Phospholipid Species in Newborn and 4 Month Old Infants after Consumption of Different Formulas or Breast Milk

<div><p>Introduction</p><p>Arachidonic acid (AA) and docosahexaenoic acid (DHA) are important long-chain polyunsaturated fatty acids for neuronal and cognitive development and are ingredients of infant formulae that are recommended but there is no evidence based minimal supplementation level available. The aim of this analysis was to investigate the effect of supplemented AA and DHA on phospholipid metabolism.</p><p>Methods</p><p>Plasma samples of a randomized, double-blind infant feeding trial were used for the analyses of phospholipid species by flow-injection mass spectrometry. Healthy term infants consumed isoenergetic formulae (intervention formula with equal amounts of AA and DHA—IF, control formula without additional AA and DHA—CF) from the first month of life until the age of 120 days. A group of breast milk (BM) -fed infants was followed as a reference.</p><p>Results</p><p>The plasma profile detected in newborns was different from 4 month old infants, irrespective of study group. Most relevant changes were seen in higher level of LPC16:1, LPC20:4, PC32:1, PC34:1 and PC36:4 and lower level of LPC18:0, LPC18:2, PC32:2, PC36:2 and several ether-linked phosphatidylcholines in newborns. The sum of all AA and DHA species at 4 month old infants in the CF group showed level of 40% (AA) and 51% (DHA) of newborns. The supplemented amount of DHA resulted in phospholipid level comparable to BM infants, but AA phospholipids were lower than in BM infants. Interestingly, relative contribution of DHA was higher in ether-linked phosphatidylcholines in CF fed infants, but IF and BM fed infants showed higher overall ether-linked phosphatidylcholines levels.</p><p>Conclusion</p><p>In conclusion, we have shown that infant plasma phospholipid profile changes remarkably from newborn over time and is dependent on the dietary fatty acid composition. A supplementation of an infant formula with AA and DHA resulted in increased related phospholipid species.</p></div

Sum of all species containing docosahexaenoic acid (black bar) and arachidonic acid (white bars) in newborn (n = 231) and at 4 month feeding a control formula (CF, n = 79), intervention formula (IF, n = 83) or breast milk (BM, n = 91).

<p>Significant differences to newborn are marked with an asterisk.</p

Fatty acid content (g/100 mL) of the studied infant formulas.

<p>Fatty acid content (g/100 mL) of the studied infant formulas.</p

Median values and interquartile ranges (IQR) in % of total arachidonic acid and docosahexaenoic acid species in infant plasma at 4 month of age.

<p>Significant changes between groups are calculated by Mann-Whitney-U tests after Bonferroni correction and marked in gray.</p

Fatty acid (FA) composition of adipose tissue sites.

<p>Ratio of FA percentages in subcutaneous adipose tissue (sAT) and visceral adipose tissue (vAT) by chain length and number of double bonds.</p

Correlation of pNEFA and AT sites.

<p>Correlation coefficients (r) of plasma nonesterified fatty acids (pNEFA), subcutaneous adipose tissue (sAT) and visceral adipose tissue (vAT). FA are arranged by chain length and double bond number. Colour gradient with red (r = 0), yellow (r = 0.5) and green (r = 1). † p>0.001068.</p

Quantile regression models.

<p>Quantile regression models were established to predict visceral (vAT) and subcutaneous adipose tissue (sAT) by plasma nonesterified fatty acids (pNEFA)±BMI. For model comparison, ANOVA was performed whereas presented p-values indicate significant more explanation of variance with model containing pNEFA and BMI.</p

Fatty acid composition of plasma nonesterified fatty acids (pNEFA), subcutaneous adipose tissue (sAT) and visceral adipose tissue (vAT).

<p>Fatty acid (FA) percentage concentrations (mol%) of plasma nonesterified fatty acids (pNEFA), subcutaneous adipose tissue (sAT) and visceral adipose tissue (vAT) are given as median and interquartile range.</p><p>*- significantly higher in vAT compared to sAT, +- significantly lower in vAT compared to sAT; Wilcoxon test adjusted for multiple testing with Sidak correction: significance is assumed with p<0.001068 achieving a global significance level of 0.05.</p

Regression models for AT FA and pNEFA.

<p>Comparison of analysed subcutaneous (sAT) and visceral adipose tissue (vAT) fatty acid composition and predicted AT fatty acid composition by using different multiple linear regression models with pNEFA (blue squares) or pNEFA+BMI (orange circles).</p

Anthropometry and body composition at 4 years of age (intention-to-treat population).

<p>Anthropometry and body composition at 4 years of age (intention-to-treat population).</p