Highlights
- •Current infant formulas provide DHA and ARA.
- •Our results support a DHA: ARA ratio of 1:1 or 1:2.
- •A DHA intake exceeding ARA intake reduced benefit in some cognitive measures.
- •Declining RBC ARA implicates dietary DHA/ARA balance in cognitive outcomes
Abstract
The DHA Intake and Measurement of Neural Development (DIAMOND) trial represents one of only a few studies of the long-term dose-response
effects of LCPUFA-supplemented formula feeding during infancy. The trial contrasted
the effects of four formulations: 0.00% docosahexaenoic acid (DHA)/0.00% arachidonic
acid (ARA), 0.32% DHA/0.64% ARA, 0.64% DHA/0.64% ARA, and 0.96% DHA/0.64% ARA against
a control condition (0.00% DHA/0.00% ARA). The results of this trial have been published
elsewhere, and show improved cognitive outcomes for infants fed supplemented formulas,
but a common finding among many of the outcomes show a reduction of benefit for the
highest DHA dose (i.e., 0.96%DHA/0.64% ARA, that is, a DHA: ARA ratio 1.5:1.0). The
current paper gathers and summarizes the evidence for the reduction of benefit at
this dose, and in an attempt to account for this reduced benefit, presents for the
first time data from infants’ red blood cell (RBC) assays taken at 4 and 12 months
of age. Those assays indicate that blood DHA levels generally rose with increased
DHA supplementation, although those levels tended to plateau as the DHA-supplemented
level exceeded 0.64%. Perhaps more importantly, ARA levels showed a strong inverted-U
function in response to increased DHA supplementation; indeed, infants assigned to
the formula with the highest dose of DHA (and highest DHA/ARA ratio) showed a reduction
in blood ARA relative to more intermediate DHA doses. This finding raises the possibility
that reduced ARA may be responsible for the reduction in benefit on cognitive outcomes
seen at this dose. The findings implicate the DHA/ARA balance as an important variable
in the contribution of LCPUFAs to cognitive and behavioral development in infancy.
Abbreviations:
ARA (arachidonic acid), DHA (docosahexaenoic acid), DIAMOND (DHA intake and measurement of neural development)Keywords
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Article info
Publication history
Published online: May 31, 2017
Accepted:
May 30,
2017
Received in revised form:
April 24,
2017
Received:
January 11,
2017
Footnotes
☆Mead Johnson Nutrition provided support for the parent DIAMOND study and for investigators at both Dallas and Kansas City sites to follow the long term development of these children, results of which are reviewed here.
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
