Gestational age dependent changes of the fetal brain, liver and adipose tissue fatty acid compositions in a population with high fish intakes.

INTRODUCTION: There are no data on the intrauterine fatty acid (FA) compositions of brain, liver and adipose tissue of infants born to women with high fish intakes. SUBJECTS AND METHODS: We analyzed the brain (n=18), liver (n=14) and adipose tissue (n=11) FA compositions of 20 stillborn infants with different gestational ages (range 8-38 weeks) born to Tanzanian women with low linoleic acid (LA) intakes and high intakes of docosahexaenoic (DHA) and arachidonic (AA) acids from local fish. RESULTS AND DISCUSSION: With advancing gestation, brain saturated-FA (SAFA; in g/100g FA), polyunsaturated-FA (PUFA), DHA, 20:3ω6, 22:4ω6 and 22:5ω6 increased, while monounsaturated-FA (MUFA), 20:3ω9, 22:3ω9 and AA decreased. Decreasing brain AA might be caused by increasing AA-metabolism to 20:3ω6, 22:4ω6 and 22:5ω6. In the liver, SAFA, PUFA and LA increased, while MUFA decreased with gestation. The steep increase of (mostly de novo synthesized) SAFA in adipose tissue coincided with relative decreases of MUFA, PUFA, DHA, LA and AA with advancing gestation. Compared to Western infants, the currently studied African infants had higher DHA, lower AA, and a higher DHA/AA-ratio in brain and adipose tissue, while the LA content of adipose tissue was lower. CONCLUSION: The low LA and high DHA and AA intakes by the mothers of these infants might support optimal α-linolenic (ALA) vs. LA competition for Δ5D and Δ6D-activities and DHA vs. AA antagonism. Conversely, the Western diet, characterized by high LA and lower DHA and AA intakes, might disturb these evolutionary conserved mechanisms aiming at an optimal ω3/ω6-balance.

Fetal intrauterine whole body linoleic, arachidonic and docosahexaenoic acid contents and accretion rates.

INTRODUCTION: There is no information on the whole body fatty acid (FA) contents of preterm or term infants, although scattered information on the FA-composition of many organs is available. MATERIAL AND METHODS: We collected data on the weights, lipid contents and FA-compositions of the quantitatively most important fetal organs of appropriate for gestational age (AGA) Western infants. From these we estimated the total body contents of linoleic (LA), arachidonic (AA) and docosahexaenoic (DHA) acids at 25, 35 and 40 weeks of gestation. RESULTS: Western infants accrete FA in the order of LA>AA>DHA at all stages during pregnancy and the highest accretion rates are reached in the last 5 weeks of gestation, i.e. 342 mg LA, 95 mg AA and 42 mg DHA/day. At term, most of the infant's LA, AA and DHA is located in adipose tissue (68, 44 and 50%, respectively), with substantial amounts of LA also located in skeletal muscle (17%) and skin (13%); of AA in skeletal muscle (40%) and brain (11%); and of DHA in brain (23%) and skeletal muscle (21%). The term AGA infant has accreted about 21 g LA, 7.5 g AA and 3 g DHA, which constitutes a gap of 12 g LA, 3.3 g AA and 1.5 g DHA compared to a 35 weeks old AGA infant. CONCLUSION: The current fetal LA, AA and DHA pool sizes and accretion rates may especially be useful to estimate the preterm infant's requirements and the maternal LCP needs during pregnancy. Since they derive from populations with typically Western diets they do not necessarily reflect 'optimality' or 'health'.

Gestational age dependent content, composition and intrauterine accretion rates of fatty acids in fetal white adipose tissue.

BACKGROUND: Little is known about the gestational age (GA) dependent content, composition and intrauterine accretion rates of fatty acids (FA) in fetal white adipose tissue (WAT). OBJECTIVE & DESIGN: To acquire this information, we collected abdominal subcutaneous WAT samples from 40 preterm and term fetuses. Their GA ranged from 22 to 43 weeks. FA were expressed as mg/g wet WAT and g/100g FA (g%). Intrauterine WAT FA accretion rates were estimated for appropriate (AGA) and large (LGA) for gestational age infants. RESULTS: From 25 to 40 weeks gestation, saturated-FA (SAFA) increased from 83 to 298 mg/g WAT and monounsaturated-FA (MUFA) from 83 to 226 mg/g WAT, while polyunsaturated-FA (PUFA) increased insignificantly from 18.0 to 23.2 mg/g WAT. As percentages of total FA, SAFA increased from 46 to 55 g%, MUFA decreased from 44 to 41 g%, and PUFA from 10.3 to 4.26 g%. Docosahexaenoic (DHA) and arachidonic acid (AA) accretion rates in WAT during the 3rd trimester for AGA infants were 88 and 193 mg/week, respectively. Contemporaneous DHA and AA accretion rates for 4500 g LGA infants were 184 and 402 mg/week, respectively. Compared to the whole 3rd trimester, increment rates during the last 5 weeks of gestation were about 2-fold higher. CONCLUSION: FA accretion rates, notably those of DHA and AA, may be important for designing nutritional regiments for preterm infants. The current WAT-DHA and WAT-AA accretion rates are considerably lower than previously reported in the literature.

High prevalence of HIV infection in Saint Martin, French West Indies - abstract

Saint-Martin is a melting pot of Caribbean populations. A sharp increase of immigrant people was noted these last years, as a consequence of the booming tourism-related activity. Since no data were available on AIDS, an epidemiological study was developed. Since almost all births take place in the only hospital, hosptial-based information was considered as a reliable indicator of the development of the epidemic in the whole population. During pregnancy, or at delivery, blood samples were taken for HIV detection. Results were ready within four days. Positive results were found in 3 per cent of the women (n=54), in the years 1991 - 1993. All babies born from HIV-positive mothers were also positive. In 1991 and 1991, only a small minority of these women and their children was followed, since no appropriate structure existed. In 1993, a special clinic was instituted, and two-thirds of them could be followed. Evaluation of materno-foetal viral transmission is in process. The prevalence in Saint-Martin is estimated to be 4 times as high as in New York City, and 20 times as high as in Paris (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)

Intake of medium chain fatty acids (notably 12:0 and 14:0) from human milk in Antigua is not related to growth and does not cause energy wasting due to excessive beta-oxidation - abstract

The effect of postnatal intake of medium chain fatty acids (MCFA; C6-C14) from human milk on excessive beta-oxidation and growth was studied in Antigua. On day 23-28 a mean estimated intake of 8.9 g(range:3.8-16.6) of MCFA (notably 12:0 and 14:0) per litre did not cause excessive beta-oxidation, as derived from urinary excretion of ketone bodies and beta-hudroxybutyric acid. MCFA intake was not related to growth in the first 23-28 days. Intakes of as low as 2.7 g MCFA (notably 8:0 and 10:0) per litre from semisynthetic medium chain triglycerides are known to produce excessive beta-oxidation and urinary excretion of dicarboxylic acids (Rebouche et al, Am J. Clin. Nutri. 1990;52:820-824). It is concluded that, from a metabolic point of view, 12:0 and 14:0 from human milk belong to an intermediate subclass of MCFA that resembles long chain fatty acids greater than or equal to 16). Their uptake into adipose tissue may prevent hepatic oxidation, despite conceivable transportation of free 12:0 via the portal vein (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)

Adipose tissue in foetuses, infants, children and adolescents in Curacao (Netherlands Antilles), its fatty acid content and composition: the fatty acid disappearance rate in childhood - abstract

There are uncertainties about the fatty acid (FA) disappearance rate in adipose tissue of infants. We therefore studied the adipose tissue FA content and composition in the foetal period in relation to samples obtained in infancy, childhood and adolescence. Adipose tissue samples were obtained in Curacao from Black foetuses and newborns (n = 42, gestation ages 22-43 weeks), and from infants, children and adolescents (n = 62, ages 0-19 years). FA was analysed by capillary gas chromatography. It was assumed that feeds of human milk or formula in the first ñ6 months accomplished 'pulse labelling' of newborn adipose tissue FA with medium chain saturated fatty acid (MC-SAFA), and that feeding of a "mixed" diet after 6 months of age constituted a 'wash-out' or 'chase' of the marker FAs. FA half-life was calculated from the disappearance rate of MC-SAFAs (AU)

Foetal adipose tissue fatty acid accretion - abstract

There are still uncertainties about the origin of the fatty acids (FA) deposited in the foetus, notably the percentage derived from the maternal circulation. This study describes a method to determine the amount of FA synthesized de novo in the foetus and the amount derived from the maternal circulation. Autopsy samples of subcutaeneous adipose tissue were obtained from 42 black foetuses and newborn infants. Samples of similar tissue were obtained from 50 pregnant women and 13 non-pregnant black women during surgery. FA analysis was done by gas chromatography. The accretion rate of FA in foetal adipose tissue was calculated by linear regression analysis of the FA data obtained from foetal/infant samples from the 22nd to 43rd week of gestation. The rate of foetal FA synthesized de novo in adipose tissue was calculated as the difference between the total foetal FA accretion rate and an estimate of the maternally derived FA. The latter was estimated from the values for accretion rates of saturated FA (SAFA), mono-unsaturated FA (MUFA), and polyunsaturated FA (PUFA) and total FA in foetal tissue, and the SAFA, MUFA and PUFA composition of adipose tissue in women (Table). Results show that of the total FA increment in foetal adipose tissue (22.7mg/g wet wt./week), 86.6 per cent was synthesized de novo by the foetus and the rest (13.2 per cent) was maternally derived (AU)

Human milk in mothers in Belize, Curacao, Dominica, St. Lucia and Suriname, the fatty acid composition and the relevance of medium chain fatty acids containing triglycerides - abstract

Fatty acid composition of mature milk from Belize, Curacao, Dominica and Suriname and of colostrum, transitional and mature milk from women in St. Lucia was analyzed by capillary gas chromatography. Remarkable differences and striking similarities were found in fatty acid compositions. The levels of 6:0-12:0, the medium chain fatty acids (MCFA), and 14:0 were high (12:0-16:9 and 9.6-15.0 gm percent respectively) in all 5 countries as compared to reports from European countries. Palmitic acid (16:) levels (20.2-23.6 gm percent were similar to reported levels from other societies. The levels of 22.+c, W3 (docosahexaenoic acid or DHA) were extremely high in Dominica (average 1.15 gm percent) and relatively high (0.25-0.56 gm percent) in other Caribbean countries as compared to reported levels of 0.05-0.23 gm percent in studies from the USA. When a mother is in energy equilibrium or positive energy balance, the fatty acid composition of her breast milk is related to that of her diet, whereas in negative energy balance, it resembles that of her adipose tissue. High levels of DHA in breast milk may be explained by consumption of fish rich in DHA. A high carbohydrate intake leads to a high MCFA content of breast milk, such as seen in all 5 Caribbean countries but especially in Dominica. The levels of MCFAs and 14:0 in breast milk from St. Lucia increased substantially from colostrum to mature milk at the expense of the longer chain fatty acids (AU)

Comparisons of perinatal statistics and nutritional status during pregnancy between Belize and Curacao - abstract

The number of inhabitants in Belize is similar to that in Curacao, but the number of livebirths is almost double in Belize (1985:694): the infant mortality rate in Belize appeared to be 75 percent higher than in Curacao (26.3 vs 15.0/1000). Despite a striking difference in Gross Domestic Product between Belize and Curacao, the perinatal mortality figures in Belize are only slightly higher than those in Curacao. In 1985, the perinatal death rate (0-7 days) was 24.6 as compared to Curacao 20.2/1000. No remarkable differences in the nutritional status of pregnant women as determined by anthropometrical measurements were found between the two populations. Mean birthweights were not different between the two countries (AU)

Maternal plasma, blood and extracellular water volume at 34 to 38-week gestation and their influence on the neonatal body compartments at birth - abstract

Measurements of plasma volume (PV) and extra-cellular water volume (ECW) were performed on 13 pregnant Curacaoan women between 34 and 38 week gestation. Maternal PV and ECW were measured simultaneously, using a double indicator (Evan's blue/Sucrose) single injection dilution technique. Mean maternal PV and blood volume (BV) per kg bodyweight was 45 and 67.5 ml respectively. Mean ECW was 226.5 ml/kg which includes the ECW of the foetus, amniotoc fluid and placenta. The calculated corrected mean maternal ECW (mECW), excluding the products of conception, was 203.0 ml/kg. From all infants delivered by these mothers, total body water volume (TBW), ECw and PV were simultaneously measured, on the first day of life, using a triple-indicator (sucrose/D20/Evans' blue), single injection dilution technique. No relationship was observed between the measured maternal compartments at 34 -38 weeks and any of the determined body compartments of their infants, who were born some weeks later. No relationship was observed between the Maternal PV at 34 - 38 weeks and the neonatal birthweight (AU)

Local curacaoan beans and their value for diabetic control: back to the past, a step forward? - abstract

In former days, Curacaoan beans were commonly used. Nowadays, these beans are mainly replaced by food rich in simple carbohydrates and fat. We therefore investigated whether a diet rich in beans might facilitate the metabolic control of gestational diabetes mellitus. We compared the effect of consuming 5 locally grown beans (Bonchi Cora, Bonchi Pela Berde, Wandu, Bonchi Wowo Pretu and Bonchi di Kunuku) on the blood glucose response in non-pregnant, healthy pregnant and diabetic pregnant women. The area under the incremental blood glucose 3-hr curve, after consuming 25 gm of each type of bean, was expressed as a percentage of the blood glucose area obtained after a 25 gm bread-and-cheese breakfast. The mean of these values for each food was designed as the "glycaemic index, G.I." for that food. All beans showed a lower glycaemic index than the test bread meal. We found lower glycaemic indexes in both the healthy pregnant and diabetic pregnant women than in non-pregnant women. It is possible that gestational diabetics (and other diabetics) will be more easily controlled with "old fashioned" tasty bean-meals prepared with locally grown products than with refined foods (AU)

Water distribution (total body water and extracellular water) and plasma-volume in Curacaoan newborn infants measured by a triple indicator method - abstract

The postnatal weight loss of normal Curacaoan term infants is approximately 4-5 per cent of the birth weight whereas the average Caucasian term infant will lose ñ 10 percent of the birthweight. As part of a study to investigate the influence of the neonatal body (water) compartments on the postnatal weight loss, the "water distribution" (the total body water, extracellular water), and the plasma volume in a group of 13 Curacaoan neonates were measured simultaneously, using a triple indicator (deuterium oxide, sucrose and evans blue), single injection dilution technique. The high precision of the method used to determine extracellular water volume (ECW) allows the use of very small samples in the neonates. Mean neonatal total body water volume (75.1 percent) on the first day use of life in this group of term Curacaoan in fants corresponds to values presented in other studies. However, the distribution of the total water volume between the intracellular (43.9 percent) and extracellular (31.1 percent) space showed, in comparison with studies in term-AGA infants from other countries, an increased proportion of total water occupied by the intracellular compartment at the expense of the extracellular space (AU)

Some perinatal characteristics from the Netherlands Antilles - abstract

Information regarding various perinatal conditions in Curacao and Aruba (Netherlands Antilles) leading directly or indirectly to permanent brain damage of the infant is scarce. In this study, the high perinatal morality rate for Curacao (35.4 per thousand total births) is comparable to those from other (Eastern) Caribbean countries. On the other hand in Aruba with similar socio-economic conditions to Curacao, a much lower perinatal mortality rate (18.0 per thousand total births) is found. The relatively higher mean birthweight (3390 gram) in Aruba resulted in a high incidence of large-for-dates babies (14.1 percent) and a relatively low incidence of low birthweight infants (5.8 percent). Early neonatal weight loss occurring immediatley after birth is greater in "large" babies as compared to "smaller size" babies of the same gestational age. This will result in different growth patterns between these two groups of infants and may be explained by differences in body water content. The statement that increasing the mean birthweight of a population by food supplementation during pregnancy will automatically reduce the perinatal mortality and morbidity can only be made with caution (AU)