Makrides M, Neumann M, Simmer K, Pater J, Gibson R
Department of Paediatrics and Child Health, Flinders Medical Centre, Bedford Park, Adelaide, Australia.
Lancet. 1995 Jun 10;345(8963):1463-8. doi: 10.1016/s0140-6736(95)91035-2.
We investigated whether the disparity in neural maturation between breastfed and formula-fed term infants could be corrected by the addition of fish oil, a source of docosahexaenoic acid (DHA, 22:6 omega 3), to infant formula. Healthy, term infants were randomised at birth to receive either a supplemented or placebo formula if their mothers had chosen to bottle feed. Breastfed term infants were enrolled as a reference group. Infant erythrocyte fatty acids and anthropometry were assessed on day 5 and at 6, 16, and 30 weeks of age. Visual evoked potential (VEP) acuity was determined at 16 and 30 weeks. VEP acuities of breastfed and supplemented-formula-fed infants were better than those of placebo-formula-fed infants at both 16 and 30 weeks of age (p < 0.001 and p < 0.01). Erythrocyte DHA in breastfed and supplemented-formula-fed infants was maintained near birth levels throughout the 30-week study period but fell in placebo-formula-fed infants (p < 0.001). Erythrocyte DHA was the only fatty acid that consistently correlated with VEP acuity in all infants at both ages tested. A continuous supply of DHA may be required to achieve optimum VEP acuity since infants breastfed for short periods (< 16 weeks) had slower development of VEP than infants receiving a continuous supply of DHA from either breastmilk or supplemented formula. Erythrocyte arachidonic acid (20:4 omega 6) in supplemented-formula-fed infants was reduced below that of infants fed breastmilk or placebo formula at 16 and 30 weeks (p < 0.001), although no adverse effects were noted, with growth of all infants being similar. DHA seems to be an essential nutrient for the optimum neural maturation of term infants as assessed by VEP acuity. Whether supplementation of formula-fed infants with DHA has long-term benefits remains to be elucidated.
我们研究了在婴儿配方奶粉中添加鱼油（二十二碳六烯酸，DHA，22:6 ω-3的来源）是否能够纠正母乳喂养和配方奶喂养足月儿之间神经成熟度的差异。如果母亲选择奶瓶喂养，健康足月儿在出生时被随机分配接受添加了鱼油的配方奶粉或安慰剂配方奶粉。母乳喂养的足月儿作为参照组。在出生第5天以及6周、16周和30周龄时评估婴儿红细胞脂肪酸和人体测量指标。在16周和30周龄时测定视觉诱发电位（VEP）视力。在16周和30周龄时，母乳喂养和添加鱼油配方奶粉喂养婴儿的VEP视力均优于安慰剂配方奶粉喂养的婴儿（p < 0.001和p < 0.01）。在整个30周的研究期间，母乳喂养和添加鱼油配方奶粉喂养婴儿的红细胞DHA维持在接近出生时的水平，但安慰剂配方奶粉喂养的婴儿红细胞DHA水平下降（p < 0.001）。在两个测试年龄的所有婴儿中，红细胞DHA是唯一始终与VEP视力相关的脂肪酸。由于短期母乳喂养（< 16周）的婴儿VEP发育比从母乳或添加鱼油配方奶粉中持续获得DHA的婴儿慢，可能需要持续供应DHA才能达到最佳VEP视力。在16周和第30周时，添加鱼油配方奶粉喂养婴儿的红细胞花生四烯酸（20:4 ω-6）低于母乳喂养或安慰剂配方奶粉喂养的婴儿（p < 0.001），尽管未观察到不良反应，所有婴儿的生长情况相似。通过VEP视力评估，DHA似乎是足月儿最佳神经成熟所必需的营养素。给配方奶喂养的婴儿补充DHA是否有长期益处仍有待阐明。
