Effect of reducing the n−6:n−3 long-chain PUFA ratio during pregnancy and lactation on infant adipose tissue growth within the first year of life: an open-label randomized controlled trial

Hauner, Hans; Much, Daniela; Vollhardt, Christiane; Brunner, Stefanie; Schmid, Daniela; Sedlmeier, Eva-Maria; Heimberg, Ellen; Schuster, Tibor; Zimmermann, Andrea; Schneider, Karl-Theo M.; Bader, B.; Amann-Gassner, Ulrike

doi:10.3945/ajcn.111.022590

Cited by 110 publications

(162 citation statements)

References 44 publications

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“…We could not verify the initial hypothesis because we found no intervention effect on fat mass development in the offspring (15).…”

contrasting

confidence: 47%

“…This finding is consistent with previous reports from RCTs (16,(18)(19)(20), describing that n-3 LCPUFA supplementation during pregnancy and lactation does not decrease the proportion of AA in mature breast milk. Also, the concomitant moderate reduction in dietary AA intake during pregnancy in the present study (15) did not affect breast milk AA content. Indeed, breast milk AA is relatively uniform across populations on a worldwide basis (~0.24-1.0% of FAs) (21), suggesting a physiological and critical role of AA for infant growth and development.…”

Section: Discussionmentioning

confidence: 64%

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Breast milk fatty acid profile in relation to infant growth and body composition: results from the INFAT study

et al. 2013

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Background: There is some evidence that the n-6/n-3 long-chain polyunsaturated fatty acids (LCPUFAs) ratio in early nutrition, and thus in breast milk, could influence infant body composition. Methods:In an open-label randomized controlled trial (RCT), 208 healthy pregnant women were allocated to a dietary intervention (supplementation with 1,200 mg n-3 LCPUFAs per day and instructions to reduce arachidonic acid (AA) intake) from the 15th wk of gestation until 4 mo of lactation or to follow their habitual diet. Breast milk LCPUFAs at 6 wk and 4 mo postpartum were related to infant body composition assessed by skinfold thickness (SFT) measurements and ultrasonography during the first year of life. results: Dietary intervention significantly reduced breast milk n-6/n-3 LCPUFAs ratio. In the whole sample, early breast milk docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and n-3 LCPUFAs at 6 wk postpartum were positively related to the sum of four SFT measurements at age 1. Breast milk AA and n-6 LCPUFAs at 6 wk postpartum were negatively associated with weight, BMI, and lean body mass (LBM) up to 4 mo postpartum. conclusion: Breast milk n-3 LCPUFAs appear to stimulate fat mass growth over the first year of life, whereas AA seems to be involved in the regulation of overall growth, especially in the early postpartum period. t he amount of n-3 long-chain polyunsaturated fatty acids (LCPUFAs) in human breast milk is subject to maternal nutrition and further modified by maternal adipose tissue stores (1), gestational age and stage of lactation (2,3), and the individual's genetic constitution (variants in the FADS1/2 gene cluster) (4,5). There is an ongoing debate about whether the amount of n-3 LCPUFAs, and particularly the proportions of docosahexaenoic acid (DHA,, provided to the developing infant during the breastfeeding period may result in functional differences of health outcomes in the offspring.As recently reviewed, there is insufficient evidence from randomized controlled trials (RCTs) to support or refute the practice of giving n-3 LCPUFA supplementation ("fish oil") to breastfeeding mothers to improve infant growth, children's neurodevelopment, visual acuity, or allergy risk (6).An upcoming question in the context of fetal programming of later disease susceptibility is whether the balance between the n-6 and n-3 LCPUFAs in early nutrition, and thus in breast milk, could play a role in childhood obesity (7). Although prenatal and/or postnatal n-3 LCPUFA supplementation has been shown to reduce obesity in rodents (8,9), although not consistently proven (10,11), evidence in humans is limited and restricted to a few post hoc studies using in large part inadequate methods to assess infant fat mass (12).The INFAT (The Impact of Nutritional Fatty acids during pregnancy and lactation for early human Adipose Tissue development) study addresses the question as to whether lowering the n-6/n-3 long-chain fatty acid (FA) ratio in the diet of pregnant and breastfeeding women may reduce adipose tissue growth early ...

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“…We could not verify the initial hypothesis because we found no intervention effect on fat mass development in the offspring (15).…”

contrasting

confidence: 47%

Section: Discussionmentioning

confidence: 64%

Breast milk fatty acid profile in relation to infant growth and body composition: results from the INFAT study

et al. 2013

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“…The study rationale and design, baseline characteristics of the pregnant women as well as the clinical results on infant body composition up to 1 year of age were previously described in detail (15,16). In brief, 208 healthy pregnant women with a prepregnancy BMI between 18 and 30 kg m 22 were randomly assigned to either an intervention or a control group from the 15th week of gestation until 4 months postpartum (pp).…”

Section: Methodsmentioning

confidence: 99%

“…Anthropometric measurements in the infants were taken at birth (3-5 days pp for skinfolds), 6 weeks, 4 months, 1 year, and 2 years pp by trained investigators according to standardized procedures (15). Birth weight and length, head circumference and sex of the newborn were collected from the maternal obstetric record.…”

Section: Maternal Characteristics and Infant Anthropometrymentioning

confidence: 99%

Effect of reducing the n‐6/n‐3 fatty acid ratio on the maternal and fetal leptin axis in relation to infant body composition

Brunner

Schmid

Hüttinger

et al. 2013

Obesity

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Objective: To investigate the effect of reducing the n-6/n-3 fatty acid ratio in maternal nutrition on the maternal and cord blood leptin axis and their association with infant body composition up to 2 years. Design and Methods: 208 healthy pregnant women were randomized to either a dietary intervention to reduce the n-6/n-3 fatty acid ratio from 15th week of gestation until 4 months postpartum or a control group. Leptin, soluble leptin receptor and free leptin index were determined in maternal and cord plasma and related to infant body composition assessed by skinfold thicknesses up to 2 years. Results: The intervention had no effect on either the maternal or fetal leptin axis. Maternal leptin in late pregnancy was inversely related to infant weight and lean body mass (LBM) up to 2 years, after multiple adjustments. Cord leptin was positively related to weight, body fat, and LBM at birth, and inversely associated with weight, BMI, fat mass, and LBM at 2 years and weight gain up to 2 years. The contribution of cord leptin to infant outcomes was overall stronger compared with maternal leptin. Conclusions: Both, maternal and fetal leptin were associated with subsequent infant anthropometry with a greater impact of fetal leptin.

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“…Les reserves que l'on peut emettre sur ces etudes portent notamment sur le niveau de base moyen de consommation en AGPI qui semble adequat (et donc non desequilibre) dans la population supplementee (Hauner et al, 2012 long terme d'une supplementation en DHA, mais egalement sur un besoin specifique en DHA apres les 6 premiers mois de la vie.…”

Section: Abstract: Lipids In Infant Nutritionunclassified

Place des lipides dans l’alimentation du nourrisson

Guesnet¹,

Ailhaud

Delplanque

et al. 2013

Cahiers de Nutrition et de Diététique

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Effect of reducing the n−6:n−3 long-chain PUFA ratio during pregnancy and lactation on infant adipose tissue growth within the first year of life: an open-label randomized controlled trial

Cited by 110 publications

References 44 publications

Breast milk fatty acid profile in relation to infant growth and body composition: results from the INFAT study

Breast milk fatty acid profile in relation to infant growth and body composition: results from the INFAT study

Effect of reducing the n‐6/n‐3 fatty acid ratio on the maternal and fetal leptin axis in relation to infant body composition

Place des lipides dans l’alimentation du nourrisson

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