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Pure DHA Drop
Pure DHA Drop
All EFA are not same:There are important differences between Omega 6 and Omega 3 fatty acids and some of
the differences are very important from clinical point of view.
Omega 6 LCPUFA (Eicosanoids) are more potent, are proinflammatory and
adipogenic
Omegas 3 LCPUFA (Eicosanoids) on the other hand are anti inflammatory and
decreases fat deposition. Fish oil (EPA & DHA) has been used in Rheumatoid
arthritis emphasizing its anti inflammatory properties. There are various
differences between EPA and DHA as well. DHA has been shown to prevent
CVS disease by reducing blood vessel inflammation and atherosclerosis1.There
are less heart diseases in Eskimos and Japanese fisherman which has been
attributed to higher blood DHA/EPA levels c.f. Omega 6 LCPUFA in them.
Triglyceride levels fall more with 26% in DHA (26%) compared to EPA (21%).
So evidence is in favor of DHA compared to EPA for the beneficial effects seen
with Omega 3 fatty acids. More over EPA concentration in mothers milk in
negligible making its importance very doubtful in infant nutrition.
5-10:1
Indian Diet
USA
Japan
30-70:1
12:1
2:1
The main reason for poor Omega 3 FA in Indian diet is lack of animal products especially
fish and excess intake of animal milk and milk products. There are a number of vegetable
sources of EFA and one must have knowledge so that the same can be advised to the
mother.
Flaxseed or linseed
Sunflower
Rapeseed or canola
Safflower
Peanut
Sesame
Olive
Palmolive
Perilla
Corn
Walnut
Primrose
Soya
Borage
Invisible fats
Supplementation of DHA during Pregnancy:It has shown to improve cord Omega 3 levels and neonatal short follow up 3- 6
mths has not shown any benefits (Malcom et al. Helland et al but long term follow up till
4 yrs has shown beneficial effects on mental ability2 Some studies also show less atopy
and lower type I IDDM in supplemented infants. We must remember that these studies
are done in west in mothers with better DHA content in their diet and if we reciprocate
the results for Indian mother with poor DHA content in their diet, the beneficial effects
are bound to be more.
Pregnancy & LCPUFA DHA accretion occurs in III rd trimester mainly and
the transfer depends on the age of the mother (at elderly age transfer would be less),
primi or second gravida (primi expected to have better transfer), interval between the
pregnancies (less the interval, less is the transfer in the second baby), Maternal diet (Fish,
Marine products) and alcohol intake (reduces DHA transfer).
Supplementation during Lactation:It has also shown to improve breast milk DHA content but clinical effects shown
in different studies are not consistent. In Indian Context, DHA supplementation should
help the neurodevelopment of the infants and children.
All infants should be fed on exclusive mothers milk for first six months and in
case mothers milk is not sufficient, alternative milk with sufficient amounts of EFA
should be provided. As unmodified bovine milk (cow or buffalo or goat) does not contain
any EFA, the only option is a balanced infant formula with ratio of LA/ALA between5:1
to 15:1.
DHA supplementation in term formula:Cochrane (2001) reviews after analyzing 10 trials have concluded that there are
contradictory results on beneficial effects on developmental indices. Certain trials show
better problem solving (finding a hidden toy)3 or higher scores on Bayley Mental
Development Index until 17 weeks of age4 while others show no benefits5 / Transient
benefit6 There is some effect seen in reduction of BP and Type I DM with no documented
side effects.
LCPUFA and preterm formula:There is no ambiguity as far as preterm milk formula and their supplementation is
concerned. Meta analysis by San Giovanni show better visual acuity at 2&4 months.
There is strong recommendation by AAP that preterm formulae should contain both AA
and DHA.
Infant nutrition 6months to one year:Recommendations for fat intake
First 6 months
40-60% of total energy
Omega 6: omega 3 ratio 5-10:1
<1% trans fats
After 2 yrs
Fat 30-35% calories
Omega 6: 4-10% energy
Omega 3: 1-2% energy
Transfats <2% energy
Infants must be continued breast milk or term baby follow-up formula along with
addition of semisolid diet with emphasis on addition of vegetable oils with high Omega 3
FA (Soyabean oil, canola oil, mustard oil, fish oil, rapseed oil etc.)
Prime Key Messages:Essential fatty acids are important for brain, retina and growth
All essential fatty acids are not same
Omega 3 LCPUFA have anti allergic properties, good for brain and heart
References:
1. Grimble RF. Dietary lipids and the inflammatory response. Proceedings of the
Nutrition Society 1998; 57:535-542.
2. Helland. Pediatrics 2003; 111(1): e 39-440.
3. Williatts P. Lancet 1998; 352:688-91)
4. Birch EE.Dev Med Child Neurol 2000; 42:174-81)
5. Makrides M. Pediatrics 2000; 105:32-38.
6. Carlson SE. J Pediatr 1992; 120:S159-67.
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