Crawford Michael A, Wang Yiqun, Forsyth Stewart, Brenna J Thomas
Reproductive Physiology, Chelsea and Westminster Hospital Campus of Imperial College, London SW10 9NH, UK.
Reproductive Physiology, Chelsea and Westminster Hospital Campus of Imperial College, London SW10 9NH, UK.
Prostaglandins Leukot Essent Fatty Acids. 2015 Dec;102-103:1-3. doi: 10.1016/j.plefa.2015.07.005. Epub 2015 Sep 21.
The European Food Safety Authority (EFSA) has concluded from a limited review of the literature that although docosahexaenoic acid (DHA) is required for infant formula, arachidonic acid is not required "even in the presence of DHA" (EFSA Journal, 12 (2014) 3760). This flawed opinion is grounded in human trials which tested functionality of DHA in neural outcomes and included arachidonic acid ostensibly to support growth. The EFSA report mistakes a nutrient ubiquitous in the diets of newborn infants, through breast milk and with wide-ranging health and neurodevelopmental effects, for an optional drug targeted to a particular outcome that is properly excluded when no benefit is found for that particular outcome. Arachidonic acid has very different biological functions compared to DHA, for example, arachidonic acid has unique functions in the vasculature and in specific aspects of immunity. Indeed, the overwhelming majority of trials include both DHA and arachidonic acid, and test development specific to DHA such as neural and visual development. DHA suppresses membrane arachidonic acid concentrations and its function. An infant formula with DHA and no arachidonic acid runs the risk of cardio and cerebrovascular morbidity and even mortality through suppression of the favorable oxylipin derivatives of arachidonic acid. The EFSA recommendation overruling breast milk composition should be revised forthwith, otherwise being unsafe, ungrounded in most of the evidence, and risking lifelong disability.
欧洲食品安全局(EFSA)通过对文献的有限审查得出结论,尽管婴儿配方奶粉需要二十二碳六烯酸(DHA),但花生四烯酸“即使在有DHA的情况下”也并非必需(《EFSA杂志》,12(2014)3760)。这一有缺陷的观点基于人体试验,这些试验测试了DHA在神经发育方面的功能,表面上添加花生四烯酸是为了支持生长。EFSA的报告将一种通过母乳存在于新生儿饮食中、具有广泛健康和神经发育影响的营养素,错误地当作一种针对特定结果的可选药物,当未发现该特定结果有任何益处时就将其合理排除。与DHA相比,花生四烯酸具有非常不同的生物学功能,例如,花生四烯酸在脉管系统和免疫的特定方面具有独特功能。事实上,绝大多数试验同时包括DHA和花生四烯酸,并测试了特定于DHA的发育情况,如神经和视觉发育。DHA会抑制膜花生四烯酸的浓度及其功能。一种含有DHA但不含花生四烯酸的婴儿配方奶粉,存在通过抑制花生四烯酸有益的氧化脂质衍生物而导致心脑血管疾病甚至死亡的风险。EFSA否决母乳成分的建议应立即修订,否则既不安全,在大多数证据上也无依据,还可能导致终身残疾。