DHA Supplementation during Pregnancy and Lactation Affects Infants' Cellular but Not Humoral Immune Response

Granot, Esther; Jakobovich, E.; Rabinowitz, Ruth; Levy, Paloma; Schlesinger, Michael

doi:10.1155/2011/493925

Cited by 26 publications

(18 citation statements)

References 32 publications

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“…Furuhjelm et al [59] reported a lower prevalence of food allergy and a cumulative incidence of immunoglobulin E (IgE)-associated diseases in the first 2 years of life after supplementing 145 at-risk pregnant women in Sweden with a provision of DHA and EPA during pregnancy and the first 3.5 months of breast-feeding [59]. Granot et al [60] found changes in CD4 and CD8 cells compatible with attenuation of the proinflammatory response in the infants of 60 pregnant women supplemented with 400 mg DHA/day from early gestation until 4 months postpartum. A lower prevalence of atopic dermatitis (AD) was also observed in Finnish infants whose mothers had been supplemented with black currant seed oil during pregnancy until the cessation of breast-feeding, suggesting a possible beneficial role also for n-6 PUFA [61] .…”

Section: Resultsmentioning

confidence: 99%

Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy: Systematic Review and Practice Recommendations from an Early Nutrition Academy Workshop

et al. 2014

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The Early Nutrition Academy supported a systematic review of human studies on the roles of pre- and postnatal long-chain polyunsaturated fatty acids (LC-PUFA) published from 2008 to 2013 and an expert workshop that reviewed the information and developed recommendations, considering particularly Asian populations. An increased supply of n-3 LC-PUFA during pregnancy reduces the risk of preterm birth before 34 weeks of gestation. Pregnant women should achieve an additional supply ≥200 mg docosahexaenic acid (DHA)/day, usually achieving a total intake ≥300 mg DHA/day. Higher intakes (600-800 mg DHA/day) may provide greater protection against early preterm birth. Some studies indicate beneficial effects of pre- and postnatal DHA supply on child neurodevelopment and allergy risk. Breast-feeding is the best choice for infants. Breast-feeding women should get ≥200 mg DHA/day to achieve a human milk DHA content of ∼0.3% fatty acids. Infant formula for term infants should contain DHA and arachidonic acid (AA) to provide 100 mg DHA/day and 140 mg AA/day. A supply of 100 mg DHA/day should continue during the second half of infancy. We do not provide quantitative advice on AA levels in follow-on formula fed after the introduction of complimentary feeding due to a lack of sufficient data and considerable variation in the AA amounts provided by complimentary foods. Reasonable intakes for very-low-birth weight infants are 18-60 mg/kg/day DHA and 18-45 mg/kg/day AA, while higher intakes (55-60 mg/kg/day DHA, ∼1% fatty acids; 35-45 mg/kg/day AA, ∼0.6-0.75%) appear preferable. Research on the requirements and effects of LC-PUFA during pregnancy, lactation, and early childhood should continue.

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Section: Resultsmentioning

confidence: 99%

Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy: Systematic Review and Practice Recommendations from an Early Nutrition Academy Workshop

et al. 2014

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“…Este cambio consistió en un aumento de la respuesta bioquímica dependiente de la activación de linfocitos T-helper 1 (Th1) en desmedro de la respuesta Th2 (47). En este mismo ámbito, un tercer estudio mostró que la suplementación materna con DHA (400 mg diarios desde las 12 semanas hasta 4 meses post-parto) se asoció a una atenuación de la respuesta inmune infantil (48). En este trabajo, el grupo de niños nacidos de mujeres que recibieron el suplemento evidenció una disminución en la producción de citoquinas pro-inflamatorias en linfocitos CD4 y CD8, con una mayor proporción de células CD4 inactivas (48).…”

Section: Resultsunclassified

Section: Discussionunclassified

“…La estrecha relación existente entre los ácidos grasos y la generación de mediadores inflamatorios ha contribuido a la propuesta de un potencial rol de los niveles circulantes de DHA en el desarrollo del sistema inmune infantil (48). Efectivamente, los estudios analizados muestran que es factible una cierta modulación de la capacidad de respuesta inmune infantil, al menos a nivel bioquímico (47,48). Sin embargo, aunque tales modificaciones deberían asociarse a un menor riesgo de enfermedades alérgicas en los niños, la incidencia de los síntomas clínicos de estas patologías a los 2 años de vida no se modifica en respuesta a la suplementación materna con DHA (46).…”

Section: Discussionunclassified

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La suplementación materna con ácido docosahexaenoico (DHA) carece de beneficio clínicamente significativo

Farías

Poblete

Carvajal

2012

Rev. chil. obstet. ginecol.

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RESUMENObjetivo: Evaluar los beneficios maternos y fetales de la suplementación prenatal con ácido docosahexaenoico (DHA). Método: Revisión sistemática de investigaciones clínicas controladas aleatorizadas. Resultados: La suplementación prenatal con DHA incrementó los niveles de DHA en sangre materna, en la leche materna o células neonatales. La suplementación con DHA no redujo los síntomas depresivos maternos ni mejoró el desempeño neurológico y visual de los niños. Aunque se apreció un menor riesgo de retraso cognitivo entre los hijos de mujeres suplementadas con DHA (RR 0,4; IC 95% 0,22-0,78) y un mejor desempeño en el procesamiento mental a los 4 años, el seguimiento a 7 años mostró ausencia de diferencias significativas en el nivel intelectual. El análisis secundario de dos estudios mostró que la suplementación con DHA redujo el riesgo de parto prematuro < 34 semanas (RR 0,49; IC95% 0,25-0,94; p=0,03), ingreso a UCI neonatal (RR 0,57; IC95% 0,34-0,97; p=0,04), peso < 2500 g (RR 0,65; IC95% 0,44-0,96; p=0,03) y restricción de crecimiento intrauterino en pacientes primigestas (RR 0,5; IC 95% 0,3-1,0; p=0,03). Sin embargo, la prevención de parto prematuro no fue reproducida en estudio diseñado específicamente para ello. Conclusiones: Los estudios reportan un mayor contenido de DHA materno y neonatal en respuesta a la suplementación prenatal con este ácido graso. Sin embargo, la ausencia actual de efectos clínicos relevantes no permite apoyar ni descartar completamente esta intervención durante el embarazo. PALABRAS CLAVES: Suplementación prenatal, DHA, omega-3, resultado neonatal SUMMARYAims: To evaluate maternal and fetal benefits of prenatal supplementation with docosahexaenoic acid (DHA). Method: Systematic review of clinical randomized controlled trials. Results: Prenatal DHA supplementation increased DHA levels on maternal blood, breast milk or neonatal cells. Maternal supplementation with DHA neither reduced mother`s depressive symptoms nor improved the neurological and visual performance of the children. Although it was observed a reduction in risk of cognitive delay between infants of women supplemented with DHA (RR 0.4; IC95 % 0.22-0.78) and a better performance in the mental processing at the age of 4, the 7 years follow-up showed absence of significant differences in the intellectual level. The secondary analysis of two studies showed that the supplementation with DHA reduced the risk of premature birth <34 weeks (RR 0.49; IC95% 0.25-0.94; p=0.03), neonatal ICU hospitalizations (RR 0.57; IC95% 0.34-0.97; p=0.04), birth weight <2500 g (RR 0.65; IC95% 0.44-0.96; p=0.03) and intrauterine growth restriction in nulliparous patients (RR 0.5; IC95% 0.3-1.0; p=0.03). Nevertheless, prevention of premature birth was not reproduced in a specifically designed study. Conclusions: Studies report an increased mother REV CHIL OBSTET GINECOL 2012; 77(5): 355 -366

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“…Only 3 nutritional intervention studies were performed during the lactation period. We decided to include 1 study, for which 3 research articles have been published, that started the nutritional intervention during the third trimester of pregnancy, but excluded other studies that started earlier in pregnancy (Granot et al 2011). All selected studies were RCT in which a daily fish oil supplement containing EPA (range: 195-1600 mg/day) and DHA (900-1100 mg/day) was provided to lactating women.…”

Section: Introductionmentioning

confidence: 99%

Evidence for the essentiality of arachidonic and docosahexaenoic acid in the postnatal maternal and infant diet for the development of the infant’s immune system early in life

Richard

Lewis

Field

2016

Appl. Physiol. Nutr. Metab.

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Long-chain polyunsaturated fatty acids (LCPUFA), especially the balance between arachidonic (AA) and docosahexaenoic (DHA) acids are known to have important immunomodulatory roles during the postnatal period when the immune system is rapidly developing. AA and DHA are required in infant formula in many countries but are optional in North America. The rationale for adding these LCPUFA to full-term formula is based on their presence in breast milk and randomized controlled studies that suggest improved cognitive function in preterm infants, but results are more variable in full-term infants. Recently, the European Food Safety Authority has proposed, based on a lack of functional evidence, that AA is not required in infant formula for full-term infants during the first year of life but DHA should remain mandatory. The purpose of this review is to review the evidence from epidemiological and intervention studies regarding the essentiality of AA and DHA in the postnatal infant and maternal diet (breast-feeding) for the immune system development early in life. Although studies support the essentiality of DHA for the immune system development, more research is needed to rule out the essentiality of AA. Nevertheless, intervention studies have demonstrated improvement in many markers of immune function in infants fed formula supplemented with AA and DHA compared with unsupplemented formula, which appears to consistently result in beneficial health outcomes including reduction in the risk of developing allergic and atopic disease early in life.Key words: nutritional immunology, postnatal diets, early development, arachidonic acid, docosahexaenoic acid, allergy, atopic diseases, infant formula, breast milk. Résumé :Les acides gras polyinsaturés à longue chaîne (AGPLC) et particulièrement la proportion des acides arachidonique (AA) et docosahexaénoïque (DHA) exercent, selon des études, d'importantes fonctions immunomodulatoires durant la période postnatale lorsque le système immunitaire se développe rapidement. La présence de AA et DHA est obligatoire dans les préparations pour nourrissons dans plusieurs pays, mais facultative en Amérique du Nord. On ajoute des AGPLC dans les préparations complètes parce qu'ils sont présents dans le lait maternel et, aussi, que des études randomisées contrôlées rapportent une amélioration de la fonction cognitive chez des enfants prématurés, mais les résultats ne sont pas uniformes chez les enfants nés à terme. Récemment, l'European Food Safety Authority a proposé, faute de résultats probants, que AA ne soit pas obligatoire durant la première année dans les préparations pour nourrissons nés à terme, mais que DHA demeure obligatoire. Cette analyse documentaire a pour objectif de réviser les données probantes dans les études épidémiologiques et interventionnelles traitant de l'essentialité des AA et DHA dans le régime alimentaire postnatal du nourrisson et de la mère allaitante pour le développement du système immunitaire tôt dans la vie. Même si des études plaident en faveur de l'e...

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DHA Supplementation during Pregnancy and Lactation Affects Infants' Cellular but Not Humoral Immune Response

Cited by 26 publications

References 32 publications

Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy: Systematic Review and Practice Recommendations from an Early Nutrition Academy Workshop

Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy: Systematic Review and Practice Recommendations from an Early Nutrition Academy Workshop

La suplementación materna con ácido docosahexaenoico (DHA) carece de beneficio clínicamente significativo

Evidence for the essentiality of arachidonic and docosahexaenoic acid in the postnatal maternal and infant diet for the development of the infant’s immune system early in life

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