Polyunsaturated Fatty Acid Intake During Complementary Feeding and Neurodevelopmental Outcome in Very Low Birth Weight Infants

Overview

Journal Nutrients

Date 2023 Jul 29

PMID 37513559

Authors

Melanie Gsoellpointner

Margarita Thanhaeuser

Fabian Eibensteiner

Robin Ristl

Bernd Jilma

Renate Fuiko

Sophia Brandstetter

Angelika Berger

Nadja Haiden

Affiliations

Soon will be listed here.

Abstract

Polyunsaturated fatty acids (PUFAs) are vital for brain development, yet limited knowledge exists regarding PUFA intake during complementary feeding (CF) and its impact on neurodevelopmental outcomes in very low birth weight (VLBW) infants. This secondary analysis of a randomized intervention trial, aimed to investigate the association between dietary intake of total PUFAs, arachidonic acid (AA), and docosahexaenoic acid (DHA) during CF and neurodevelopmental outcomes at 12 and 24 months of corrected age (CA). Dietary intakes were assessed using monthly 3 day dietary protocols from 3 to 12 months CA. Neurodevelopmental outcome was evaluated using the Bayley Scales of Infant Development-III. Among the 177 randomized patients, PUFA intake and neurodevelopmental outcomes were evaluated in 140 (79%) infants. Higher total PUFA and DHA intakes significantly correlated with improved cognitive and motor function at 12 months CA, while increased AA intake notably enhanced motor scores at 12 months CA. However, median dietary intakes of AA and DHA (AA: 53.50-84.25 mg/d; DHA: 51.47-76.23 mg/d) fell short of recommended levels (AA: 140 mg/d; DHA: 100 mg/d) at any of the investigated timepoints. These findings emphasize the need to enhance total PUFA, DHA and AA intakes during CF, ensuring adherence to guidelines and unlocking the potential to improve neurodevelopmental outcomes in VLBW infants.

Citing Articles

Lipidomics Analysis Reveals the Effects of Docosahexaenoic Acid from Different Sources on Prefrontal-Cortex Synaptic Plasticity.

He Z, Xiong W, Yang Y, Zhang Y, Li B, Wang F Nutrients. 2025; 17(3).

PMID: 39940315 PMC: 11819862. DOI: 10.3390/nu17030457.

Macronutrient Intake during Complementary Feeding in Very Low Birth Weight Infants Comparing Early and Late Introduction of Solid Foods: A Secondary Outcome Analysis.

Gsoellpointner M, Thanhaeuser M, Kornsteiner-Krenn M, Eibensteiner F, Ristl R, Jilma B Nutrients. 2024; 16(19).

PMID: 39408387 PMC: 11478545. DOI: 10.3390/nu16193422.

Dietary Supplementation with n-3 Polyunsaturated Fatty Acids Delays the Phenotypic Manifestation of Krabbe Disease and Partially Restores Lipid Mediator Production in the Brain-Study in a Mouse Model of the Disease.

Signorini C, Pannuzzo G, Graziano A, Moretti E, Collodel G, Cardile V Int J Mol Sci. 2024; 25(13).

PMID: 39000257 PMC: 11241235. DOI: 10.3390/ijms25137149.

Could early life DHA supplementation benefit neurodevelopment? A systematic review and meta-analysis.

Hu R, Xu J, Hua Y, Li Y, Li J Front Neurol. 2024; 15:1295788.

PMID: 38645744 PMC: 11032049. DOI: 10.3389/fneur.2024.1295788.

References

Smith S, Rouse C . Docosahexaenoic acid and the preterm infant. Matern Health Neonatol Perinatol. 2017; 3:22. PMC: 5725938. DOI: 10.1186/s40748-017-0061-1. View

Heath R, Klevebro S, Wood T . Maternal and Neonatal Polyunsaturated Fatty Acid Intake and Risk of Neurodevelopmental Impairment in Premature Infants. Int J Mol Sci. 2022; 23(2). PMC: 8775484. DOI: 10.3390/ijms23020700. View

Brenna J, Varamini B, Jensen R, Diersen-Schade D, Boettcher J, Arterburn L . Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr. 2007; 85(6):1457-64. DOI: 10.1093/ajcn/85.6.1457. View

Dewey K, Beaton G, Fjeld C, Lonnerdal B, Reeds P . Protein requirements of infants and children. Eur J Clin Nutr. 1996; 50 Suppl 1:S119-47; discussion S147-50. View

Fleith M, Clandinin M . Dietary PUFA for preterm and term infants: review of clinical studies. Crit Rev Food Sci Nutr. 2005; 45(3):205-29. DOI: 10.1080/10408690590956378. View

Yang Y, Kim M, Hwang S, Ahn Y, Shim J, Kim D . Relative validities of 3-day food records and the food frequency questionnaire. Nutr Res Pract. 2010; 4(2):142-8. PMC: 2867225. DOI: 10.4162/nrp.2010.4.2.142. View

Lauritzen L, Brambilla P, Mazzocchi A, Harslof L, Ciappolino V, Agostoni C . DHA Effects in Brain Development and Function. Nutrients. 2016; 8(1). PMC: 4728620. DOI: 10.3390/nu8010006. View

Julvez J, Guxens M, Carsin A, Forns J, Mendez M, Turner M . A cohort study on full breastfeeding and child neuropsychological development: the role of maternal social, psychological, and nutritional factors. Dev Med Child Neurol. 2013; 56(2):148-56. DOI: 10.1111/dmcn.12282. View

Saini R, Keum Y . Omega-3 and omega-6 polyunsaturated fatty acids: Dietary sources, metabolism, and significance - A review. Life Sci. 2018; 203:255-267. DOI: 10.1016/j.lfs.2018.04.049. View

10.

Li D, Ng A, Mann N, Sinclair A . Contribution of meat fat to dietary arachidonic acid. Lipids. 1998; 33(4):437-40. DOI: 10.1007/s11745-998-0225-7. View

11.

Klevebro S, Juul S, Wood T . A More Comprehensive Approach to the Neuroprotective Potential of Long-Chain Polyunsaturated Fatty Acids in Preterm Infants Is Needed-Should We Consider Maternal Diet and the n-6:n-3 Fatty Acid Ratio?. Front Pediatr. 2020; 7:533. PMC: 6965147. DOI: 10.3389/fped.2019.00533. View

12.

Gsoellpointner M, Eibensteiner F, Thanhaeuser M, Ristl R, Jilma B, Berger A . Effects of early introduction of solid foods on nutrient intake in preterm infants during their 1st year of life: a secondary outcome analysis of a prospective, randomized intervention study. Front Nutr. 2023; 10:1124544. PMC: 10232899. DOI: 10.3389/fnut.2023.1124544. View

13.

Haiden N, Thanhaeuser M, Eibensteiner F, Huber-Dangl M, Gsoellpointner M, Ristl R . Randomized Controlled Trial of Two Timepoints for Introduction of Standardized Complementary Food in Preterm Infants. Nutrients. 2022; 14(3). PMC: 8839701. DOI: 10.3390/nu14030697. View

14.

Schuchardt J, Huss M, Stauss-Grabo M, Hahn A . Significance of long-chain polyunsaturated fatty acids (PUFAs) for the development and behaviour of children. Eur J Pediatr. 2009; 169(2):149-64. DOI: 10.1007/s00431-009-1035-8. View

15.

Bernard J, Armand M, Garcia C, Forhan A, De Agostini M, Charles M . The association between linoleic acid levels in colostrum and child cognition at 2 and 3 y in the EDEN cohort. Pediatr Res. 2015; 77(6):829-35. DOI: 10.1038/pr.2015.50. View

16.

Komprda T, Zelenka J, Fajmonova E, Fialova M, Kladroba D . Arachidonic acid and long-chain n-3 polyunsaturated fatty acid contents in meat of selected poultry and fish species in relation to dietary fat sources. J Agric Food Chem. 2005; 53(17):6804-12. DOI: 10.1021/jf0504162. View

17.

Koletzko B, Lien E, Agostoni C, Bohles H, Campoy C, Cetin I . The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med. 2008; 36(1):5-14. DOI: 10.1515/JPM.2008.001. View

18.

Guxens M, Mendez M, Molto-Puigmarti C, Julvez J, Garcia-Esteban R, Forns J . Breastfeeding, long-chain polyunsaturated fatty acids in colostrum, and infant mental development. Pediatrics. 2011; 128(4):e880-9. PMC: 9923846. DOI: 10.1542/peds.2010-1633. View

19.

Taber L, Chiu C, Whelan J . Assessment of the arachidonic acid content in foods commonly consumed in the American diet. Lipids. 1999; 33(12):1151-7. DOI: 10.1007/s11745-998-0317-4. View

20.

Jelena Vidakovic A, Gishti O, Voortman T, Felix J, Williams M, Hofman A . Maternal plasma PUFA concentrations during pregnancy and childhood adiposity: the Generation R Study. Am J Clin Nutr. 2016; 103(4):1017-25. PMC: 5426536. DOI: 10.3945/ajcn.115.112847. View