Docosahexaenoic acid is selectively enriched in plasma phospholipids during pregnancy in Trinidadian women - Results of a pilot study

The fetal demand for docosahexaenoic acid (DHA) has to be satisfied by the mother. We determined the fatty acids in maternal plasma non-esterified fatty acid (NEFA), triacylglycerol (TAG) and phosphatidylcholine (PC), in a cross-sectional study of non-pregnant (n = 10), pregnant (n = 19), and postpartum (n = 9) women. There were lipid class-dependent differences in plasma polyunsaturated fatty acid (PUFA) concentrations between groups. During pregnancy, DHA was most highly enriched in PC, about 230 percent, with more modest enrichment for linoleic acid (LA) and arachidonic acid (AA), and no enrichment of alpha-linolenic acid (-LNA). There was relative enrichment of LA, AA and -LNA in TAG, but not of DHA. There was no specific enrichment of any PUFA in the NEFA pool. These data accord with the suggestion that the enrichment of -LNA in TAG and of DHA in phospholipids reflects hepatic regulation of n-3 PUFA metabolism which potentially enhances the delivery of DHA to the placenta.

A multi-centre safety and efficacy trial of a preterm infant formula supplemented with long chain polyunsaturated fatty acids (LCP) (48 weeks PCA analysis)

LCP supplementation of premature infant formula has been shown to produce plasma and erythrocyte lipid profiles similar to human milk (HM)-fed preterm infants. Previous studies reported decreased growth with LCP supplemented formula. This prospective, double-blind, randomised, controlled, parallel trial compared safety, growth and phospholipid fatty acid (PFA) levels in preterm infants fed preterms formula with (L+) or without (Lo) LCP. The study consisted of Phase I: enrolment to 40 weeks (wk) postconceptual age (PCA); and Phase II: 40 to 48 wk PCA. Infants (birth weight 750-2000 g, 0-28 days of age) were fed L+ or L preterm formula, 24 Kcal/oz during Phase I, and 20 Kcal/oz during Phase II. A control group was exclusively HM-fed preterms who, if weaned at the end of Phase I, received L. HM and formula intake were unrestricted. Weight (wt), length (Lt), head circumference (OFC) and upper mid-arm circumference (MAC), and phospholipid profiles were measured at 40 and 48 wk PCA. Adverse events were monitored. 183/288 infants completed Phase II. There were no difference in growth rates between formula groups. At 48 wk PCA, mean PFA levels in infants fed L+ were similar to HM-fed and were significantly higher than the L fed group. Adverse events were similar between the 2 formula groups. The number of infants who were discontinued because of an adverse event was similar among all groups. In conclusion the LCP preterm infant formula is safe, support normal growth and maintains phospholipid profiles similar to HM-fed infants.(AU)

Umbilical vessels in preeclamptic pregnancies have low contents of both w3 and w6 long chain polyunsaturated fatty acids

We determined the fatty acid compositions of maternal and umbilical platelets (PLT), and of the umbilical arteries (UA) and veins (UV) of 27 preeclamptic pregnancies and 24 normotensive controls, mostly of Afro-Caribbean descents. Between-group differences were analyzed with the Kruskal-Wallis test or with analysis of convariance with gestational age as covariate. PLT of preeclamptic women contained lower 20:5 w3, and a higher 20.4 w6/20:5 w3 ratio. Linear discriminant analysis revealed higher 20:4 w6. Major differences were found in UV and especially UA fatty acid compositions. UA and UV of preeclamptic pregnancies contained lower long chain polyunsaturated fatty acids of the w3-series (LCPUFA w3), LCPUFA w6 and 20:3 w6. UA had lower 20:4 w6 higher 20:3 w9 and 20:3 w9/20:4 w6. We conclude that the low LCPUFA w3 and LCPUFA w6 levels in umbilical vessels of preeclamptic women with adequate w6 status may indicate insufficient LCPUFA transplacental transfer. The low 20:4 w6, high 20:3 w9 and high 20:3 w9/20:4 w6 ratio in UA may unfavourably affect local prostacylin production and cause other 20:3 w9 related adverse effects. Low 20:3 w6 in UV and UA, and low 20:5 w3 in maternal PLT, may contribute to the dominance of 20:4 w6 derived eicosanoids.(AU)

The dietary fatty acids of patients with coronary artery disease and control in Curacao: implications for primary and secondary prevention

Patients with coronary artery diseases are advised to augment their dietary linoleic acid intakes at the expense of saturated fatty acids. We investigated whether the dietary linoleic acid intake of 57 patients with coronary artery disease (47 males, 10 females; ages 61 ñ 10 years) in Curacao is higher as compared with 77 controls (51 males, 26 females; ages 56 ñ 7 years). For this, we measured plasma cholesterol ester fatty acids, which reflect the dietary fatty acid composition of the preceeding weeks. Patients with coronary artery disease and controls had minor differences in cholesterol ester fatty acids. Their cholesterol ester linoleic acid content suggests that the dietary polyunsaturated/saturated fatty acid ratio is far below 1. Comparison with data reported for the the Netherlands, Greenland and Crete showed that the dietary fatty acid composition in Curacao is typically Western with a high intake of saturated fatty acids, a low intake of monounsaturated fatty acids and the consumption of linoleic acid as the predominant polyunsaturated fatty acid. Intake of long chain polyunsaturated fatty acids from fatty fish is low. Reduction of dietary saturated fatty acids, augmentation of fish consumption, and an increase of the O-linolenic/linoleic acid ratio are likely to be of benefit to both primary and secondary prevention from coronary artery disease in Curaco.(AU)

Comparison of antioxidant status during recovery from malnutrition on a corn oil- or coconut oil-based diet - abstract

Children recovering from malnutrition are given a high-energy diet during the "catch-up" phase. Corn oil, a poly-unsaturated fatty acid (PUFA) rich vegetable oil, is used to supply 60 per cent of the energy in the recovery diets. Previous work suggests that this high intake of corn oil may be associated with a deterioration of antioxidant status. A normal antioxidant status is essential for protection against cell damage. We therefore compared indices of antioxidant status (whole blood gluthathione, GSH; plasma vitamen E; and urinary mercapturic acid outputs (UMCA) in two groups of malnourished children who had recovered on isocaloric diets containing either PUFA rich, corn oil (Control group) or coconut oil (test group), which is rich in saturated fatty acids. Both groups showed an initial normalisation of GSH and vitamin E levels; whereas the test group maintained normal levels, the control group showed a progressive decrease of both indices during recovery. At discharge the test group had GSH (2.7 ñ 0.08 vs 2.44 ñ 0.88 mmol/Lrbc, mean ñ SEM) and vitamen E (8.44 ñ 1.21 vs 7.38 ñ 1.01 mg/l), levels that were significantly higher (p< 0.05) that in the Control group. Several children in the Control group had vitamen E levels that were below the accepted normal range. At recovery, UMCA outputs of the Control group (4.85 ñ 0.55 umol/kg/24 hr) were further increased, and as such were significantly higher (p < 0.05) than the admission mean (3.32 ñ 0.54 umol/kg/24 hr). In the test group, mean discharge UMCA output (1.98 ñ 0.44 umol/kg/24 hr) was significantly lower than admission values, as well as the mean discharge UMCA output of the Control group. This suggests that the body's burden of compounds that require detoxification is significantly increased when malnourished children are rehabilitated on a diet rich in corn oil. Following recovery on the coconut oil diet, plasma cholesterol levels (2.30 ñ 0.15 mmol) were similar to the pre-treatment mean (2.15 ñ 0.11 mmol). However, plasma levels of triglycerides fell significantly (p < 0.05) with treatment (pre: 1.23ñ0.14; post 0.88ñ0.08 mmol). When given a diet that is not rich in PUFA, malnourished children are able to maintain their antioxidant status within the normal range. It is suggested that coconut oil be used routinely in the formulation of recovery diets for malnourished children (AU)

Indicators of long chain polyunsaturated fatty acid status of exclusively breastfed infants at delivery and after 20-22 days

The fatty acid composition of plasma cholesterol esters (CE), erythrocytes (RBC) and mature milk from seven lactating women and their exclusively breastfed newborns, living on Dominica, were studied. Blood samples were taken from umbilical cord and mother at birth. A sample of breastmilk was collected on day 20-22 postpartum, together with a blood sample from the baby. At birth, cord blood plasma CE and RBC total long chain polyunsaturated fatty acid (LC-PUFA) contents were higher, and linoleic (18:2c, omega 6) and alpha-linolenic (18:3c, omega 3) acid contents lower, than in corresponding maternal compartments. Cord blood RBC LC-PUFA omega 3 content was lower and LC-PUFA omega 6 content higher than in maternal RBC. After birth, feeding with human milk led to a drop in LC-PUFA content in the plasma CE fraction, whereas RBC LC-PUFA content remained virtually constant. Current understanding of the origin and relative affinity of fatty acids incorporated in plasma CE and RBC suggests that RBC LC-PUFA content is a more reliable parameter for LC-PUFA status than plasma CE LC-PUFA content. The RBC LC-PUFA data suggest therefore that at birth the newborn has a lower LC-PUFA omega 3 status than the mother, and that this does not change during three weeks of exclusive breastfeeding (AU)

Long chain polyunsaturated fatty acid status of the exclusively breastfed infant in Dominica at delivery and after 20-22 days - abstract

The fatty compositions of plasma cholesterol esters (CE) and erythrocytes (RBC) from five lactating women and their exclusively breastfed newborns, living in Dominica, were studied. Blood samples were taken from the umbilical cord and mother at birth. A second blood sample of the newborn and a sample of breast milk were taken on day 20-22 postpartum. Fatty acids were determined by capillary gas chromatography. At birth, cord blood plasma CE and RBC long chain polyunsaturated fatty acids (LC-PUFA) contents were higher, and linoleic acid (18:2c, w6) contents lower, than in corresponding maternal compartments. Accretion of LC-PUFA by the foetus may be accomplished by a-fetoprotein , that has a high affinity for LC-PUFA and is taken up by a variety of foetal tissues in a receptor-mediated fashion. After birth breastfeeding leads to a drop of LC-PUFA content in the plasma CE fraction, whereas RBC LC-PUFA content remains constant. Is is conceivable that RBC LC-PUFA content is a more reliable parameter for LC-PUFA status than the plasma CE LC-PUFA (AU)

Vitamin E, lipid fractions, and fatty acid composition of colostrum, transitional milk, and mature milk: an international comparative study

Triglycerides, cholesterol, fatty acid composition, and tocopherols were determined in colustrum, transitional milk, and mature milk in St. Lucia. With progress of lactation, triglycerides and percentage medium-chain fatty acids increased whereas tocopherols, cholesterol and percentage long-chain polyunsaturated fatty acids decreased. These changes reflect augmented de novo synthesis of fatty acids (8:0, 10:0, 12:0, and 14:0) in the mammary gland and a tendency of increasing fat-globule size as milk matures. Transitional and mature milks, but particularly colustrum, contained higher concentrations of components considered to be derived from the fat-globule membrane (cholesterol, tocopherols, percentage long-chain polyunsaturated fatty acids) compared with those reported for Western countries. Percentage medium-chain fatty acids in mature milk was two to three times higher than in developed countries. Differences from data from studies in Western countries are discussed in relation to analytical methods and possible consequences for lipid digestion, lipid absorption, growth, and brain development.(AU)

Dietary and other characteristics relevant for coronary heart disease in men of Indian, West Indian and European descent in London

The origins of the high standardized mortality ratio (SMR) for coronary heart disease (CHD) among Indians in Britain, and the low SMR for West Indian immigrants, have been explored by a community survey in London. Serum lipoproteins, plasma glucose, haemostatic factors and other putative risk characteristics were measured in 75 Indian, 64 European and 24 West Indian men aged 45-54 years. These represented 81 percent of men registered with a general practice and resident within a defined area. In 51 men, diet was assessed by 5-day weighed inventory. Plasma phospholipid fatty acids (PFA) were measured in 18 Indians and 19 Europeans with dietary records. The relatively high HDL and HDL2-cholesterol concentration, reduced fat intake, increased ratio of dietary polyunsaturated/saturated fat, relatively frequent use of alcohol, and lack of obesity in West Indians accorded with thier low SMR from CHD. By contrast, only the relatively low HDL and HDL2-cholesterol concentrations, infrequency of alcohol consumption, and lower proportion of PFA as n-3 fatty acids of marine origin afforded explanations for the high SMR of Indians. Hyperglycaemia appeared similarly prevalent in Indians and West Indians, but less common in Europeans. Of the haemostatic factors, West Indians had a relatively low VIIc (not statistically significant), while Indians had an increased platelet count and reduced platelet volume. Improved understanding of these ethnic differences in CHD mortality may depend upon elucidation of the contrasts in HDL-cholesterol concentration. (AU)

Effect of pregnancy on plasma lipid concentration in Trinidadian women. Result of a pilot study

In Trinidad and Tobago, Cardiovascular disease and Type 2 diabetes mellitus are important causes of morbidity and mortality, and birth weight is significantly less than reference standards. Lower birth weight is associated with increased risk of these diseases. Variation in birth weight is due, in part, to deposition of adipose tissue in the foetus during the last trimester at the same time that maternal plasma triacylglycerol (TAG) increases. We conducted a pilot cross-sectional analysis of maternal plasma lipid status and birth weight in healthy, non-pregnant, primigravida Trinidadian women. Non-pregnant and pregnant women, in their second and third trimesters, and at term, were recruited at random from an antenatal clinic. Adult and umbilical cord plasma TAG, non-esterified fatty acids (NEFA) and phosphatidylcholine (PC) concentrations were determined from gas chromatographic analysis of fatty acids. Maternal height, weight, skinfold thickness and infant birth weight were measured. The infant born to Afro-Trinidadian and Indo-Trinidadian women were of low to normal birth weight (medians 3.07 and 3.22 kg, respectively). At term, plasma TAG concentration was approximately two fold (p <0.05) greater than for non-pregnant women. The increment between 30-34 weeks was 1.5 to 1.9 fold lower than reported in other populations. There was a strong relationship (r=0.8771, p=0.019) between maternal and cord plasma TAG and NEFA, but not PC concentrations. There was no significant relationship between maternal TAG concentration at term and birth weight. The result suggests an impaired ability to increase plasma TAG concentration during late gestation. (AU)