Fatty acid supply with complementary foods and LC-PUFA status in healthy infants: results of a randomised controlled trial.
PURPOSE
Introduction of complementary food usually leads to decreasing intakes of long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFA), compared to full breastfeeding. In the randomised controlled PINGU intervention trial, we tested the effects of complementary foods with different contents of alpha-linolenic acid (ALA) and docosahexaenoic acid (DHA) on term infant LC-PUFA status.


METHODS
Healthy infants born at term were randomised to receive from the introduction of complementary feeding at the age of 4 to 6 months until age of 10 months ready-made complementary meals either with ALA-rich rapeseed oil (intervention group (IG)-R), with salmon twice weekly to provide preformed DHA (IG-F), or with linoleic acid-rich corn oil (control group, CG). Fatty acid composition was assessed in erythrocyte (RBC) and plasma glycerophospholipids.


RESULTS
Complete data of fatty acids in RBC (plasma) were available from 158 (155) infants. After intervention, infants assigned to IG-F showed higher RBC and plasma percentages of eicosapentaenoic acid (EPA), DHA, and total n-3 LC-PUFA than CG (each p < 0.001). In IG-R, levels of ALA and the ratio of ALA to LA in plasma and RBC (all p < 0.0001) as well as RBC-EPA (p < 0.0001) were higher than in CG, while DHA levels did not differ between IG-R and CG.


CONCLUSIONS
Regular fish consumption during complementary feeding enhances infant EPA and DHA status. The usage of rapeseed oil in small amounts concordant with EU-law for commercial meals enhances endogenic EPA-synthesis, but does not affect DHA status. Provision of oily fish with complementary feeds is advisable to prevent a decline of DHA status.


CLINICAL TRIAL REGISTRATION
www.clinicaltrials.gov , identifier: NCT01487889, title: Polyunsaturated fatty acids in child nutrition-a German multimodal optimisation study (PINGU).
['Libuda|Lars|L|', 'Mesch|Christina M|CM|', 'Stimming|Madlen|M|', 'Demmelmair|Hans|H|', 'Koletzko|Berthold|B|', 'Warschburger|Petra|P|', 'Blanke|Katharina|K|', 'Reischl|Eva|E|', 'Kalhoff|Hermann|H|', 'Kersting|Mathilde|M|']
D000328:Adult D000818:Animals D003430:Cross-Sectional Studies D004032:Diet D004281:Docosahexaenoic Acids D015118:Eicosapentaenoic Acid D004912:Erythrocytes D044943:Fatty Acid Desaturases D005260:Female D005399:Fishes D020404:Glycerophospholipids D006801:Humans D007223:Infant D007227:Infant Nutritional Physiological Phenomena D019787:Linoleic Acid D008297:Male D005810:Multigene Family D009752:Nutritional Status D010938:Plant Oils D020641:Polymorphism, Single Nucleotide D000074262:Rapeseed Oil D017747:Seafood D017962:alpha-Linolenic Acid
Complementary food Alpha-linolenic acid DHA Complementary feeding Rapeseed oil Fish DHA status