Abstract
Epidemiological studies have reported that breastfed children have improved psychomotor development compared to never breastfed children. Human studies suggest that polyunsaturated fatty acids (PUFA), especially long chain PUFA (LC-PUFA) which are highly contained in breast milk, could explain this link, since they are needed for pre-and postnatal brain development. Our aim was to study the relationships between several measures of pre-and postnatal exposures to PUFA and child's psychomotor development at 2 and 3 years in the EDEN cohort. We evaluated breastfeeding duration, colostrum PUFA levels and maternal dietary PUFA intake during pregnancy, that we related with three scores of psychomotor development, after taking into account potential confounders. Breastfeeding duration was positively associated with psychomotor development. No relationship was found with both pre-and postnatal exposure to LC-PUFA. However, the maternal dietary omega-6/omega-3 ratio was negatively associated with psychomotor development, mainly driven by intake in linoleic acid (LA). Among breastfed children, linoleic acid levels were negatively associated with psychomotor development. Furthermore, children exposed to the highest colostrum LA levels tended to score closer to never breastfed children than to children exposed to the lowest colostrums LA levels. Taken together, these results do not provide evidence in favour of a positive role of pre-and postnatal exposure to LC-PUFA on later psychomotor development, but highlight a potential negative role of being exposed in early life to high LA levels. From a public health perspective, this work reiterates the need to promote breastfeeding duration, and to monitor the balance of PUFA intake during pregnancy and lactation periods.
Highlights
The two series of polyunsaturated fatty acids (PUFA), the omega-3 (n-3) and omega-6 (n-6) PUFA, are essential fatty acids which must be provided by the diet and play important biological roles in metabolism, membrane structure and cell signalling, especially in nervous system (German, 2011)
Human studies suggest that polyunsaturated fatty acids (PUFA), especially long chain PUFA (LC-PUFA) which are highly contained in breast milk, could explain this link, since they are needed for pre- and postnatal brain development
Using data of colostrum fatty acid content, we found no evidence of such a benefit of LC-PUFA in breast milk
Summary
The two series of polyunsaturated fatty acids (PUFA), the omega-3 (n-3) and omega-6 (n-6) PUFA, are essential fatty acids which must be provided by the diet and play important biological roles in metabolism, membrane structure and cell signalling, especially in nervous system (German, 2011). Metabolic pathways and nutrient requirements differ across species, limiting to fully extend inputs from animal studies to humans (Innis, 2000). A scientific consensus has since emerged on the requirements of LC-PUFA during pregnancy, lactation and infancy, clearly identified as a critical period for brain development (Koletzko et al, 2008), especially in preterm infants (Lapillonne et al, 2013). Despite evidences on the link between LC-PUFA and human brain development, most randomized controlled trials have failed to prove the benefit of LCPUFA on child’s psychomotor development. Recent meta-analyses and systematic reviews have concluded to no clear benefit on child’s psychomotor development of supplementing both term and preterm infants with formulas enriched in LC-PUFA (Schulzke et al, 2011; Simmer et al, 2011). Trials supplementing pregnant or lactating women with fish-oil rich in LC-PUFA have not resulted in more evidence regarding similar outcomes in children (Delgado-Noguera et al, 2010; Gould et al, 2013)
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