Recommended DHA Intakes for Pregnancy/Lactation
Koletzko et al. British Journal of Nutrition. 98: 873-877 (2007)
Dr. von Hauner Children’s Hospital, University of Munich, Germany Department for Health of Woman, Child and Neonate, IRCCS Foundation Po.Ma.Re., University of Milan, Italy
The European Commission charged the PERILIP (Perinatal Lipid Intake working group) together with the Early Nutrition Programming Project to develop recommendations on dietary fatty acid intakes during pregnancy and lactation. The process involved major evidence-based literature reviews and a consensus conference held with international experts in the field including representatives of various international scientific associations with expertise related to the topic. One of the important conclusions on recommendations was advising an average dietary intake of at least 200mg DHA per day for pregnant and lactating women to support the availability of this physiologically-essential nutrient for the baby during fetal life and early post-natal life. The consensus statement also concluded that the intake of alpha-linolenic acid, a precursor for DHA formation (via metabolism), is much less effective with regard to DHA deposition in fetal brain than the intake of preformed DHA. The report also indicated that DHA intakes up to 1000mg per day had been used in randomized trials without occurrence of significant adverse effects. Finally, the committee indicated that women of child-bearing age can meet the recommended intake of DHA by consuming 1-2 portions of sea fish per week assuming that the source is an oily fish enriched in DHA. Avoiding certain species of fish which may be contaminated with environmental needs consideration and appropriate advice. In this regard, the statement indicates ‘dietary fish should be selected from a wide range of species without undo preference for large predatory fish, which are more likely to be contaminated with methyl mercury’.
Dr. Holub's Comments:
It should be pointed out that a published paper from our research group in 2005 (J. Nutr. 135:206-211 (2005)) directly quantified dietary omega-3 intakes in pregnant Canadian women and found the average daily intake to be only 82mg DHA. This average intake is only 40% of the recommendation from the working group (see above). This low intake of DHA in pregnancy (and likely also similar intakes during lactation) of DHA reflects an average North American fish intake of approximately 1 serving every 8-11 days. Furthermore, approximately 50% of women in North America are likely to be consuming DHA at intake levels below 82mg/day. It is anticipated that influential North American associations and medical groups will carefully evaluate these recommendations on behalf of the European Commission. Such North American recommendations can be expected to have a major impact in enhancing DHA omega-3 intakes during pregnancy and lactation in the United States and Canada and therefore providing increased deliveries of this important nutrient for infants and young children.