigate the impact of infant formula fatty acid composition on LCPUFA levels in preterm infants.
  • To determine if an experimental formula can replicate the LCPUFA profiles found in breast milk.
  • To provide recommendations for essential fatty acid content in preterm infant formulas.

Main Methods:

  • Comparison of LCPUFA levels in plasma phospholipids between infants fed standard formula, supplemented formula, and breast milk.
  • Administration of an experimental infant formula with a specific balance of C20 and C22 omega-6 and omega-3 fatty acids.
  • Analysis of clinical studies and evolutionary data to inform recommendations.

Main Results:

  • Infant formulas currently lack essential C20 and C22 fatty acids.
  • An experimental formula, balanced in C20 and C22 omega-6 and omega-3 fatty acids within human milk ranges, resulted in similar plasma phospholipid levels to breastfed infants.
  • Fish oil supplementation partially addressed the issue but did not fully restore arachidonic acid levels.

Conclusions:

  • Balanced incorporation of omega-6 and omega-3 LCPUFAs in infant formula is advisable due to uncertainties in neonatal essential fatty acid metabolism.
  • Recommendations include increasing linolenic acid and decreasing linoleic acid content in infant formulas.
  • Further research and specific recommendations for preterm infant formula essential fatty acid content are suggested.

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