Hoffman D R, Birch E E, Birch D G, Uauy R, Castañeda Y S, Lapus M G, Wheaton D H
Retina Foundation of the Southwest, and Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75231, USA.
J Pediatr Gastroenterol Nutr. 2000 Nov;31(5):540-53. doi: 10.1097/00005176-200011000-00016.
In contrast to human milk, current infant formulas in the United States do not contain omega3 and omega6 long-chain polyunsaturated fatty acids. This may lead to suboptimal blood lipid fatty acid profiles and to a measurable diminution of visual function in developing term infants. The need for docosahexaenoic acid and arachidonic acid supplementation in the infant diet was evaluated in a double-blind, randomized clinical trial.
Healthy term infants were randomized to diets of (1) commercial formula, (2) docosahexaenoic acid-enriched formula (0.35% of total fatty acids), or (3) docosahexaenoic acid- (0.36%) and arachidonic acid- (0.72%) enriched formula. Eighty-seven infants completed the 17-week nutritional trial, and 58 were observed until 52 weeks of life. A reference group was exclusively breast fed for at least 17 weeks (n = 29). Outcome measures included electroretinographic responses, visual evoked potentials, and blood fatty acid analysis in infants at birth and at 6, 17, and 52 weeks of age.
Commercial formula-fed infants had 30% to 50% lower content of docosahexaenoic acid in total red blood cell lipids during the 17-week feeding trial compared with breastfed infants. Significant differences persisted at the 1-year follow-up. Arachidonic acid content was consistently reduced in the commercial formula group by 15% to 20%. Infants fed long-chain polyunsaturated fatty acid-enriched formulas had docosahexaenoic acid and arachidonic acid blood lipid profiles resembling those of human milk-fed infants. Infants receiving this enriched formula had more mature electroretinographic responses than commercial formula-fed infants at 6 weeks of age. Human milk-fed and docosahexaenoic acid-enriched formula-fed infants had better visual acuity than commercial formula-fed infants at both 17 and 52 weeks of age. Early (17-week) fatty acid profiles in blood lipids were correlated with later (52-week) visual function development in study infants.
Results from this clinical trial demonstrate that long-chain polyunsaturated fatty acid supplementation of formula in term infants produces blood lipid fatty acid profiles that are similar to those observed in breast-fed infants. This supplementation leads to better visual function later in life (i.e., 1 year of age) than that shown by infants fed commercial formula.
与母乳不同，美国目前的婴儿配方奶粉不含ω-3和ω-6长链多不饱和脂肪酸。这可能导致足月发育中婴儿的血脂脂肪酸谱不理想，并使视觉功能出现可测量的减退。在一项双盲随机临床试验中，对婴儿饮食中补充二十二碳六烯酸和花生四烯酸的必要性进行了评估。
将健康足月婴儿随机分为以下饮食组：（1）商业配方奶粉；（2）富含二十二碳六烯酸的配方奶粉（占总脂肪酸的0.35%）；或（3）富含二十二碳六烯酸（0.36%）和花生四烯酸（0.72%）的配方奶粉。87名婴儿完成了为期17周的营养试验，58名婴儿被观察至52周龄。设立一个参考组，该组婴儿纯母乳喂养至少17周（n = 29）。观察指标包括出生时、6周龄、17周龄和52周龄婴儿的视网膜电图反应、视觉诱发电位以及血液脂肪酸分析。
在为期17周的喂养试验期间，与母乳喂养的婴儿相比，食用商业配方奶粉的婴儿总红细胞脂质中二十二碳六烯酸的含量低30%至50%。在1年随访时，显著差异仍然存在。商业配方奶粉组中花生四烯酸含量持续降低15%至20%。喂养富含长链多不饱和脂肪酸配方奶粉的婴儿，其血液脂质中的二十二碳六烯酸和花生四烯酸谱与母乳喂养婴儿相似。在6周龄时，接受这种强化配方奶粉喂养的婴儿比食用商业配方奶粉的婴儿有更成熟的视网膜电图反应。在17周龄和52周龄时，母乳喂养和富含二十二碳六烯酸配方奶粉喂养的婴儿视力均优于食用商业配方奶粉的婴儿。研究婴儿血液脂质中的早期（17周龄）脂肪酸谱与后期（52周龄）视觉功能发育相关。
该临床试验结果表明，足月婴儿配方奶粉中补充长链多不饱和脂肪酸可使血脂脂肪酸谱与母乳喂养婴儿相似。这种补充剂能使婴儿在生命后期（即一岁时）的视觉功能比食用商业配方奶粉的婴儿更好。
