Higher DHA Levels Improve Neurodevelopmental Outcomes in Premature Girls – Study

The randomized, double-blind, placebo-controlled study, "Neurodevelopmental Outcomes of Preterm Infants Fed High-Dose Docosahexaenoic Acid," compared the effects of a high concentration DHA diet with a standard DHA diet in premature infants born earlier than 33 weeks.

27/01/09 Tripling the level of DHA (docosahexaenoic acid) in the early diet of some of the smallest infants born prematurely improved the neurodevelopment outcome of girls, according to a study published in the January 14, 2009 issue of the Journal of the American Medical Association (JAMA). DHA is an important nutrient for brain, eye and overall infant development that is normally found in mother's milk and, in recent years, in infant formulas.

The randomized, double-blind, placebo-controlled study, "Neurodevelopmental Outcomes of Preterm Infants Fed High-Dose Docosahexaenoic Acid," compared the effects of a high concentration DHA diet with a standard DHA diet in premature infants born earlier than 33 weeks. Mothers participating in the study were encouraged to provide breast milk for their premature infants. An infant formula was available for mothers who could not provide breast milk or when additional nutrition was required.

The mothers of infants receiving breast milk were given either DHA supplements (900 mg per day) to increase the DHA levels of their milk or a matching placebo. The breast milk DHA level in the placebo treated mothers was approximately 0.25% (of total fatty acids) while that of the DHA treated mothers was approximately 0.85% (of total fatty acids).

Infants receiving formula were given either high concentration DHA infant formula (DHA= approximately 1.1% of total fatty acids) or standard DHA preterm formula (DHA = approximately 0.42% of total fatty acids). Both infant formulas also contained the omega-6 fatty acid, arachidonic acid (AA), another fatty acid important for infant development.

Enhanced or standard DHA supplementation was utilized until the expected full term delivery date (approximately nine weeks after birth). Infants received either breast milk exclusively, or a combination of breast milk and formula, or formula alone during this period.

The DHA and AA (also referred to as ARA) included in the infant formula were manufactured by Martek Biosciences Corp. The supplement given to the breast feeding mothers was not provided by Martek. Martek was not involved in the design, management or evaluation of the study.

At 18 months of age, the 657 infant subjects were evaluated using standard development tests. A preplanned analysis by gender found that premature girls on the high DHA diet achieved a mean score approximately five points higher on the mental development test than the girls receiving the standard DHA diet, resulting in approximately a 55 % reduction in mild mental delay and approximately an 80% reduction in significant mental delay, which were statistically significant improvements versus the control group. However, the same benefit was not found in the male infants, resulting in no statistically significant differences overall between all infants on high-dose DHA versus the control group.

The reason for the gender difference is unclear. The authors theorize that male infants may need a higher level of DHA than female infants in order to see benefit.

"Infants born prematurely do not have time to accumulate DHA to the same level as their full-term counterparts and this research indicates the requirements of DHA may be even higher for pre-term infants than previously thought," said Dr. Maria Makrides, the study's lead researcher and Deputy Director of the Women and Children's Health Research Institute, Adelaide, and professor of human nutrition, University of Adleaide in Australia. "We think the level of DHA used in this study should become the new 'gold standard' for preterm infants, whether it is supplied through breast milk or infant formula."

According to the study authors, the improvement in the developmental scores of the female infants may "...point the way for higher-dose interventions in future studies. Given the lack of an alternative therapy for cognitive delay in this group of infants and the apparent safety of the current dose of DHA, further studies are warranted."

"We are pleased to see research like this because it illustrates an important shift in the scientific dialogue about DHA," said Martek's Chief Scientific Officer, Norman Salem, Jr., PhD. "We are no longer debating whether DHA is beneficial to infants, but rather how much DHA is optimal. And, as this research indicates, it appears that enhancing DHA levels above the current standard in both breast milk and infant formula may be better, especially in the vulnerable preemie population."

Naturally present in human breast milk, DHA (docosahexaenoic acid), and ARA (arachidonic acid) are fatty acids important to infant development and growth. Clinical studies have demonstrated numerous benefits for infants receiving DHA and ARA supplemented formula, including improved mental and visual development. Martek's blend of DHA and ARA, life'sDHA & life'sARA, is the only source of these nutrients currently used in U.S. infant formula, and is present in more than 99 percent of infant formula sold in the U.S. Additionally, Martek is a leading global supplier of DHA and ARA and infant formulas containing Martek's nutritional oils are available in more than 75 countries worldwide.

Martek's DHA can also be found in a wide variety of prescription and over-the counter prenatal supplements around the world. Women of childbearing age who consume a typical Western diet are at risk for low stores of DHA. For example, pregnant and breastfeeding women in North America consume, on average, just 60-80 mg of DHA per day, far less than the 300 mg recommended by an expert body. DHA supplementation has been demonstrated to increase DHA levels in breast milk and thereby increase DHA levels in breastfed babies.