Okai-Mensah Pervy, Brkić Diandra, Hauser Jonas
Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S. A., Lausanne, Vaud, Switzerland.
Front Nutr. 2025 Jun 24;12:1488647. doi: 10.3389/fnut.2025.1488647. eCollection 2025.
This review focuses on the effects of polyunsaturated fatty acids (FA) supplementation on neurodevelopmental outcomes in the first year of life in low- and middle-income countries (LMIC). Lipids are an essential part of early life diet; they provide crucial FAs for brain development and healthy growth. The high cost of relevant food sources providing specific FAs restricts their use and consumption in LMIC where more than 3 billion people cannot afford a healthy diet. This narrative review summarizes current knowledge extracted from 24 studies on the impact of specific FAs on neurodevelopment from birth to 12 years of age, with a particular focus on LMICs. We illustrate that most studies focus on effects of polyunsaturated FAs supplementation on neurodevelopmental outcomes in the first year of life. The strongest evidence in the literature is on supplementation during pregnancy with omega-3 fatty acids, in particular alpha-linolenic acid (ALA) and omega-6 fatty acids, in particular linoleic acid (LA), which show promising effects on infant neurodevelopmental outcomes in LMIC. These two essential fatty acids (EFAs) are key substrates necessary to synthesize the long-chain poly-unsaturated fatty acids (LC-PUFA) docosahexaenoic acid (DHA) and arachidonic acid (ARA), which have been reported to be important for neurodevelopment. For the postnatal supplementation we did not observe a clear consensus across studies, either due to mixed finding before 2 years of life or due to the low number of studies beyond 2 years of life. Differences across studies in the choice of FAs, dosage, treatment windows, age and type of neurodevelopment assessments likely contribute to the complexity of the results observed in the studies investigating postnatal supplementation. Finally, this review underlies the need for more research into FAs that support optimal development of children in LMICs and highlight the importance to find affordable solutions without compromising on quality.
本综述聚焦于在低收入和中等收入国家（LMIC）补充多不饱和脂肪酸（FA）对生命第一年神经发育结局的影响。脂质是早期饮食的重要组成部分；它们为大脑发育和健康成长提供关键脂肪酸。提供特定脂肪酸的相关食物来源成本高昂，限制了它们在低收入和中等收入国家的使用和消费，在这些国家，超过30亿人无力负担健康饮食。本叙述性综述总结了从24项关于特定脂肪酸对出生至12岁神经发育影响的研究中提取的现有知识，特别关注低收入和中等收入国家。我们表明，大多数研究聚焦于补充多不饱和脂肪酸对生命第一年神经发育结局的影响。文献中最有力的证据是孕期补充ω-3脂肪酸，特别是α-亚麻酸（ALA）和ω-6脂肪酸，特别是亚油酸（LA），这对低收入和中等收入国家的婴儿神经发育结局显示出有前景的影响。这两种必需脂肪酸（EFA）是合成对神经发育很重要的长链多不饱和脂肪酸（LC-PUFA）二十二碳六烯酸（DHA）和花生四烯酸（ARA）的关键底物。对于出生后补充，我们在各项研究中未观察到明确的共识，这要么是由于2岁前的研究结果不一，要么是由于2岁后研究数量较少。各项研究在脂肪酸选择、剂量、治疗窗口期、年龄和神经发育评估类型方面的差异，可能导致了在调查出生后补充的研究中观察到的结果的复杂性。最后，本综述强调了对支持低收入和中等收入国家儿童最佳发育的脂肪酸进行更多研究的必要性，并突出了在不降低质量的前提下找到经济实惠解决方案的重要性。
