LC-PUFA

Video Transcript

LC-PUFAs are thought to have many health benefits both in the short and long-term. While
it is difficult to pinpoint direct cause and effect, studies suggest LC-PUFAs may improve
visual acuity, cognitive development and allergy outcomes as well as support immune
function and improve markers of cardiovascular disease.

Cognitive Development

Breastfeeding is associated with an advantage of 2.2 IQ points adjusted for maternal IQ

(Horta & Victora 2013). It has been hypothesized that the observed difference in cognitive
outcomes between breastfed and formula fed infants may be attributable at least in part to
the provision of n-6 and n-3 LC-PUFA's that are present in breastmilk but not in
conventional infant formula. This is based on evidence that breastfed infants have a better
LC-PUFA status compared to formula fed infants. (Gibson et al. 1997, Simmer et al. 2011).

Furthermore, interaction of breastfeeding and genetic variation in the FADS genes has
been shown to improve IQ at school age. FADS genes are responsible for endogenous
synthesis of LC-PUFAs from precursor PUFAs. Different genotypes are associated with
different levels of synthesis.

Results showed that for all genotypes breastfed infants, that is, those infants receiving
preformed LC-PUFAs, performed significantly better in IQ tests at 8 years of age (Steer et
al. 2010).

Those children who are homozygous for a mutation predicting low endogenous LC-PUFA
synthesis (GG children) and have been breastfed, performed better than their formula fed
counterparts by an additional 5.8 points [1.4, 10.1] (interaction p = 0.0091). The breastfed
infants in the GG group received similar results compared to the other groups, while those
having received infant formula achieved the lowest scores

Since FADS genotypes are distributed at random throughout the population and not linked
to the maternal decision to breastfed, the study provides strong evidence that availability of
LC-PUFA in early life is related to intelligence development at school age and that
breastfeeding effects on cognition are attributable to LC-PUFAs (Steer et al. 2010; Morales
et al. 2011).

Allergy and Immune Function

Work by Koletzko and colleagues (Koletzko et al. 2014a) indicate that PUFA status in
infancy may have a protective effect on the development of allergies. LC-PUFA supply to
term infants has been assessed based on breastmilk composition, supplementation of
breastfeeding mothers and enrichment of infant formula (Richard et al. 2016) Results from
observational studies show a clear association between low DHA content of breastmilk and
an increased risk of atopic disease in the infant. Supplementation with DHA or DHA+EPA in
breastfeeding women has been shown to improve markers of allergy and atopic disease in
their breastfed offspring. The role of ARA in the development of atopic disease remains
conflicting.

Visual Acuity

Development of visual acuity in infancy reflects nervous system development, and not
refractive errors that are correctable with eyeglasses. Breastfed infants having received
DHA-enriched complementary foods had more mature visual evoked potentials at 9 and 12
months of age compared to the control group (Hoffman et al. 2004).

Results of a meta-analysis found improved visual acuity of infants fed enriched formula
compared to a standard formula (Qawasmi et al. 2013). However, the effect cannot be
extrapolated to children beyond 12 months. Better visual acuity has not been observed in
studies comparing breastfeeding to standard or enriched formula feeding or comparing
differently composed formulae and further work should be carried out to better understand
these results.

Research indicates that a continuous supply of LC-PUFA remains important throughout

infancy. Standard formula or complementary foods are insufficient to maintain DHA levels,
even if breastfeeding is continued throughout the first months of weaning (Hoffman et al.
2003).

While further evidence is required for a conclusive role of LC-PUFAs in several health
outcomes, studies suggest they play an important role in supporting proper infant health
and development, particularly in terms of cognitive development, visual acuity and allergy.