title: New European Food Safety Authority recommendation for infant formulae contradicts the physiology of human milk and infant development.
abstract: The European Food Safety Authority (EFSA) has concluded from a limited review of the literature that although docosahexaenoic acid (DHA) was required for infant formula, arachidonic acid was not 'even in the presence of DHA'. The EFSA report mistakes a nutrient ubiquitous in the diets of infants, and with wide-ranging effects, for an optional drug targeted to a particular outcome that is properly excluded when no benefit is found for that particular outcome. The EFSA's conclusion is not evidence-based. Its conclusions are grounded in trials which tested functionality of DHA, not arachidonic acid. Arachidonic acid has very different biological functions, for instance, in the vasculature and in specific aspects of immunity. None of the trials cited tested any property specific to arachidonic acid. The test of time through natural selection and human evolution has resulted in milk composition in which arachidonic acid and its long-chain polyenoic family members are conserved and occupy a prominent position. As DHA suppresses arachidonic acid, an infant formula with DHA and no arachidonic acid runs the risk of cardio- and cerebrovascular morbidity through suppression of the favourable eicosanoid derivatives of arachidonic acid and cell structural integrity. The EFSA recommendation should be rejected forthwith as unsafe and risking lifelong disability.
authors.affiliation: Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital Campus of Imperial College, London, UK michael.crawford@imperial.ac.uk.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Crawford
authors.affiliation: Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital Campus of Imperial College, London, UK.
authors.forename: Yiqun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Paediatrics, University of Dundee, West Ferry, Dundee, UK.
authors.forename: Stewart
authors.initials: S
authors.lastname: Forsyth
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Brenna
mesh_terms: D016718:Arachidonic Acid / Q000008:administration & dosage / Q000009:adverse effects; D002657:Child Development; D004281:Docosahexaenoic Acids / Q000008:administration & dosage / Q000009:adverse effects; D005060:Europe; D059022:Food Safety; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000737:chemistry* / Q000592:standards*; D007227:Infant Nutritional Physiological Phenomena; D008895:Milk, Human / Q000737:chemistry*; D012307:Risk Factors
chemical_list: D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid
keywords: EFSA recommendation; arachidonic acid; docosahexaenoic acid; infant formula; morbidity