Perinatal supply and metabolism of long-chain polyunsaturated fatty acids: importance for the early development of the nervous system.
The long-chain polyunsaturated fatty acids, arachidonic (AA) and docosahexaenoic acid (DHA), are essential structural lipid components of biomembranes. During pregnancy, long-chain polyunsaturated fatty acids (LC-PUFA) are preferentially transferred from mother to fetus across the placenta. This placental transfer is mediated by specific fatty acid binding and transfer proteins. After birth, preterm and full-term babies are capable of converting linoleic and alpha-linolenic acids into AA and DHA, respectively, as demonstrated by studies using stable isotopes, but the activity of this endogenous LC-PUFA synthesis is very low. Breast milk provides preformed LC-PUFA, and breast-fed infants have higher LC-PUFA levels in plasma and tissue phospholipids than infants fed conventional formulas. Supplementation of formulas with different sources of LC-PUFA can normalize LC-PUFA status in the recipient infants relative to reference groups fed human milk. Some, but not all, randomized, double-masked placebo-controlled clinical trials in preterm and healthy full-term infants demonstrated benefits of formula supplementation with DHA and AA for development of visual acuity up to 1 year of age and of complex neural and cognitive functions. From the available data, we conclude that LC-PUFA are conditionally essential substrates during early life that are related to the quality of growth and development. Therefore, a dietary supply during pregnancy, lactation, and early childhood that avoids the occurrence of LC-PUFA depletion is desirable, as was recently recommended by an expert consensus workshop of the Child Health Foundation.
Larque
Elvira
E
Division of Metabolism and Nutrition, Kinderklinik and Kinderpoliklinik, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Germany.
Demmelmair
Hans
H
Koletzko
Berthold
B
D016718:Arachidonic Acid / Q000493:pharmacokinetics / Q000494:pharmacology*; D004281:Docosahexaenoic Acids / Q000493:pharmacokinetics / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000187:drug effects; D007231:Infant, Newborn; D007234:Infant, Premature; D008431:Maternal-Fetal Exchange; D008895:Milk, Human; D009420:Nervous System / Q000254:growth & development*; D011247:Pregnancy; D014792:Visual Acuity / Q000187:drug effects
D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid