title: The importance of dietary DHA and ARA in early life: a public health perspective.
abstract: Although the literature on the contribution of DHA and arachidonic acid (ARA) to fundamental metabolic functions in brain, immune and cardiovascular systems is extensive, there is a lack of consensus on the need for explicit recommendations on dietary intake for both DHA and ARA during the early years of life. This review takes a public health perspective with the objective of ensuring that recommendations protect the most vulnerable children worldwide. Most studies on the effects of DHA and ARA in early life have been undertaken in high-income countries and this is reflected in policy recommendations. Although breast milk is considered the gold standard and always contains DHA and ARA, there are proposals that infant formulas, especially follow-on formulas, do not need to be supplemented with these fatty acids. Complementary foods frequently have low concentrations of ARA and DHA and this is most significant in low-income countries where availability is also limited. Recent evidence shows that in developing countries, intakes of DHA and ARA during the age period 6-36 months are low and this relates to low national income. It is concluded that a continuum of DHA and ARA intake needs to be maintained during early life, a critical period of infant growth and development. For both infant and follow-on formulas, DHA and ARA should be mandatory at levels that are equivalent to breast milk. An optional recommendation may be limited to countries that can demonstrate evidence of adequate intakes of DHA and ARA during early life.
authors.affiliation: University of Dundee,1 Ellieslea Road, West Ferry, Dundee DD5 1JG,UK.
authors.forename: Stewart
authors.initials: S
authors.lastname: Forsyth
authors.affiliation: DSM Nutritional Products,6480 Dobbin Road, Columbia, MD 21045,USA.
authors.forename: Sheila
authors.initials: S
authors.lastname: Gautier
authors.affiliation: DSM Nutritional Products,6480 Dobbin Road, Columbia, MD 21045,USA.
authors.forename: Norman
authors.initials: N
authors.lastname: Salem
mesh_terms: D016718:Arachidonic Acid / Q000008:administration & dosage*; D002675:Child, Preschool; D003906:Developing Countries; D004041:Dietary Fats / Q000008:administration & dosage*; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000737:chemistry; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008895:Milk, Human / Q000737:chemistry; D011203:Poverty; D011634:Public Health; D064167:Recommended Dietary Allowances
chemical_list: D004041:Dietary Fats; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid
keywords:  ARA arachidonic acid;  LCPUFA long-chain PUFA;  RCT randomised controlled trials; Arachidonic acid; DHA; Dietary intakes; Infants and children; Public health