Administration of an Intravenous Fat Emulsion Enriched with Medium-Chain Triglyceride/ω-3 Fatty Acids is Beneficial Towards Anti-Inflammatory Related Fatty Acid Profile in Preterm Neonates: A Randomized, Double-Blind Clinical Trial (original) (raw)
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The American journal of clinical nutrition, 2004
Maternal essential fatty acid status declines during pregnancy, and as a result, neonatal concentrations of docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6) may not be optimal. Our objective was to improve maternal and neonatal fatty acid status by supplementing pregnant women with a combination of alpha-linolenic acid (ALA, 18:3n-3) and linoleic acid (LA, 18:2n-6), the ultimate dietary precursors of DHA and AA, respectively. From week 14 of gestation until delivery, pregnant women consumed daily 25 g margarine supplying either 2.8 g ALA + 9.0 g LA (n = 29) or 10.9 g LA (n = 29). Venous blood was collected for plasma phospholipid fatty acid analyses at weeks 14, 26, and 36 of pregnancy, at delivery, and at 32 wk postpartum. Umbilical cord blood and vascular tissue samples were collected to study neonatal fatty acid status also. Pregnancy outcome variables were assessed. ALA+LA supplementation did not prevent decreases in maternal DHA and AA concentrations durin...
The American Journal of Clinical Nutrition, 2004
Background: Maternal essential fatty acid status declines during pregnancy, and as a result, neonatal concentrations of docosahexaenoic acid (DHA, 22:6nϪ3) and arachidonic acid (AA, 20:4nϪ6) may not be optimal. Objective: Our objective was to improve maternal and neonatal fatty acid status by supplementing pregnant women with a combination of ␣-linolenic acid (ALA, 18:3nϪ3) and linoleic acid (LA, 18:2nϪ6), the ultimate dietary precursors of DHA and AA, respectively. Design: From week 14 of gestation until delivery, pregnant women consumed daily 25 g margarine supplying either 2.8 g ALA ϩ 9.0 g LA (n ϭ 29) or 10.9 g LA (n ϭ 29). Venous blood was collected for plasma phospholipid fatty acid analyses at weeks 14, 26, and 36 of pregnancy, at delivery, and at 32 wk postpartum. Umbilical cord blood and vascular tissue samples were collected to study neonatal fatty acid status also. Pregnancy outcome variables were assessed. Results: ALAϩLA supplementation did not prevent decreases in maternal DHA and AA concentrations during pregnancy and, compared with LA supplementation, did not increase maternal and neonatal DHA concentrations but significantly increased eicosapentaenoic acid (20:5nϪ3) and docosapentaenoic acid (22:5nϪ3) concentrations. In addition, ALAϩLA supplementation lowered neonatal AA status. No significant differences in pregnancy outcome variables were found. Conclusions: Maternal ALAϩLA supplementation did not promote neonatal DHAϩAA status. The lower concentrations of Osbond acid (22:5nϪ6) in maternal plasma phospholipids and umbilical arterial wall phospholipids with ALAϩLA supplementation than with LA supplementation suggest only that functional DHA status improves with ALAϩLA supplementation.
The Journal of Lipid Research, 2003
Most preterm infant formulas contain mediumchain triacylglycerols (MCT), but the effects of MCT on polyunsaturated fatty acid status and metabolism are controversial. Thus, we studied the effects of MCT on linoleic acid metabolism using stable isotopes. Enterally fed preterm infants were randomized to receive for 7 days 40% of fat as MCT (n ؍ 10) or a formula without MCT (n ؍ 9). At study day 5, infants received orally 2 mg/kg body weight of 13 C-labeled linoleic acid. Fatty acids in plasma lipid classes and 13 C enrichment of phospholipid fatty acids were measured and tracer oxidation was monitored. Compared with the control group, the MCT group showed lower breath 13 CO 2 and higher plasma triacylglycerol contents of octanoic acid, of decanoic acid, and of total long-chain polyunsaturated fatty acids (57.1 ؎ 4.4 mol/l vs. 37.9 ؎ 4.8 mol/l, P Ͻ 0.01). Concentrations of several polyunsaturated fatty acids in plasma phospholipids and non esterified fatty acids were higher in the MCT group. 13 C concentrations in phospholipid n-6 fatty acids indicated no difference in the relative conversion of linoleic to arachidonic acid. We conclude that oral MCT effectively reduce polyunsaturated fatty acid and long chain polyunsaturated fatty acid oxidation in preterm infants without compromising endogenous n-6 long chain polyunsaturated fatty acid synthesis. -Rodriguez, M., S. Kiss, M. Fink, H. Demmelmair, M. Turini, G. Crozier, and B. Koletzko. Plasma fatty acids and [ 13 C]linoleic acid metabolism in preterm infants fed a formula with medium-chain triglycerides. J. Lipid Res. 2003. 44: 41-48. Supplementary key words long chain polyunsaturated fatty acid • tracer • long-chain triacylglycerols • LCT • fatty acid oxidation Abbreviations: AP, atom percent; APE, atom percent excess; LCFA, long chain fatty acid; LCP, long chain polyunsaturated fatty acids; LCT, long chain triacylglycerol; MCFA, medium chain fatty acids (8:0-12:0); MCT, medium chain triacylglycerols (8:0-12:0); MUFA, monounsaturated fatty acids; PUFA, polyunsaturated fatty acids; SFA, saturated fatty acids.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2018
To determine the plasma triglyceride (TG) and unbound free fatty acid (FFAu) levels in infants treated with increasing dosages of soybean lipid, intralipid (IL), infusion. TG and FFAu levels were measured in 78 preterm infants (BW 500-2000 g; GA 23-34 weeks) using the fluorescent probe ADIFAB2 and enzymatic method. The infants' BW was 1266.2 ± 440.7 g and GA 28.8 ± 3.1 weeks. TG levels were 77.4 ± 50 mg/dL, 140.2 ± 188 mg/dL (p < .04 compared to levels during low dose IL infusion) and 135.6 ± 118 mg/dL (p < .004), respectively during increased IL rates. FFAu levels were 17.7 ± 13 nM, 47.3 ± 102.8 nM (p = .07) and 98 ± 234 nM (p = .03). TG levels correlated with IL dose, the rate of IL administration, and FFAu levels. TG and FFAu levels were higher in infants below 28 weeks' gestation Conclusions: Increasing dosage of IL is associated with increasing levels of TG and FFAu, especially in infants below 29 weeks of gestation. The increased level of FFAu suggests inefficien...
International Journal of Child Health and Nutrition, 2014
Background: Total parenteral nutrition (TPN) is a life-saving therapy given to neonates with intestinal failure. However, infants on long-term TPN may experience Parenteral Nutrition-Associated Liver Disease (PNALD). New formulations for lipid emulsions are purportedly better than the traditional soy-based lipid emulsions (SLE). Our primary objective was to determine the prevalence of PNALD in infants who received non-soybean-based lipid emulsions (NSLE) or SLE. Methods: In this retrospective study, medical records of all infants admitted to a tertiary neonatal intensive care unitfrom 2004 to 2013 were reviewed. Late preterm (34-36 weeks of gestation) and term infants who were on TPN for more than two weeks were included. Their demographic data and clinical variables were collected. Results: 208 infants received SLE for more than two weeks. The prevalence rate of PNALD in those who received SLE was 21% while that of those who received the NSLE was 17%. No significant difference was found between the 'Soy' or 'NonSoy' subgroups (p = 0.315). Seventy infants received TPN for more than four weeks. The prevalence rate of PNALD in infants who received SLE and NSLE was 35% and 25% respectively. No significant statistical difference was found between the 'Soy' or 'NonSoy' subgroups (p = 0.132). Conclusions: The type of lipid emulsion does not significantly influence the rate of PNALD in late preterm and term infants on long-term TPN.
Effect of omega-3 Fatty Acid Supplementation in Preterm Neonates
IOSR Journals , 2019
Background; There is growing evidence that, in addition to effects on development, omega-3 LCPUFAs may reduce the incidence or severity of neonatal morbidities by affecting different steps of the immune and anti-inflammatory response. Also omega-3 LCPUFA have been linked to a favorable impact on lipidemic profile. Objectives; The aim of our study was to assess the effect of omega-3 fatty acid supplementation in preterm neonates and their lipid profile. Patients and methods; Our study included two groups: first group: included 25 preterm neonates whose birth weight was appropriate for gestational age, received omega-3 supplement (DHA 40 mg/kg day)with regular preterm formula within 5 days of the first enteral feeding for 21 days or until discharge, whatever comes first. Second groupincluded 25 preterm neonates matched to group 1 as regard gestational age and birth weight, received regular preterm formula without any supplement. CBC, liver enzymes, kidney function tests and lipid profile were done on enrollment, before omega-3 supplementation and after 21 days of initiation of therapy or before discharge of the case for the cases (group1) and for the control(group2) on enrollment and before discharge. Results; There was significant decrease in serum cholesterol, triglycerides, LDL and VLDL while significant increase in serum HDL after omega-3 supplement in group 1. There was no statistical significant difference between two groups as regard growth, duration of respiratory support measures, secondary outcome of prematurity and duration of hospital stay. Conclusion; Omega-3 supplementation in preterm infants in a dose (40 mg/kg/day) decreases serum level of cholesterol, triglycerides, LDL, VLDL and increases serum HDL, no effect of omega-3 supplementation on rate of growth, improving of feeding intolerance, duration of respiratory support during hospital stay, no significant difference as regard the total duration of hospital stay or secondary outcome(ROP, IVH, NEC, BPD and death) between the supplementation group and control group, omega-3 could be safe in preterm neonates for controlling serum lipid profile.
Pediatrics International, 2011
Background: Although a variety of different lipid emulsions with varying fatty acid contents have been developed, there are some concerns about the administration of these lipid emulsions because of potential adverse effects, including oxidative stress-related morbidity. The aim of the present study was to evaluate and compare the effects of the standard soybean oil-based and olive oil-based i.v. lipid emulsions (ILE) on oxidative stress, determined by total antioxidant capacity (TAC), and to investigate the safety of the use of these two emulsions in terms of biochemical indices. Methods: In this prospective study, premature infants were randomly assigned to two groups, each group consisting of 32 patients who received parenteral ILE of either 20% olive oil or 20% soybean oil. They were given ILE for 7 days and then were evaluated with regard to TAC. Results: No statistically significant difference was observed between the groups in terms of routine biochemical parameters. TAC for both groups on day 7 was significantly lower compared with that on day 0. Although the decrease in TAC within 7 days of ILE administration was greater in the soybean group compared with that in the olive oil group, it was not statistically significant. Conclusions: Olive oil-based ILE exhibit similar antioxidant activity and can be used as an alternative to soybean oil-based ILE. TAC significantly decreased in infants following administration of either lipid emulsion, and premature infants tolerated either ILE well, both biochemically and clinically.
European Journal of Clinical Nutrition, 2004
Objective: The aim of this study was to assess the effects of fish oil supplementation in pregnancy on maternal erythrocyte fatty acid composition at different stages of pregnancy and in the post-partum period, and on neonatal erythrocyte fatty acid composition. Design: A double-blind, randomised, placebo-controlled study. Setting: Subiaco, Western Australia. Subjects: In all, 98 women booked for delivery at St John of God Hospital, Subiaco, were recruited from private rooms of obstetricians. In total, 83 women and their healthy full-term babies completed the study. Intervention: Women received either 4 g of fish oil (n ¼ 52) (56% docosahexaenoic acid (DHA) and 28% eicosapentaenoic acid (EPA) or placebo (olive oil) (n ¼ 46) per day from 20 weeks gestation until delivery. Main outcome measures: Erythrocyte phospholipid fatty acids were measured in maternal peripheral blood at 20, 30 and 37 weeks of pregnancy and at 6 weeks post partum, and from cord blood collected at birth. Results: Compared to the control group, maternal EPA and DHA were significantly higher in the fish oil group at 30 and 37 weeks gestation, and remained elevated at 6 weeks post partum (Po0.001). The proportions of n-6 polyunsaturated (arachidonic acid, 22:3n-6 and 22:4n-6) were significantly lower in the fish oil supplemented group at the same time periods (Po0.001). Similarly, the proportions of EPA and DHA were significantly higher (Po0.001), and those of n-6 polyunsaturated fatty acids arachidonic acid, 20:3n-6, 22:3n-6 and 22:4n-6 were significantly lower (Po0.001), in erythrocytes from neonates in the fish oil group, compared to those in the control group. Conclusion: Fish oil supplementation from 20 weeks of pregnancy until birth is an effective means of enhancing n-3 fatty acid status of both mothers and neonates. Furthermore, the changes in maternal erythrocyte fatty acid composition are retained until at least 6 weeks post partum. It is essential to assess the effects of concomitant decreases in arachidonic acid status before any dietary recommendations can be made.
Nutrients, 2018
Preterm infants require fortification of human milk (HM) with essential fatty acids (FA) to ensure adequate post-natal development. As part of a larger randomized controlled study, we investigated FA metabolism in a subset of 47 clinically stable preterm infants (birth weight ≤1500 g or gestational age ≤32 weeks). Infants were randomized to receive HM supplemented with either a new HM fortifier (nHMF; = 26) containing 12.5 g medium-chain FA (MCFA), 958 mg linoleic acid (LA), 417 mg α-linolenic acid (ALA), and 157 mg docosahexaenoic acid (DHA) per 100 g of powder (in compliance with the latest guidelines) or a fat-free HMF (cHMF; = 21). Plasma phospholipid (PL) and triacylglycerol (TAG), and red blood cell phosphatidylcholine (RBC-PC) and phosphatidylethanolamine (RBC-PE) FA profiles were assessed before and after 21 days of feeding. In the nHMF group, significantly increased levels of -9 monounsaturated fatty acids were observed, formed most likely by elongation and desaturation of ...
PEDIATRICS, 2001
Objective. There have been indications that high intake of n-3 long-chain polyunsaturated fatty acids (PUFAs) during pregnancy may increase birth weight and gestational length. In addition, n-3 longchain PUFAs may be important for the neurobiological development of the infants. High levels of docosahexaenoic acid (DHA, 22:6 n-3) are found in the gray matter of the cerebral cortex and in the retina, and it seems as if the availability of long-chain PUFAs may be limiting cerebral development. The fetus and the newborn are dependent on a high supply from their mothers, either via the placenta or via breast milk. We supplemented pregnant and lactating women with n-3 or n-6 long-chain PUFAs to evaluate the effect on birth weight, gestational length, and infant development.