Research Article| Volume 22, ISSUE 1, P157-175, March 1995

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Nutritional Role of Omega-3 Fatty Acids During the Perinatal Period

  • Ricardo Uauy-Dagach
    Address reprint requests to: Ricardo Uauy-Dagach, MD, PhD, Institute of Nutrition and Food Technology (INTA), University of Chile, Casilla 138-11 Santiago, Chile
    From the Clinical Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile

    Neonatology Unit Hospital Sotero del Rio, Santiago, Chile

    Retina Foundation of the Southwest, Dallas, Texas
    Search for articles by this author
  • Patricia Mena
    Neonatology Unit Hospital Sotero del Rio, Santiago, Chile
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.
      There is now clear evidence that dietary supplementation of ω-3 fatty acid is essential for normal eye and brain development. Corn oil-based diets induce ω-3 deficiency in preterm infants, affecting retinal responses to light, cortical visual evoked potentials, and behavioral measures of visual acuity. Preterm infants require doc- osahexanoic acid (DHA) because they are unable to form sufficient quantities from precursors provided by soy oil-based formula products. Human milk provides an ideal source of essential fatty acids for premature infants. There is increasing evidence that premature infant formulas containing vegetable oils should be supple-merited with long-chain EFAs to promote optimal retinal and cortical visual development.
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        • Al M.D.M.
        • Hornstra G.
        • van der Schouw Y.T.
        • et al.
        Biochemical E.F.A. status of mothers and their neonates after normal pregnancy.
        Early Hum Dev. 1990; 24: 239-248
      1. Arnold RW Retinopathy of prematurity in Alaska In Proceedings of the 19th Annual Providence Hospital Perinatal Symposium Anchorage A.L. 1992

        • Birch D.G.
        Clinical electroretinography.
        Ophthalmol Clin North Am. 1989; 2: 469-497
        • Birch D.G.
        • Birch E.E.
        • Hoffman D.R.
        • et al.
        Retinal development in very-low-birth-weight infants fed diets differing in ω-3 fatty acids.
        Invest Ophthalmol Vis Sci. 1992; 33: 2365-2376
        • Birch E.E.
        Visual acuity testing in infants and young children.
        Ophthalmol Clin North Am. 1989; 2: 369-389
        • Birch E.E.
        • Birch D.G.
        • Hoffman D.R.
        • et al.
        Dietary essential fatty acid supply and visual acuity development.
        Invest Ophthalmol Vis Sci. 1992; 33: 3242-3253
        • Birch E.E.
        • Birch D.G.
        • Hoffman D.
        • et al.
        Breast feeding and optimal visual development.
        J Pediatr Ophthalmol Strabismus. 1993; 30: 33-38
        • Birch E.E.
        • Birch D.G.
        • Petrig B.
        • et al.
        Retinal and cortical function of infants at 36 and 57 weeks postconception.
        Clin Vis Sci. 1990; 5: 363-373
        • Bourre J.M.
        • Francois M.
        • Youyou A.
        The effects of dietary α-linolenic acid on the composition of nerve membranes, enzymatic activity, amplitude of electrophysiological parameters, resistance to poisons and performance of learning tasks in rats.
        J Nutr. 1989; 119: 1880-1892
        • Brenner R.R.
        • Peluffo R.O.
        Regulation of unsaturated fatty acid biosynthesis.
        Biochim Biophys Acta. 1969; 176: 471-479
      2. British Nutrition Foundation: Task Force on Unsaturated Fatty Acids, a report of the British Nutrition, Foundation., London Chapmann and Hall 1992

        • Burr G.O.
        • Burr M.M.
        A new deficiency disease produced by rigid exclusion of fat from the diet.
        J Biol Chem. 1929; 82: 345-367
        • Bush R.A.
        • Reme C.E.
        • Malnoe A.
        Light damage in the rat retina: The effect of dietary deprivation of n-3 fatty acids on acute structural alterations.
        Exp Eye Res. 1991; 53: 741-752
        • Caldwell M.D.
        • Johnsson H.T.
        • Othersen H.B.
        Essential fatty acid deficiency in an infant receiving prolonged parenteral alimentation.
        J Pediatr. 1972; 81: 894-898
        • Carlson S.E.
        • Carver J.D.
        • House S.G.
        High fat diets varying in ratios of polyunsaturated to saturated fatty acid and linoleic to linolenic acid: A comparison of rat neural and red cell membrane phospholipids.
        J Nutr. 1986; 116: 718-726
        • Carlson S.E.
        • Cooke R.J.
        • Rhodes P.G.
        • et al.
        Long-term feeding of formulas high in linolenic acid and marine oil to very low birth weight infants: Phospholipid fatty acids.
        Pediatr Res. 1991; 30: 404-412
        • Carlson S.E.
        • Cooke R.J.
        • Rhodes P.G.
        Effect of vegetable and marine oils in preterm infant formulas on blood arachidonic and docosahexaenoic acids.
        J Pediatr. 1992; 120: S159-S167
        • Carlson S.E.
        • Werkman S.H.
        • Pepples J.M.
        • et al.
        Arachidonic acid status correlates with first year growth in preterm infants.
        Proc Natl Acad Sci USA. 1993; 90: 1073-1077
        • Connor W.E.
        • Lin D.S.
        • Neuringer M.
        Is docosahexaenoic acid (DHA 22 6 n-3) content of erythrocytes a marker for the DHA content of brain phospholipids?.
        FASE.B.J. 1993; 7: 152A
        • Dahlan W.
        • Richelle M.
        • Kulapongse S.
        • et al.
        Effects of essential fatty acid contents of lipid emulsions on erythrocyte polyunsaturated fatty acid composition in patients on longterm parenteral nutrition.
        Clin Nutr. 1992; 11: 262-268
        • Dratz E.
        • Deese A.
        The role of docosahexaenoic acid (22:6 n-3) in biological membranes.
        in: Simopoulos AP. Kiffer RR. Martin RE. Health Effects of Polyunsaturated Fatty Acids in Seafoods. Academic Press, New York1986: 319-351
        • Dyerberg J.
        • Bang H.O.
        Haemostatic function and platelet polyunsaturated fatty acids in Eskimos.
        Lancet. 1979; 2: 433-435
        • Endres S.
        Messengers mediators: Interactions among lipids eicosanoids cytokines.
        Am J. Clin Nutr. 1993; 57: 798S-800S
      3. European Society of Paediatric Gastroenterology and Nutrition Committee on Nutrition: Comment on the content and composition of lipids in infant, formulas.
        Acta Paediatr Scand. 1991; 80: 887-896
        • Fagioli I.
        • Baroncini P.
        • Ricour C.
        • et al.
        Decrease of slow-wave sleep in children with prolonged absence of essential lipids intake.
        Sleep. 1989; 12: 495-499
      4. FAO/WHO., Report of a Joint Expert Consultation.
        Fats and Oils in Human, Nutrition., Rome, Food and Agriculture Organization. 1994; : 49-55
        • Farquharson J.
        • Cockburn F.
        • Ainslie P.W.
        • et al.
        Infant cerebral cortex phospholipid fatty- acid composition and diet.
        Lancet. 1992; 340: 810-813
        • Fleisler S.J.
        • Anderson R.E.
        Chemistry and metabolism of lipids in the vertebrate retina.
        Prog Lipid Res. 1983; 22: 79-131
        • Friedman Z.
        Essential fatty acids revisited.
        Am J. Dis Child. 1980; 134: 397-408
        • Friedman Z.
        • Shochat S.J.
        • Maiseis M.J.
        Correction of essential fatty acid deficiency in newborn infants by cutaneous application of sunflower seed oil.
        Pediatrics. 1976; 58: 650-654
        • Galli C.
        • Socini A.
        Dietary lipids in pre-post-natal development.
        in: Dietary Fats Health. Proceedings of American Oil Chemist Society Conference, Chicago IL1983: 278-301
        • Garrido A.
        • Garate M.
        • Campos R.
        • et al.
        Increased susceptibility of cellular membranes to the induction of oxidative stress is observed after ingestion of high doses of fish oil: Effect of aging and protective action of dl a-tocopherol supplementation.
        Nutr Biochem. 1993; 4: 118-122
        • Garrido A.
        • Garrido F.
        • Guerra R.
        • et al.
        Ingestion of high doses of fish oil increases the susceptibility of cellular membranes to the induction of oxidative stress.
        Lipids. 1989; 24: 833-835
        • Hansen A.E.
        • Wiese H.F.
        • Boelsche A.N.
        • et al.
        Role of linoleic acid in infant nutrition: Clinical and chemical study of 428 infants fed on milk mixtures varying in kind and amount of fat.
        Pediatrics. 1963; 31: 171-192
        • Hansen J.
        Appendix: Commercial formulas for preterm infants.
        in: Tsang RC. Lucas A. Uauy R. Nutritional Needs of Preterm Infants: Scientific Basis and Practical Guidelines. Wilkins by Caduceus Medical Publishers, Pawling, NY, Williams1993: 297-301
        • Hoffman D.
        • Uauy R:
        Essentiality of dietary ω -3 fatty acids for premature infants: Plasma and red blood cell fatty acid composition.
        Lipids. 1992; 27: 886-895
        • Hoffman D.R.
        • Birch E.E.
        • Birch D.G.
        • et al.
        Effects of ω-3 long chain polyunsaturated fatty acid supplementation on retinal cortical development in premature infants.
        Am J. Clin Nutr. 1993; 57: 807S-812S
        • Holman R.T.
        • Johnson S.B.
        • Hatch T.F.
        A case of human linolenic acid deficiency involving neurological abnormalities.
        Am J Clin Nutr. 1982; 35: 617-623
        • Holman R.T.
        • Johnson S.B.
        • Ogbum P.L.
        Deficiency of essential fatty acids and membrane fluidity during pregnancy and lactation.
        Proceedings National Academy of Science USA. 1991; 88: 4835-4839
        • Hornsby P.
        • Crivello J.
        The role of lipid peroxidation and biological antioxidants in the function of the adrenal cortex.
        Mol Cell Endocrinol. 1983; 30: 1-20
        • Innis S.M.
        Essential fatty acids in growth and development.
        Prog Lipid Res. 1991; 30: 39-103
        • Innis S.M.
        • Foote K.D.
        • MacKinnon M.J.
        Plasma and red blood cell fatty acids of low-birth- weight infants fed their mother's expressed breast milk or preterm infant formula.
        Am J Clin Nutr. 1990; 51: 994-1000
        • Koletzko B.
        • Braun M.
        Arachidonic acid and early human growth: Is there a relation?.
        Ann Nutr Metab. 1991; 35: 128-131
        • Koletzko B.
        • Bremer H.J.
        Fat content and fatty acid composition of infant formulas.
        Acta Paediatr Scand. 1989; 78: 513-521
        • Koletzko B.
        • Schmidt E.
        • Bremer H.J.
        • et al.
        Effects of dietary long chain polyunsaturated fatty acids on the essential fatty acid status of premature infants.
        Eur J Pediatr. 1989; 148: 669-675
        • Leibovitz B.E.
        • Hu M.
        • Tappel A.L.
        Lipid peroxidation in rat tissue slices: Effect of dietary vitamin E, corn oil-lard and menhaden oil.
        Lipids. 1990; 25: 125-129
        • Li X.
        • Steiner M.
        Fish oil: A potent inhibitor of platelet adhesiveness.
        Blood. 1990; 76: 938-945
        • Lox C.D.
        The effects of dietary marine fish oils (ω-3 fatty acids) on coagulation profiles in men.
        Gen Pharmacol. 1990; 21: 241-246
        • Lucas A.
        • Morley R.
        • Cole T.J.
        Breast milk and subsequent intelligence quotient in children born preterm.
        Lancet. 1992; 339: 261-264
        • Makrides M.
        • Simmer K.
        • Goggin M.
        • et al.
        Erythrocyte docosahexaenoic acid correlates with the visual response of healthy, term infants.
        Pediatr Res. 1993; 34: 425-427
        • Malis C.C.
        • Weber P.C.
        • Leaf A.
        • et al.
        Incorporation of marine lipids into mitochondrial membranes increases susceptibility to damage by calcium and reactive oxygen species: Evidence for enhanced activation of phospholipase A2 in mitochondria enriched with n-3 fatty acids.
        Proc Natl Acad Sci USA. 1990; 87: 8845-8849
        • Me Clead R.E.
        • Lentz M.E.
        • Corriglio J.G.
        • et al.
        The effect of three intravenous fat emulsions containing different concentrations of linoleic and α-Linolenic acids on the plasma total fatty acid profile of neonates.
        J Pediatr Gastroenterol Nutr. 1991; 12: 89-95
        • Neuringer M.
        • Connor W.E.
        • Lin D.S.
        • et al.
        Dietary ω-3 fatty acids: Effect on retinal lipid composition and function in primates.
        in: Anderson RE. Hollyfield JG. LaVail MM. Retinal Degenerations. CRC Press, New York1991: 1-13
        • Neuringer M.
        • Connor W.E.
        • Van Petten C.
        • et al.
        Dietary ω-3 fatty acid deficiency and visual loss in infant rhesus monkeys.
        J Clin Invest. 1984; 73: 272-276
        • Olsen S.F.
        • Sorensen J.D.
        • Secher N.J.
        • et al.
        Randomized controlled trial of effect of fish oil supplementation on pregnancy duration.
        Lancet. 1992; 339: 1003-1007
        • Ongari M.A.
        • Ritter J.M.
        • Orchard M.A.
        • et al.
        Correlation of prostacyclin synthesis by human umbilical artery with status of essential fatty acid.
        Am J Obstet Gynecol. 1984; 149: 455-460
        • Oski F.A.
        • Barness L.A.
        Vitamin E deficiency: A previously unrecognized cause of hemolytic anemia in the premature infant.
        J Pediatr. 1967; 70: 211-220
        • Paulsrud J.R.
        • Pensler L.
        • Whitten C.F.
        Essential fatty acid deficiency in infants induced by fat-free intravenous feeding.
        Am J Clin Nutr. 1972; 25: 897-904
        • Salem Jr., N.
        • Kim H.Y.
        • Yergey J.A.
        Docosahexaenoic acid: Membrane function and metabolism.
        in: Simopoulos AP. Kiffer RR. Martin RE. Health Effects of Polyunsaturated Fatty Acids in Seafoods. Academic Press, New York1986: 263-317
        • Secher N.J.
        • Olsen S.F.
        • Sorensen J.D.
        Fish-oil and pre-eclampsia.
        Br J Obstet Gynaecol. 1991; 98: 738-740
        • Sibai B.M.
        • Caritis S.N.
        • Thom E.
        • et al.
        and NICHD Maternal Fetal Medicine Units Network: Prevention of pre-eclamsia with low dose aspirin in healthy nulliparous pregnant women.
        N Engl J Med. 1993; 329: 1213-1218
        • Simopoulos A.P.
        Ω-3 fatty acids in health and disease and in growth and development.
        Am J Clin Nutr. 1991; 54: 438-463
        • Sokol S.
        Visually evoked potentials: Theory, techniques, and clinical applications.
        Surv Ophthalmol. 1976; 21: 18-44
        • Sosenko I.R.S.
        • Irtnis S.M.
        • Frank L.
        Menhaden fish oil, n-3 fatty polyunsaturated fatty acids, and protection of newborn rats from oxygen toxicity.
        Pediatr Res. 1989; 25: 399-404
        • Sprecher H.
        Biochemistry of essential fatty acids.
        Prog Lipid Res. 1981; 20: 13-22
        • Stubbs C.D.
        • Smith A.D.
        The modification of mammalian polyunsaturated fatty acid composition in relation to fluidity and function.
        Biochim Biophys Acta. 1984; 779: 89-137
        • Treen M.
        • Uauy R.D.
        • Jameson D.M.
        • et al.
        Effect of docosahexaenoic add on membrane fluidity and function in intact cultured Y-79 retinoblastoma cells.
        Arch Biochem Biophys. 1992; 294: 564-570
        • Uauy R.
        • Hoffman D.R.
        Essential fatty acid requirements for normal eye and brain development.
        Semin Perinatol. 1991; 15: 449-455
        • Uauy R.
        • Treen M.
        • Hoffman D.
        Essential fatty acid metabolism and requirements during development.
        Semin Perinatol. 1989; 13: 118-130
        • Uauy R.D.
        • Birch D.G.
        • Birch E.E.
        • et al.
        Effect of dietary co-3 fatty acids on retinal function of very-low-birth-weight neonates.
        Pediatr Res. 1990; 28: 485-492
        • Uauy R.
        • Birch E.
        • Birch D.
        • et al.
        Visual and brain function measurements in studies on n-3 fatty acid requirements of infants.
        J Pediatr. 1992; 120: S168-S180
        • Uauy R.
        • Hoffman D.R.
        • Birch E.
        • et al.
        Role of ω-3 fatty acids in the nutrition of very-low- birth-weight infants: Soy and marine oil supplementation of formula.
        J Pediatr. 1994; 124: 612-620
        • Voss A.
        • Reinhart M.
        • Shankar S.
        • et al.
        The Metabolism of 7,10,13,16,19-docosapentaenoic acid to 4,7,10,13,16,19-docosahexaenoic acid in the rat liver is independent of a 4-de- saturase.
        J Biol Chem. 1991; 266: 19995-20000
        • Watanabe I.
        • Kato M.
        • Aonuma H.
        Effect of dietary a-linolenate/linoleate balance on the lipid composition and electroretinographic responses in rats.
        Adv Biosci. 1987; 62: 563-568
        • Wheeler T.G.
        • Benolken R.M.
        • Anderson R.E.
        Visual membranes: Specificity of fatty acid precursors for the electrical response to illumination.
        Science. 1975; 188: 1312-1314
        • White H.B.
        • Turner M.D.
        • Turner A.C.
        • et al.
        Blood lipid alterations in infants receiving intravenous fat-free alimentation.
        J Pediatr. 1973; 83: 305-313
        • Willis A.L.
        Essential fatty acids, prostaglandins, and related eicosanoids.
        in: Olson RE. Present Knowledge in Nutrition. The Nutrition Foundation, Washington, DC1984: 90-113
        • Wo C.K.W.
        • Draper H.H.
        Vitamin E status of Alaskan Eskimos.
        Am J Clin Nutr. 1975; 28: 808-813