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Omega-3: Fakten
- Therapie und Dosierung
Gehirn- und Sehleistung
von Kleinkinder: 2,0g/Tag DHA & EPA spätestens ab 4.
Monat der Schwangerschaft.
In Fachzeitschriften wurden folgende Artikel über Omega-3
publiziert. Die Liste dieser Publikationen wurde im April 2003
kompiliert und erhebt keinen Anspruch auf Vollständigkeit.
Quelle: MEDLINE.
Die Daten dienen als Referenz für Ärzte und Therapeuten,
damit ein mögliches Gesundheitsrisiko für Kleinkinder
vermindert werden kann.
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Long-chain
polyunsaturated fatty acids in breast milk: are they essential?
Gibson RA: Child Nutrition Research
Centre, Child Health Research Institute, Flinders Medical Centre,
Adelaide, SA, Australia; Makrides M
Adv Exp Med Biol 2001 501:375-83
Abstract
The need for long-chain polyunsaturated fatty acids (LC-PUFA),
such as docosahexaenoic acid (DHA, C22:6n3) and arachidonic acid
(AA, C20:4n6), in the diet of infants in order to achieve full
developmental potential is a matter of intense investigation by
several research groups worldwide. It has been widely reported
that breast-fed infants perform better on tests that assess neurodevelopmental
outcomes than do formula-fed infants. Although human milk contains
LC-PUFA that are absent from formula, it is necessary to demonstrate
that any beneficial effects of human milk on infant development
are purely attributed to the presence of LC-PUFA in human milk
and their absence from formula to establish causality. The hypothesis
that dietary DHA is associated with developmental outcome needs
to be plausible; the effect must be consistent, specific, and
independent of confounding factors. The hypothesis is certainly
plausible. DHA is avidly incorporated and retained in brain
cerebral phospholipids, and a most consistent finding has
been the lower level of cerebral DHA in the brains of formula-fed
infants (receiving no DHA) relative to those fed human milk (receiving
DHA). The formula-fed infants in these studies were generally
fed formulas with adequate alpha-linolenic acid levels, and this
may indicate a nutritional requirement for preformed DHA. Several
studies have compared the effects of breast- and formula-feeding
on functional outcomes in preterm and term infants. While many
of the outcomes have involved visual testing, others have attempted
more global assessments. The results have shown differences in
favor of breast-feeding but have been colored by the strong socioeconomic
differences between mothers who choose to breast feed and those
who choose formula-feeding. Randomized clinical trials involving
preterm infants have shown a clear requirement for DHA for full
visual and neural development. These results are consistent
with primate studies. However, intervention studies with term
infants that have attempted to improve the DHA supply of infant
formula and hence infant development have not yielded consistent
results. Some randomized studies have demonstrated improved visual
and developmental indices in supplemented over unsupplemented
infants, others have failed to demonstrate an effect. This disparity
could be due to methodological and environmental differences.
It is also notable that supplemental regimens have not specifically
added DHA and have included other LC-PUFA, raising the question
as to the specificity of the effect. However, only tissue DHA
levels have consistently correlated with outcomes.
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Neonatal
polyunsaturated fatty acid metabolism.
Innis SM: Department of Paediatrics,
University of British Columbia, Vancouver, Canada; Sprecher H,
Hachey D, Edmond J, Anderson RE
Lipids 1999 Feb 34:139-49
Abstract
The importance of n-6 and n-3 polyunsaturated fatty
acids (PUFA) in neonatal development, particularly with respect
to the developing brain and retina, is well known. This review
combines recent information from basic science and clinical studies
to highlight recent advances in knowledge on PUFA metabolism and
areas where research is still needed on infant n-6 and n-3 fatty
acid requirements. Animal, cell culture, and infant studies are
consistent in demonstrating that synthesis of 22:6n-3 involves
C24 PUFA and that the amounts of 18:2n-6 and 18:3n-3 influence
PUFA metabolism. Studies to show that addition of n-6 fatty acids
beyond delta6-desaturase alters n-6 fatty acid metabolism with
no marked increase in tissue 20:4n-6 illustrate the limitations
of analyses of tissue fatty acid compositions as an approach to
study the effects of diet on fatty acid metabolism. New information
to show highly selective pathways for n-6 and n-3 fatty acid uptake
in brain, and efficient pathways for conservation of 22:6n-3 in
retina emphasizes the differences in PUFA metabolism among different
tissues and the unique features which allow the brain and retina
to accumulate and maintain high concentrations of n-3 fatty acids.
Further elucidation of the delta6-desaturases involved in 24:5n-6
and 22:6n-3 synthesis; the regulation of fatty acid movement between
the endoplasmic reticulum and peroxisomes; partitioning to acylation,
desaturation and oxidation; and the effects of dietary and hormonal
factors on these pathways is needed for greater understanding
of neonatal PUFA metabolism.
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Maternal
supplementation with very-long-chain n-3 fatty acids during pregnancy
and lactation augments children's IQ at 4 years of age.
Helland IB: Institute for Nutrition
Research, University of Oslo, Oslo, Norway; Smith L, Saarem K,
Saugstad OD, Drevon CA
Pediatrics 2003 Jan 111:e39-44
Abstract
OBJECTIVES: Docosahexaenoic acid (DHA; 22:6 n-3) and
arachidonic acid (AA; 20:4 n-6) are important for development
of the central nervous system in mammals. There is a growth
spurt in the human brain during the last trimester of pregnancy
and the first postnatal months, with a large increase in the cerebral
content of AA and DHA. The fetus and the newborn infant depend
on maternal supply of DHA and AA. Our hypothesis was that
maternal intake of DHA during pregnancy and lactation is marginal
and that high intake of this fatty acid would benefit the child.
We examined the effect of supplementing pregnant and lactating
women with very-long-chain n-3 polyunsaturated fatty acids (PUFAs;
cod liver oil) on mental development of the children, compared
with maternal supplementation with long-chain n-6 PUFAs (corn
oil). METHODS: The study was randomized and double-blinded.
Pregnant women were recruited in week 18 of pregnancy to take
10 mL of cod liver oil or corn oil until 3 months after delivery.
The cod liver oil contained 1183 mg/10
mL DHA, 803 mg/10 mL eicosapentaenoic acid (20:5 n-3),
and a total of 2494 mg/10 mL summation operator n-3 PUFAs.
The corn oil contained 4747 mg/10 mL linoleic acid (18:2 n-6)
and 92 mg/10 mL alpha-linolenic acid (18:3 n-3). The amount of
fat-soluble vitamins was identical in the 2 oils (117 micro g/mL
vitamin A, 1 micro g/mL vitamin D, and 1.4 mg/mL dl-alpha-tocopherol).
A total of 590 pregnant women were recruited to the study, and
341 mothers took part in the study until giving birth.
All infants of these women were scheduled for assessment of cognitive
function at 6 and 9 months of age, and 262 complied with the request.
As part of the protocol, 135 subjects from this population were
invited for intelligence testing with the Kaufman Assessment Battery
for Children (K-ABC) at 4 years of age. Of the 135 invited children,
90 came for assessment. Six children did not complete the
examination. The K-ABC is a measure of intelligence and achievement
designed for children aged 2.5 years through 12.5 years. This
multisubtest battery comprises 4 scales: Sequential Processing,
Simultaneous Processing, Achievement (not used in the present
study), and Nonverbal Abilities. The Sequential Processing and
Simultaneous Processing scales are hypothesized to reflect the
child's style of problem solving and information processing. Scores
from these 2 scales are combined to form a Mental Processing Composite,
which serves as the measure of intelligence in the K-ABC. RESULTS:
We received dietary information from 76 infants (41
in the cod liver oil group and 35 in the corn oil group),
documenting that all of them were breastfed
at 3 months of age. Children who were born to mothers
who had taken cod liver oil (n = 48) during pregnancy and lactation
scored higher on the Mental Processing Composite of the K-ABC
at 4 years of age as compared with children whose mothers had
taken corn oil (n = 36; 106.4 [7.4] vs 102.3 [11.3]). The Mental
Processing Composite score correlated significantly with head
circumference at birth (r = 0.23), but no relation was found
with birth weight or gestational length. The
children's mental processing scores at 4 years of age correlated
significantly with maternal intake of DHA and eicosapentaenoic
acid during pregnancy. In a multiple regression model,
maternal intake of DHA during pregnancy was the only variable
of statistical significance for the children's mental processing
scores at 4 years of age. CONCLUSION: Maternal intake of very-long-chain
n-3 PUFAs during pregnancy and lactation may be favorable for
later mental development of children.
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Polyunsaturated
fatty acids in human milk and their role in early infant development.
Koletzko B: Division Metabolic Diseases
and Nutrition Kinderklinik and Kinderpoliklinik, Dr. von Haunersches
Kinderspital, Ludwigs-Maximilians-University of Munich; Rodriguez-Palmero M
J Mammary Gland Biol Neoplasia 1999 Jul 4:269-84
Abstract
The lipid fraction of human milk represents
the main source of energy for the newborn infant and supplies essential
nutrients such as fat-soluble vitamins and polyunsaturated fatty
acids (PUFA). The essential fatty acids linoleic and alpha-linolenic
acids are precursors of long-chain polyunsaturated fatty acids (LC-PUFA),
such as arachidonic (C20:4 n-6) and docosahexaenoic (C22:6 n-3)
acids, present in human milk in considerable amounts. LC-PUFA are
indispensable structural components of all cellular membranes, and
they are incorporated in relatively large amounts during early growth
of the brain and the retina. Moreover, some LC-PUFA are precursors
of eicosanoids, molecules with potent biological activity that modulates
various cellular and tissue processes. The supply of long-chain
fatty acids has been associated with functional outcomes of the
recipient infants such as visual acuity and development of cognitive
functions during the first year of life. Here we discuss the PUFA
composition of human milk, factors which determine and modulate
milk PUFA content, and possible effects of milk LC-PUFA on infant
growth and development. |
Physiological
aspects of human milk lipids.
Koletzko B: Department of Pediatrics,
Kinderklinik and Kinderpoliklinik, Dr. von Haunersches Kinderspitel,
Ludwig-Maximilians-University of Munich; Rodriguez-Palmero M,
Demmelmair H, Fidler N, Jensen R, Sauerwald T
Early Hum Dev 2001 Nov 65 Suppl:S3-S18
Abstract
Human milk from healthy and well-nourished
mothers is the preferred form of feeding for all healthy newborn
infants. The nutrient supply with human milk supports normal growth
and development of the infant. Here the general characteristics
of human milk lipids and recent knowledge on lactational physiology,
composition and functional aspects of human milk lipids are discussed.
Lipids in human milk represent the main source of energy for the
breastfed baby and supply essential nutrients such as fat-soluble
vitamins and polyunsaturated fatty acids (PUFA). The essential fatty
acids linoleic and alpha-linolenic acids (LA and ALA) are precursors
of long-chain polyunsaturated fatty acids (LC-PUFA), including arachidonic
(20:4n-6) and docosahexaenoic (22:6n-3) acids (AA and DHA). LC-PUFA
serve as indispensable structural components of cellular membranes
and are deposited to a considerable extent in the growing brain
and the retina during perinatal development. The supply of preformed
LC-PUFA with human milk lipids has been related to functional outcomes
of the recipient infants such as visual acuity and development of
cognitive functions during the first year of life. Recent stable
isotope studies indicate that the major portion of milk PUFA is
not derived directly from the maternal diet, but stems from endogenous
body stores. Thus, not only the woman's current but also her long-term
dietary intake is of marked relevance for milk fat composition. |
Essential
fatty acids in visual and brain development.
Uauy R: Institute of Nutrition and Food
Technology (INTA), University of Chile, Santiago, Chile; Hoffman DR,
Peirano P, Birch DG, Birch EE
Lipids 2001 Sep 36:885-95
Abstract
Essential fatty acids are structural components
of all tissues and are indispensable for cell membrane synthesis;
the brain, retina and other neural tissues are particularly rich
in long-chain polyunsaturated fatty acids (LC-PUFA). These fatty
acids serve as specific precursors for eicosanoids, which regulate
numerous cell and organ functions. Recent human studies support
the essential nature of n-3 fatty acids in addition to the well-established
role of n-6 essential fatty acids in humans, particularly in early
life. The main findings are that light
sensitivity of retinal rod photoreceptors is significantly reduced
in newborns with n-3 fatty acid deficiency, and that docosahexaenoic
acid (DHA) significantly enhances visual acuity maturation and cognitive
functions. DHA is a conditionally essential nutrient for adequate
neurodevelopment in humans. Comprehensive clinical studies
have shown that dietary supplementation with marine oil or single-cell
oil sources of LC-PUFA results in increased blood levels of DHA
and arachidonic acid, as well as an associated improvement in visual
function in formula-fed infants matching that of human breast-fed
infants. The effect is mediated not only by the known effects on
membrane biophysical properties, neurotransmitter content, and the
corresponding electrophysiological correlates but also by a modulating
gene expression of the developing retina and brain. Intracellular
fatty acids or their metabolites regulate transcriptional activation
of gene expression during adipocyte differentiation and retinal
and nervous system development. Regulation of gene expression by
LC-PUFA occurs at the transcriptional level and may be mediated
by nuclear transcription factors activated by fatty acids. These
nuclear receptors are part of the family of steroid hormone receptors.
DHA also has significant effects on photoreceptor membranes and
neurotransmitters involved in the signal transduction process; rhodopsin
activation, rod and cone development, neuronal dendritic connectivity,
and functional maturation of the central nervous system. |
Fatty
acid composition of human brain phospholipids during normal development.
Martinez M: Center for Research in Biochemistry
and Molecular Biology, Maternity-Children's Hospital Vall d'Hebron,
Barcelona, Spain; Mougan I
J Neurochem 1998 Dec 71:2528-33
Abstract
The fatty acid composition of phosphatidylethanolamine
(PE), ethanolamine plasmalogens (EPs), phosphatidylserine (PS),
phosphatidylcholine (PC), and sphingomyelin was studied in 22 human
forebrains, ranging in age from 26 prenatal weeks to 8 postnatal
years. Phospholipids were separated by two-dimensional TLC,
and the fatty acid methyl esters studied by capillary column GLC.
Docosahexaenoic acid (22:6n-3) increased with age in PE and PC,
whereas arachidonic acid (20:4n-6) remained quite constant. In EP,
22:6n-3 increased less markedly than 20:4n-6, adrenic (22:4n-6)
and oleic (18:1n-9) acids being the predominant fatty acids during
postnatal age. In PS, 18:1n-9 increased dramatically throughout
development, and 20:4n-6 and 22:4n-6 increased only until approximately
6 months of age. Although 22:6n-3 kept quite constant during development
in PS, its percentage decreased due to the accretion of other polyunsaturated
fatty acids (PUFAs). As a characteristic myelin lipid, sphingomyelin
was mainly constituted by very long chain saturated and monounsaturated
fatty acids. Among them, nervonic acid (24:1n-9) was the major very
long chain fatty acid in Sp, followed by 24:0, 26:1n-9, and 26:0,
and its accretion after birth was dramatic. As myelination advanced,
18:1n-9 increased markedly in all four glycerophospholipids, predominating
in EP, PS, and PC. In contrast, 22:6n-3 was the most important
PUFA in PE in the mature forebrain. |
Higher
maternal plasma docosahexaenoic acid during pregnancy is associated
with more mature neonatal sleep-state patterning.
Cheruku SR: Department of Nutritional
Sciences, the University of Connecticut, Storrs, USA; Montgomery-Downs HE,
Farkas SL, Thoman EB, Lammi-Keefe CJ
Am J Clin Nutr 2002 Sep 76:608-13
Abstract
BACKGROUND: The effect of docosahexaenoic
acid (DHA) on the developing fetal central nervous system (CNS)
and related functional outcomes in infancy remain unexplored. Sleep
and wake states of newborns provide a tool for assessing the functional
integrity of the CNS. OBJECTIVE: We investigated whether CNS
integrity in newborns, measured with sleep recordings, was associated
with maternal concentrations of long-chain polyunsaturated fatty
acids, especially DHA. DESIGN: Plasma phospholipid fatty acid
concentrations were measured in 17 women at parturition.
On postpartum day 1 (P1) and day 2 (P2), a pressure-sensitive pad
under the infants' bedding recorded body movements and respiratory
patterns to measure sleep and wake states. RESULTS: Maternal plasma
phospholipid DHA ranged from 1.91% to 4.5% by wt of total fatty
acids. On the basis of previously published data and the median
DHA concentration, the women were divided into 2 groups: high DHA
(> 3.0% by wt of total fatty acids) and low DHA (</= 3.0%
by wt of total fatty acids). Infants of high-DHA mothers had
a significantly lower ratio of active sleep (AS) to quiet sleep
(QS) and less AS than did infants of low-DHA mothers. Furthermore,
the former infants had less sleep-wake transition and more wakefulness
on P2. Correlations of maternal DHA status with infant sleep states
were consistent with these data. Also, the ratio of maternal n-6
to n-3 fatty acids on P1 was inversely associated with QS and positively
associated with arousals in QS. On P2, maternal n-6:n-3 was positively
associated with AS, sleep-wake transition, and AS:QS. CONCLUSION:
The sleep patterns of infants born to mothers with higher plasma
phospholipid DHA suggest greater CNS maturity. |
Role
of essential fatty acids in the function of the developing nervous
system.
Uauy R: Institute of Nutrition and Food
Technology (INTA), University of Chile, Santiago, Chile; Peirano P,
Hoffman D, Mena P, Birch D, Birch E
Lipids 1996 Mar 31 Suppl:S167-76
Abstract
The basis for n-3 fatty acid essentially in humans includes
not only biochemical evidence but functional measures associated
with n-3 deficiency in human and nonhuman primates. Functional development
of the retina and the occipital cortex are affected by alpha-linolenic
acid deficiency and by a lack of docosahexaenoic acid (DHA) in preterm
infant formulas and, as reported more recently, in term diets. Functional
effects of n-3 supply on sleep-wake cycles and heart rate rhythms
support the need for dietary n-3 fatty acids during early development.
Our results indicate that n-3 long-chain polyunsaturated fatty
acids should be considered provisionally essential for infant nutrition.
DHA may also be required by individuals with inherited metabolic
defects in elongation and desaturation activity, such as patients
with peroxisomal disorders and some forms of retinitis pigmentosa.
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