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

Barplot comparing plasma concentrations of tricarboxylic acid cycle intermediates and keto acids across trimesters among pregnant women.

<p>Median (+ Interquartile range/2) was plotted * p-value < 0.00017, p-value was calculated by Mann-Whitney U Test between trimesters.</p

Barplot comparing plasma non-esterified fatty acid concentrations across trimesters among pregnant women.

<p>Median (+ Interquartile range/2) was plotted * p-value < 0.00017, p-value was calculated by Mann-Whitney U Test between trimesters.</p

Barplot comparing metabolic ratios as indicators of β-oxidation (right) and carnitine palmitoyl transferase-1 activity (left) across trimesters among pregnant women.

<p>Median (+ Interquartile range/2) was plotted * p-value < 0.00017, p-value was calculated by Mann-Whitney U Test between trimesters.</p

Altered NEFA pathways in cases compared to controls.

<p>At an exploratory level of significance (p<0.05), the women after GDM exhibited reduced levels of 12:0, 14:0, 16:0, 18:0, 26:0 and total SFA and elevated levels of 18:1, the essential fatty acid 18:2, total n-6 NEFA and the proportion of total n-6/n-3 NEFA. Calculated SCD-1 activity was significantly increased in the post-GDM group. Only total SFA remained significantly different after Bonferroni correction. The red arrows in the diagram represent upregulation, and the blue arrows represent downregulation in the post-GDM group.</p

Spearman correlation coefficients of selected fasting serum NEFA species with parameters of body composition.

<p>All nonesterified fatty acid (NEFA) species with a Spearman correlation coefficient ρ≥0.3 with any of the listed parameters of body composition are shown in the table. The post-GDM and the control group were combined for this analysis. n = 106 for BMI, WC and percent body fat measured by BIA. n = 62 for the MRI substudy.</p><p>*Correlation is significant with p<0.05.</p><p>**Correlation is significant with p<0.01.</p><p>***Correlation is significant with p<0.001.</p><p>Spearman correlation coefficients of selected fasting serum NEFA species with parameters of body composition.</p