[Guideline Summary] Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy

4 min read / 12.11.2019

Clinical Nutrition Obstetrics / Gynaecology Public Health Healthy Eating & Hydration Nutrition & Disease Management

[Guideline Summary] Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy

Systematic Review and Practice Recommendations from an Early Nutrition Academy Workshop

Background

The Early Nutrition Academy (ENA) reviews recent information on the roles of long-chain polyunsaturated fatty acids (LCPUFAs) during pregnancy, lactation and infancy, with particular consideration on Asian populations.
The ENA summarizes the impact of LCPUFAs from different randomized controlled trials. Recommendations for practice are presented at the end of the paper.

Summary of the Recommendations

Subject	Amount of intake
Pregnant women	An additional supply of at least 200 mg DHA/day, usually a total DHA intake of at least 300 mg/day Higher intakes (600-800 mg DHA/day) may provide greater protection against early preterm birth
Lactating women	A minimum average daily supply of 200 mg DHA to achieve a human milk DHA content of ~0.3% fatty acids
Very-low-birth weight infants (birth weight < 1,500 g)	Intakes per kg per day of DHA: 18-60 mg (preferably 55-60mg) Intakes per kg per day of AA: 18-45 mg (preferably 35-45 mg) EPA intake per kg per day should not exceed 20 mg
Term infants	Breastfeeding is recommended as the preferred choice for infant feeding During the first months of life, 100 mg DHA/day and 140 mg AA/day should be provided Infant formula should provide at least 0.3% of fatty acids as DHA along with AA
Older Infants	A supply of 100 mg DHA/day should continue during the second half of infancy No quantitative advice on AA intake with follow-on formula fed during weaning

Summary of the Reviewed Literatures

The mean concentration of DHA in human milk in Asian countries is variable.
Populations which consume fish and seafood regularly have higher intake of preformed EPA and DHA.
LCPUFA supplementation and its influences on various populations:

Subject	Intervention	Outcomes with additional LCPUFA supplementation
Pregnant and lactating women	(I) Daily 400 mg algae DHA (C) Placebo	Lower risk of early preterm delivery
	(I) Daily 2.7 g n-3 LCPUFA (C) Daily 2.8 g soybean oil	Increase in infant size at birth
	(I) Daily 1.6 g EPA + 1.1 g DHA (C) Placebo	Better neonatal and maternal immune response
	No impact on gestational diabetes and preeclampsia No firm conclusion due to limited research on maternal depression, child,growth, childhood obesity or early markers of cardiovascular diseases
Preterm infants	(I) High DHA milk (1% of total fatty acids) + 0.5% AA (C) Formula with standard DHA (0.2%-0.3%) + 0.5% AA	Positive effect on chronic lung disease and immune responses

	Inconsistent results on growth, visual and cognitive outcomes
Full term infants	(I) Formula with canola oil (C) Formula without canola oil	Better gastrointestinal comfort
	(I) Formula with 0.64% AA + 0.96%DHA (C) Formula without DHA	Better immune responses
		Better immune responses
	Inconclusive research on growth or cognitive development
Older infants	Inconclusive research on beneficial effects in any aspects

Remarks (I) = Intervention; (C) = Control

Link to PubMed

Reference

Koletzko B, Boey CC, Campoy C, Carlson SE, Chang N, Guillermo-Tuazon MA, Joshi S, Prell C, Quak SH, Sjarif DR, Su Y, Supapannachart S, Yamashiro Y, Osendarp SJ. Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy: Systematic Review and Practice Recommendations from an Early Nutrition Academy Workshop. Ann Nutr Metab. 2014 Sep 16;65(1):49-80.

WYE-EM-361-NOV-14