DHA Intakes Lower than Recommended Among Infants in Developing Countries
Forsyth, S. et al., Ann. Nutr. Metab., 70: 1-11, 2017
School of Medicine, Univ. of Dundee, West Ferry, Dundee, UK and DSM Nutritional Products, Columbia, Maryland, USA
Recommended intakes of long-chain omega-3 fatty acids as DHA (docosahexaenoic acid) and DHA plus EPA (eicosapentaenoic acid) have been forthcoming for various sectors of the population with an emphasis on DHA as well as AA (arachidonic acid omega-6) for infants and young children from various organizations and health agencies. These fatty acids are found primarily in animal-derived food sources (fish/seafood, meats/poultry, eggs). Since plant-based foods are commonplace in developing countries, the intakes of these long-chain polyunsaturated fatty acids as needed particularly for supporting growth, development, and other health outcomes in such populations was studied. Thus, dietary data as extracted from Food Balance Sheets as collected by the FAO Statistics Division and food composition tables were utilized to provide median per capita intakes for DHA (and AA) in 175 countries worldwide (of which 128 were recognised as developing nations).
Wide variances were found for food sources containing DHA with fish/seafood products being the predominant sources (median intakes ranging from 5.7 gm/capita/day in Central Asia to 80.8 gm/capita/day in East Asia). In the lowest-income countries, the per capita median intake of DHA and AA was 41 and 39 mg/day, respectively. For the total countries studied (economic status combined), the median intake of DHA/young child (6-36 months)/day was 25.6 mg from breast milk and 14.6 mg from complementary foods. The corresponding intakes for AA were 39.4 and 17.9 mg/day, respectively. Median DHA intakes ranged from 48.1 to 64.3 mg/day for children aged 3-7 years. The authors concluded that estimates of DHA (and AA) intakes in developing countries worldwide indicate that many infants and young children are ingesting low levels of these metabolically important polyunsaturated fatty acids.
Dr. Holub's Comments:
The present investigation emphasizes the widespread global deficiencies among the very young in the dietary intakes of long-chain polyunsaturated fatty acids. With respect to recommended DHA intakes during infancy (from 0-6 months) from the FAO of the United Nations (equivalence of at least 102 mg/day) or an intake of at least 100 mg DHA/day from the European Food Safety Authority for older infants and young children , it is apparent that the vast majority of infants and young children in developing countries fall well short of these target intakes for supporting optimal health outcomes as mediated by DHA omega-3 fatty acid. With respect to breast milk providing term infants with at least 100 mg DHA/day, such can be readily provided in the vast majority simply by increasing maternal DHA intakes (from selected DHA-containing foods and/or DHA supplementation). Increasing maternal intakes during lactation to approximately 300 mg DHA/day can, within 2-3 weeks, elevate breast milk levels to approx. 0.32 to 0.35 % of total fatty acids (thereby providing at least 100 mg DHA/term infant/day).