LCPs

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Long-Chain Polyunsaturated Fatty Acids

Long-chain polyunsaturated fatty acids (LCPs) are important components of cell membranes and play a key role in the development of the brain, eye, and nervous system.¹Two particularly important LCPs for infant development are arachidonic acid (AA) and docosahexaenoic acid (DHA).¹

Clinical evidence on the benefits of dietary LCPs is summarised below.

Babies need LCPs in their diet

A number of LCPs are found naturally in breast milk; those present in the highest proportions are AA (0.4–0.6%) and DHA (0.2–0.4%). Interestingly, levels of LCPs in breast milk were found to be strikingly consistent among women from different geographic regions of Europe and Africa, despite marked differences in their diet.^2,³

LCP composition of mature human milk (median) in studies in Europe and in Africa³

	Europe^†	Africa^‡
Total n-6 LCP	1.2	1.5
Total n-3 LCP	0.6	0.6
Total n-6 LCP/n-3 LCP	2.7	2.4

^† Germany, Spain, Hungary, Finland, Poland, Sweden, Slovakia, Denmark, UK
^‡ Nigeria, The Gambia S. Africa, S. Africa, Tanzania, Egypt, Ivory Coast, Uganda

Although LCPs can be made within the body, infants (especially preterm infants) have a high demand for these nutrients and benefit from LCPs in their diet.¹ Indeed, early dietary intake of LCPs appears necessary for optimal brain and eye development.⁴

Following a scientific workshop in 1999, experts recommended the minimum levels of AA and DHA that should be added to infant formulae (see table).⁵

Recommended levels of AA and DHA in formula milk in comparison with human milk ^3,5

Source	AA (% of total fatty acids)	DHA (% of total fatty acids)	Ratio of AA to DHA^†
Human milk	0.5 (0.2–1.2)	0.3 (0.1–0.6)	1.8 (0.7–5.0)
Formula milk (term infants)	0.35	0.2	1.75
Formula milk (preterm infants)^‡	0.4	0.35	1.14

^†The ratio is important as the metabolic pathways of AA and DHA are competitive and need to be balanced for optimum growth.⁶

^‡Since preterm infants are born with much less total body LCPs, they may benefit from increased levels in their diet.⁵

Dietary LCPs are important for growth and development

The advantages of LCP-supplemented formula over LCP-free formula have been demonstrated in a number of randomised controlled clinical studies. The benefits of LCP supplementation include:

Improved performance on the Mental Development Index (cognitive and motor domains) at 18 months ⁷
Superior visual acuity development at 52 weeks ⁴
Greater problem-solving ability at 10 months (a predictor of childhood IQ scores) ⁸

LCP supplementation has long-term benefits

Evidence from prospective clinical studies indicates that the effects of dietary LCPs on eye and brain development persist beyond the period of supplementation.^4,⁸

LCPs from single-cell sources are safe and effective

LCPs can be derived from various sources, including fish oils, egg yolk, and more recently, from single-cell organisms. Clinical evidence supports the safety, efficacy, and tolerability of formula supplemented with LCPs from single-cell sources in both term and preterm infants.^1,⁹

References:
1. Morris G, Moorcraft J, Mountjoy A, Wells JC. A novel infant formula milk with added long-chain polyunsaturated fatty acids from single-cell sources: a study of growth, satisfaction and health. Eur J Clin Nutr 2000; 54: 883–886.

2. Koletzko B, Thiel I, Abiodun PO. The fatty acid composition of human milk in Europe and Africa. J Pediatr 1992; 120 (4 Pt 2): S62-70.

3. Koletzko B, Thiel I, Springer S. Lipids in Human milk: a model for infant formulae? Eur J Clin Nutr 1992; 46 Suppl 4: S45–55.

4. Birch EE, Hoffman DR, Uauy R, et al. Visual acuity and the essentiality of docosahexaenoic acid and arachidonic acid in the diet of term infants. Pediatr Res 1998; 44: 201–209.

5. Koletzko B, Agostoni C, Carlson SE, et al. Long chain polyunsaturated fatty acids (LC-PUFA) and perinatal development. Acta Paediatr 2001; 90: 460–464.

6. Report of the European Commission Scientific Committee for Food on the Revision of Essential Requirements of Infant Formulae and Follow-on Formulae. European Commission, Brussels, Belgium: 18 May 2003.

7. Birch EE, Garfield S, Hoffman DR, et al. A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in term infants. Dev Med Child Neurol 2000; 42: 174–181.

8. Willatts P, Forsyth JS, DiModugno MK, et al. Effect of long-chain polyunsaturated fatty acids in infant formula on problem solving at 10 months of age. Lancet 1998; 352: 688–691.

9. Vanderhoof J, Gross S, Hegyi T, et al. Evaluation of a long-chain polyunsaturated fatty acid supplemented formula on growth, tolerance, and plasma lipids in preterm infants up to 48 weeks postconceptional age. J Pediatr Gastroenterol Nutr 1999; 29: 318-326.

IMPORTANT NOTICE: Breast feeding is best for babies. Infant milks are intended to replace breast milk when mothers do not breast feed. Good maternal nutrition is important for the preparation and maintenance of breast feeding. Introducing partial bottle feeding may have a negative effect on breast feeding and reversing a decision not to breast feed is difficult. You should always seek the advice of a doctor, midwife, health visitor, public health nurse, dietitian or pharmacist on the need for and proper method of use of infant milks and on all matters of infant feeding. Infant milk should always be prepared and used as directed. Unnecessary or improper use of infant milk may present a health hazard. Social and financial implications should be considered when selecting a method of infant feeding.

This information is intended for use only by residents of the UK and ROI