Docosahexaenoic acid (DHA), essentiality and requirements: why and how to provide supplementation
DOI:
https://doi.org/10.3989/gya.2006.v57.i2.43Keywords:
Docosahexaenoic acid, Brain development, Docosahexaenoic acid supplementation, Docosahexaenoic acid sourcesAbstract
Lipids comprize from 50-60% of the structural matter of the brain and docosahexaenoic acid (C22:6, DHA) is the most important omega-3 long-chain polyunsaturated fatty acid in the brain phospholipids comprizing 25% of the total fatty acids of the grey matter. The majority of the DHA present in the human brain is incorporated during the brain growth spurt which starts at week 26 of gestation and imposes a high demand for the fatty acid until about 2 years of age. DHA is required during brain development when neuronal and glial differentiation and migration, and active myelination and synaptogenesis take place. The fatty acid must be incorporated into the brain lipids as preformed DHA because less than 5% of its precursor (alpha linolenic acid, LNA) is converted to DHA. The human foetus has a limited ability to synthesize DHA from LNA, and therefore it must be largely supplied from maternal sources. Maternal DHA available for foetal nutrition can be provided from three main sources: adipose tissue, which is the main reservoir for the fatty acid; through biosynthesis from the precursor LNA, which occurs mainly in the liver; and as preformed DHA from dietary sources. In the postnatal period DHA is provided by the mother to the newborn through milk secretion. Western nutrition provides low LNA and DHA and Expert Nutrition Committees suggest that mothers should receive DHA supplementation during pregnancy and lactation. At present DHA supplementation can be provided from different sources: as purified free DHA, as an ethyl ester derivative, extracted from single-cell algae oils, from egg yolk phospholipids, or in the form of sn-2 DHA monoacylglycerol. In this review we revise and discuss the evidence of DHA requirements for the newborn, the need for maternal supplementation during pregnancy and nursing, and the alternatives at present for providing DHA supplementation.
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