Why ARA & DHA matter: Key lipids shaping infant development
31 Mar 2026 | dsm-firmenich
Arachidonic acid (ARA) and docosahexaenoic acid (DHA) are critical long-chain polyunsaturated fatty acids supporting infant development—yet their roles, interplay, and optimal balance are often misunderstood.
In this webinar, global pediatric nutrition expert Prof. Bert Koletzko will explore why both ARA and DHA are important throughout infancy, highlighting their impact on brain growth, cognitive maturation, and overall physiological functions.
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Hello and welcome to today's webinar titled Why ARA and DHA Matter Key Lipis Shaping Infant Development.
This webinar is sponsored by DS Infermich.
My name is Joan van Hal.
I am the editor of Nutrition Insights.
Nutrition Insight is a world-leading B2B news and insights website published by CNS Media.
We are joined today by the global pediatric nutrition expert, Doctor Bertolt Kuletzko, who is a professor at LMU University Hospitals in Munich, Germany.
In a short while, Doctor Kolleko will explain why ARA and DHA are both important throughout infancy.
Drawing on decades of clinical research and global scientific insights, Professor Koletzko will explain how infants accumulate these fatty acids during the 1st 1000 days of life, why pre-formed sources are crucial, and how dietary supply, whether through human milk or infant formula, positively shapes key developmental outcomes, including neurodevelopmental outcomes.
Before we get started, I'd like to remind all of you listening today that you can submit your questions to our speaker through the Q&A engagement tool.
Any questions that we don't have time to respond to during today's session can be answered over email following the presentation.
This webinar will also be available on-demand on nutritionInsight.com.
A link to view this on-demand webinar will be emailed to you after its conclusion.
And with that, let's begin today's webinar with our speaker presentation before we round up with a Q&A session.
Over to you, Doctor Professor Kollezko.
Good day everyone.
It's a great pleasure to share with you some thoughts on why eddonic acid, Ara and docozyxonic acid DHA matter in infant development.
Let me start with my disclosures.
I'm grateful for the support of DSM Firmanage for this webinar.
I admit that I'm biased towards breastfeeding and the work of our group is funded mostly by public agencies in Germany and Europe.
So what I would like to touch upon in this presentation is the story of the recall of infant formula in a number of countries since the end of 2024 because of a contamination with the toxin cellulite.
And the related questions that have been raised whether the source of arhydonic acid that was the cause of the contamination is really necessary or rather was the hydonic acid is necessary in ancient formula.
So to discuss that, I would like to touch upon.
DHA and hydonic acid, their characteristic metabolic pathways and perinatal supply, and look at some results of clinical studies that relates to supply to visual development, cognition and asthma risk, show you some very intriguing results on the interaction between diet and genotype and their impact on function.
And some results of systematic reviews and meta-analysis of randomized controlled trials that conclude that optimal development is achieved with adding both hydronic acid and DHA in a ratio between 1 and 2 to 1.
And finally, conclude with the recommendations of the European Academy of Pediatrics and the European Society of Pediatric Gastroenterology, Hepatology and Nutrition as begun on the supply with infant formula.
So the whole discussion started with the observation that infant formula from at least 4 manufacturers in Europe were contaminated with a toxin that is produced by the bacteria Bacillus.
Serious and in fact there was no live bacteria in the formula detected, but there was just the toxin there in variable amounts, a toxin that is known to cause, particularly in young infancy, gastrointestinal symptoms.
A lot of concern has arisen, of course, and there was a lot of public discussion about this and uncertainties among families.
The root of the problem was an oil providing arthrodonic acid from one single supplier.
And because of that, the question has been raised whether the addition of iodonic acid in infant formula is really necessary or whether the whole thing could have been avoided if you just throw out iodonic acid from formula.
So let's look at the role of the essential polyunsaturated fatty acids in early infancy.
We all know we depend on a regular supply from these essential fatty acids, and we get the precursor for PUFAs, linoleic acid, and alphaleleic acid in usually ample amounts with the consumption of vegetable oils.
We also know that the biological effects are to a large part mediated not by the precursor profile or by the long chain polyunsaturated fatty acid metabolites, RNR and DHA.
These metabolites can be synthesized from the vegetable oil precursors by a complex system of desaturating and elongating enzymes in our body.
However, the activity of these enzymes is pretty slow, pretty low in humans, and on top of that, there's quite a variation on our ability of conversion, converting this profile depending on our genotype.
So supply matters both for the status of precursor profile and the long chain metabolites.
The consumption of the long chain proof metabolites in early life is pretty high because there is ample amounts needed for tissue deposition, in addition to catabolism by oxidation and metabolic conversion, and in fact, in infants, the rate of disappearance, primarily for disappear tissue tissue deposition, I'm sorry.
Is greater than the rate of synthesis from the precursor profile profile.
Therefore, the observation has been made for many years that infants fed the old style infant formula, providing only linolate and alphalinic acid very rapidly, show a depletion of the plasma and consecutive tissue levels of arthrodomic acid and DHA.
So let's look at these two fatty acids, RR and DHA.
Both are not found in vegetable oils, but only animal lipids, hydronic acid, in a variety of animal lipids, DHA primarily in marine foods, in oily fish, and other seafoods.
They comprise a large part of tissue, omega 6 and omega 3 fatty acids.
Respectively, hydonic acid contributes about half of all the omega 6 fatty acids in the brain, and DHA contributes almost all of the omega 3 fatty acids in the brain and the largest part of the omega 3 fatty acids in the retina, where it is very important for the function of the retinal photoreceptor.
Now, they're not just sitting there, they're in intrinsic and essential elements of the cell membranes in brain tissue, and likewise in other tissues like immune cells, and thereby they influence the function of cell membranes and of tissues, the information processing, and other other functions of the tissues.
Now we said the infants cannot synthesize enough arhydronic acid and DHA themselves to maintain plasma and tissue levels as they have been at birth, but they are supplied preferentially.
We are.
The placenta prenatally there's an active transport mechanism and also breastfeeding always provides arrodonic acid and DHA.
Therefore, in early life, the endogenous synthesis is backed up by an additional security mechanism if you like.
They are biologically important.
A was shown to affect cell growth.
It's a precursor of immune mediators and other cell regulator metabolites like osanoids, thromboxanes, prostaglandins, and others.
DHA status in pregnancy was shown to have a marked effect on the risk of preterm births.
If you have a good supply of DHA, a good status of DHA, when women go into pregnancy, the risk of preterm births, particularly of early preterm births before 34 weeks, is markedly reduced.
It's also important for its shown relationship to the risk of postpartum depression.
In infants and children, DHA was linked to visual and cognitive development and to a risk reduction for asthma and infections.
Now if you look at the brain, we see that rather large amounts of RR and DHA are deposited in the brain tissues during the period of rapid brain growth from the last part of pregnancy onwards to about the age of 2 years, and you see here that both in utero and after term birth, there is more hydonic acid deposited in the brain than omega 3 DHA.
Again, the fetus is provided with both iodonic acid and DHA by an active placetal transfer.
These fatty acids can come either from the maternal diet, for example, fish consumption in pregnancy will have a marked effect on DHA supply to the fetus, and of course there's also maternal body stores maternal synthesis.
The plantar center itself has a very low activity synthesis, as does the fetus, so the fetusus really depends on the supply from the mother.
After birth, likewise, human milk always provides hydonic acid and DHA.
Worldwide, the hydronic acid content in human milk is about 0.5% of the fatty acids, and the coefficient of variation is pretty low, only 29%.
In other words, hydonic acid levels in your milk are very stable.
They're not much affected by maternal diet or lifestyle.
In contrast, omega 3 DHA, which is lower in human milk on average 0.3% in hydronic acid, has a much higher degree of variation.
The CV here is 69%, so the omega 3 DHA content in human milk depends very much on maternal intake, particularly from marine food sources.
What is interesting to see is that several studies have shown that yonic acid and DHA in human milk correlate.
You see it here are two examples in the study that we performed in women in Germany in term infants.
And on the right in a study in Canada where milk provided by mothers of preterm infants was, was studied and you see in both cases, there is this correlation between argydonic acid and DHJ.
In other words, the ratio between the two is relatively stable.
In both cases, it's close to 2 almost twice as much hydronic acid as DHA.
In human milk, which is typically found in many populations around the world except for populations that have a very high marine food intake.
So it's tempting to speculate that this mechanism could be there to protect the infant from an unbalanced ratio of hydonic acid to DHA.
Is it important to supply for infant development?
Yes, it is.
There's a number of studies that have related the supply of DHA alone or DHA combined with sulfonic acid in the first year of life.
We see visual function, the visual acuity achieved at the age of one year.
You see here a.
Of studies that show that if you provide a guide to DHA through the first year of first year of life, you have at one year about a 1.5fold benefit in your visual acuity.
The European Food Safety Authority has concluded on the basis of these and other data that a cause and effect relationship has been established between DHA supply with infant formula and visual function and concluded that one needs to provide at least 0.3% of the fatty acids in the diet with DHA to achieve an appreciable benefit for visual development.
Around the world, several bodies, authoritative bodies have provided advice on the adequate intake of these fatty acids in early infancy in the first half year of life, and you see they're pretty much aligned in that all of them here, the World Health Organization, the European Food Safety Authority, the Dutch and the French national authorities, they all conclude that infants should be provided both with argydonic acid and DHA.
And with more argydonic acid than DHA, somewhere between 1.5 to 2fold more RR than DHA.
In the European Union, legislation demands today that all infant and follow on formula must contain DHA in amounts between 20 to 50 mg per 100 kilocalories.
So that's depending on the fat content, somewhere in the range of about 0.3 to 1% of DHA of the total fatty acids.
And argydonic acid may be added, but there is no legal requirement and no defined amount of the addition of argdonic acid.
However, most infant formulas in Europe and in fact many around the world, if not most, provide DHA along with.
Could one just leave out the odonic acid and just have infant formula with DHA?
It's a novel concept to provide DHA only.
It has not been tested adequately in randomized trials.
However, infant formula with 0.3% DHA or more and hydronic acid to DHA ratio of at least 1, usually in the range between 1 to 2 to 1, have been studied in numerous trials and used around the world for many years without any concerns arising regarding suitability and safety.
And clinical experimental data on formula with arthrodonic acid less than DHA in formula really question the suitability and safety.
Let me show you some indications.
This is a very impressive study published by Professor John Colombo a number of years ago where he randomized a large group of babies, healthy term babies, to 4 different infant formulas.
They were similar in composition except for the fatty acid profile.
On the left, you see infants randomized to or the formula that the infants were randomized that provided no DHA and hydonic acid.
The other three formulas provided the same amount of arhydonic acid, 0.6%, and different amounts of DHA 0.6, 0.3.6%, and 1% of DHA.
And you would have thought maybe the more the better, you get better results with the highest amounts of DHA along with argonic acid.
However, if you increase the DHA without adapting arhydonic acid, you also change the ratio of raidonic acid to DHA from 2 to 1 to 0.5.
So let's see what the results were of this study.
What you see is that in this test of executive function at the age of 4 years, adding DHA and iodonic acid improved the outcome.
The infants did better at 4 years.
With 0.3%, they did better, with 00.6% DHA they did it even had an even greater benefit.
But if you then went up with more DHA, the result was again attenuated.
So if you have higher DHA intake but a reduced alkydonic acid to DHA ratio, the result becomes worse again compared to a higher ratio.
And you see the same for language development here at 5 years.
Adding LCPA, DHA and RR improved language development in 5 years.
But then if you increase DHA further and thereby reduce the RR to DHA ratio, again, the result was attenuated.
The the result was not as good as with an RRDHA ratio to 2 of 2 to 1.
Studies in non-human primates in infant baboons fed with similar variations of the fatty acids in the formula showed that also with a high DHA and low arhydonic acid to DHA ratio, the brain composition was distorted, the brain hydonic acid was reduced in different brain regions.
So that is raising concerns, of course.
What about our natural model of infant feeding, breastfeeding as our preferred way of infant feeding.
Several studies like this one performed on behalf of the World Health Organization showed that populations of breastfed babies tend to have a better cognitive development compared to infants fed formula at that time without added DHA and hydronic acid.
On average, if you adjust for confounders including maternal IQ, There's a 2.6 IQ point benefit, not a huge effect size, but on a population basis, very relevant.
So the question has been raised, is that related to argydonic acid and DHA status?
And if so, would then also the genotype that determines the synthesis synthesis of these fatty acids matter?
There , complicated pathway that I alluded to before for the synthesis of the LCpha from the vegetable oil, fatty acids on the top, on the left, omega 6 linoleic acid being converted by a series of desaturating and elongating enzyme mediated steps to hydronic acid, and on the right, omega 3 alpha linoleic acid.
Converted by a longer and more complex pathway to DHA.
And you, as you would guess from this pathway, the synthesis of DHA is less effective than the endogenous synthesis of iodonic acid.
What's more, the rate of synthesis is very much influenced by genotype variations, genotypes that encode these enzymes.
For the saturating enzymes, these genes are on our chromosome 11, and about 500 single nuclear polymorphisms have been reported, and they have a marked effect on the activity of the enzyme.
So, If you have, and this is a study we published many years ago on human adults on self-selected diet, if you have the major fungus genotype that carry European or Caucasian people, or 3 or 4 Caucasians, then you have an active conversion.
You have in the blood less linoleic acid and more of the product, more archidonic acid.
With the less common allele in Caucasians carried by 25% of Europeans, you have an inactive conversion where in the blood you have more linoleic acid and less ydonic acid.
And it's impressive to see that the genotype alone explains about 30% of bloodydonic acid variation in adults on self-selected dyes.
That's a big effect size, much bigger than we could ever achieve with varying the dietary intake in humans.
Now we've studied this also in babies.
This is a study in human term infants, and you see a very similar result.
The FUS gene variation has a marked effect on omega 6 LC profile synthesis, explains about 20% of the variation of iodonic acid, even 35% of the variation of the hydonic acid precursor GGLA.
But it has surprisingly little effect on the synthesis of DHA, and I remind you again that the synthesis of DHA is far more complex and much less effective and perhaps therefore we see less of an influence on the omega 3.
So the important message here is that genotype variation affects particularly the yamic acid formation.
One more point I would like to make is that this genotype variation has a very different distribution in different populations around the world.
As I said before, in Caucasians, you find the majority of people having an active convergence.
However, in most Asian populations and also in Latin American populations influenced by the genotype.
Of American Indians, the dominant genotype is that of a slow converter.
So if you think of that, the provision of pre-formed LCua is even more important in Asia, in Latin America compared to Europe.
Now does it matter?
This is an impressive study in almost 6000 children in the UK that were tested for IQ at school age at the age of 8 years, and this was related to the genotype of the FAS genome predicting the activity of endogenous synthesis.
And what you see here in children that were fed infant formula in the first year of life with no argonic acid and DHA.
There is an interaction with the genotype with the children having the GG genotype having by far the lowest IQ with a marked difference compared to the other genotypes.
These are children who do not synthesize arhydonic acid or synthesize it in very low amounts, and they have a disadvantage for IQ development.
Now of importance, the genotype distribution is basically at random.
It doesn't relate to lifestyle choices, socioeconomic status, or other factors that you might relate to IQ development at school age.
Now interestingly, if you compare this with the breastfed children who were provided with pre-formed yonga and DHA, in breastfed children, there's no effect of the genotype on IQ, which makes sense because the breastfed children don't need to synthesize that.
They don't depend on their active enzyme system in early life.
And if you look at the children with the genotype.
The provision of hydronics and DHA pre-formed with breastfeeding provides a benefit of almost 6 IQ points at school age 10 years, 8 years later.
It's quite an amazing effect size.
It underscores the importance of these fatty acids in their supply for brain function and development.
We also looked at an important immune-mediated outcome.
Doctors diagnosed asthma in a large cohort of more than 2000 children, followed in a German cohort study from birth to the age of 10 years, where information was collected both on infant feeding and doctors diagnosed asthma.
What you see here is that in the breastfed subgroup, the genotype really didn't affect the risk of asthma.
It didn't have any impact.
If you had pre-formed DHA arrodonic acid, the genotype was irrelevant.
However, if you look at the children who have a low rate of synthesis of odonic acid.
Then breastfeeding for at least 3 months, providing these fatty acids pre-formed, reduced the risk of asthma by almost 150% by the age of 10 years.
So is that plausible that only breastfeeding for 3 months or more matters?
Yes, it is, because as I showed you before, during pregnancy, the fetus is supplied with considerable amounts of DHA and hydronic acid.
The babies at birth have considerable body stores, so a lack of endogenous synthesis for the first weeks of life can be expected to be compensated by utilization of body stores, but then after a few months, the endogenous stores become limiting, and then providing pre-formed rodonic acid with DHA is an important factor to compensate for a low endogenous rate of synthesis.
So it really shows that genotype for fatty acid synthesis and therefore fatty acid status in early life matters, and you could imagine that in the future.
Women who have to decide how to feed their babies and when they go back to work, when they may have limitations in their ability to breastfeed and which formula they choose, they might want to go for genotyping because it has become very affordable when they decide on infant feeding choices.
Now what is the totality of the evidence showing?
There's a recent meta-analysis on the effect of DHA and arhydonic acid supply with infant formula on infant development, including 9 randomized trials, more than 1000 children.
And you see here on the left panel that the provision of DHA and arrodonic acid significantly improved later cognitive development.
However, if you look at the graph, you see there's an enormous variation between studies.
Some studies show no effect, some studies show modest effects, some, one study shows a very large effect.
And if you look at the details, it's understandable because first of all, assessing.
Cognitive development is complex and challenging.
It's not as easy as measuring weight, so it depends a lot on the methodology you apply.
Second, the interventions were very different, very different concepts of formula feeding and formula composition.
And third, the genotype, which we just have seen is an important mediator effect, was not taken into account in any of these studies.
On the right panels you see that for the psychomotor and mental developmental index, there was a positive trend, but it didn't reach statistical significance.
However, the investigators then did a subgroup analysis depending on the composition of the infant formula that were used, and they found that not only the provision of DHA and arroydonic acid, but also the ratio between arhdonic acid and DHAA mattered.
If you had a formula that provided more argydonic acid or at least as much argdonic acid as DHA with a ratio in the range of 1 to 2 to 1, then you really had a significant and meaningful benefit for both psychomotor and mental development.
So the conclusion clearly is.
A balanced supply matters not only just adding DHA but DHA along with the right amount of hydonic acid.
This is what the recommendations of learned societies are.
This is the recommendation of the European Academy of Pediatrics a few years back that concluded infinite follow-on formula should provide both DHA and hydonic acid.
DHA should be provided.
With infant formula for term infants in amounts of at least 0.3% of fatty acids, preferably 0.5%, to account for the variation in needs in subgroups of children that have less body stores because of lower body weight or that have less endogenous synthesis because of the genotype.
And up to DJ levels of 0.64% as tested in the study by Dr.
Colombo, hydonic acid should be provided in amounts at least as high as DHA or about twice as much arhydonic acid DHA.
And by the way, the advice of colleagues Alimentarius of the World Health Organization and the FAO, the global body responsible for setting standards for infant feeding, is.
Recommending exactly the, the same.
Very recently in March 2026, the European Society for Pediatric Gastroenterology, Hepatology and Nutrition issued its statement responding to the cellulite contamination crisis of infant formula, and among other conclusions, they say this.
They concluded also that argydonic acid plays an important role in brain development, immune function, and growth.
It reminded us that both placental transfer and human milk provide not DHA alone but DHA and hydronic acid together and that infant tissues that can accumulate more DHA than more arhydonic acid than DHA during the first year of life.
It referred to the European Academy of Pediatrics' recommendation that you've just seen a minute ago, and it emphasized that the reported contamination of infant formula with erolite was linked only to a single supplier of that resource of that oil, while other safe and compliant sources of arrodonic acid available and thereby it concluded that this is not a reason not to put arhydonic acid into formula.
With this, I thank you very much indeed for your kind attention.
Thank you so much, Doctor Koblansko, for your insightful presentation.
Once again, this is Yolanda from Tuition Insight and we'll now host a Q&A session with our experts.
We've already received some great questions.
I'm sure we'll get more as , but let's just get started with the first ones.
Doctor Colesco, there is a question whether, because she talked extensively about ARA and DHA in formula and their ratios.
To your knowledge, do all infant formulas currently on the market have the appropriate levels and ratios of DHA and ARA?
Yeah, thank you, it's a great and important question.
No, that's not the case.
As I, alluded to in the presentation, in the European Union, it's compulsory to add DHA in other jurisdictions, that's not the case.
It's still an optional ingredient.
So not all infinite follow on formulas in the world have DHA.
Only in those sold in Europe you can be sure there is DHA.
And the additional supplementation of hydronic acid is also not present in our formulas, so it's important to look at the label, look at the back of the formula package where you have the ingredient list and see whether DHA and anhedonic acid are contained.
In addition, it's also important to look at the numbers.
Is it an appropriate amount?
As I said, the EFSA recommended at least 0.3%.
The European Union legislation at least 0.5% of the Fed has DHA, and there should be at least as much edronic acid as DHA in the formula if you really want the best option.
OK, and I'm following up because there's another question that's related to this.
Someone is wondering, despite the solid scientific rationale behind including both RRA and DHA in formulas.
As you mentioned, in Europe, DHA is a mandatory ingredient, and this person is wondering if you could talk about why ARA is not yet a mandatory ingredient.
That's a good question, but it's a question that probably one has to ask to the regulatory authorities and the legislators.
I can't answer this.
There is this concept that you have essential ingredients agreed upon in infant formula, all the essential nutrients that are without doubt required for appropriate feeding.
Say protein or certain vitamins.
For DHA and iodonic acid, they have been for a long time considered conditionally essential based on the fact that you have in principle, the ability to synthesize them themselves.
However, I would argue this is also the case for vitamin D.
Of course, we can synthesize vitamin D, but we know infants.
That we actually protect from sunshine, don't synthesize enough vitamin D, and therefore it's a given that all infant formula must contain vitamin D and in most countries we add additional vitamin D as a supplement.
So with that line of thought, you could also argue.
DHA nhydronic acid, while being essential, conditionally essential nutrients, they should really be supplied with all infant formula to secure an optimal status for babies.
OK, interesting.
Er, someone else is wondering, more about lactating women's diets and whether that impacts their, her breast milk levels of DHA and ARA.
How does that work?
Yes, good, very good point.
So argydonic acid in breast milk is very stable, and we have looked at the sources of argydonic acid using stable isotope methodology, and we can show that much of the gydonic acid in breast milk is actually coming from the mother's body stores that secures a pretty stable supply with breast milk.
So hydonic acid in urine milk doesn't really depend.
On the current maternal diet, that's very different for DHA though.
DHA in human milk goes up and down tremendously with the dietary supply of the breastfeeding women and therefore it is really recommended that breastfeeding women, as as women during pregnancy, have a regular supply of DHA in lactation.
The recommendation is to provide a minimum of 200 mg DHA per day to achieve 0.3% of DHA in human milk.
So 200 mg of DHA per day you get if you eat two portions of oily fish a week, like salmon or herring.
But, many women also take a supplement with DHA during breastfeeding to ensure that they have an adequate supply.
OK.
Then there is also a question cause you, you talked about DHA and ARA extensively, of course, in your presentation.
Someone is wondering if the, if, they are correct in assuming there are no studies on infant formula with only DHA, so without ARA in it.
And if that's true, if you can explain why that is.
There have been a few studies with DHA, generally, a small number of studies and not a large number of infants, that were there.
There's different formulations that have been used in the early days.
Also, studies were performed with formula that had a lot of EPA icosaetannoic acid that is not really provided with human milk, and this concept has been left in my view, fortunately.
But most of the studies really have been performed with DHA and hydronic acid, however, with different levels and different proportions, and I would say we don't have sufficient evidence to conclude that a formula with DHA alone is safe.
In fact, I showed you the data that the evidence points to an optimal outcome with argonic acid and DHA combined with at least as much hydronic acid as DHA.
OK, someone else is wondering if DHA and ARA intake can be too high, even if it's in the correct ratio that you are talking about.
That's, that's a possibility.
Both these fatty acids are, can be oxidized.
So if the composition of the formula is not appropriate with enough antioxidants, and if you provide it in too much, there's a risk that you have too much peroxides, developing, that's a potential concern and of course, too much of a good thing may not be good.
There is a certain range, recommended as, as I've shown you in.
The European Union, the DHA intake is limited to 20 to 50 mg per 100 kilocalories, and levels above that really have not been tested, and we wouldn't put something into a formula that has not been appropriately evaluated.
Yeah, that makes clear.
There are also a few people wondering about the precursors for DHA and IRA, the precursor fats, alpha linoleic acid and linoleic acids.
And wondering if, if we're talking about pre-formed DHA and ARA, how important are those precursor fats for infants?
There is some synthesis of DHA and arhydonic acid from the precursors.
There's more arhydonic acid synthesis in DHA.
And the amount and the ratios between nenola and alphalananic acid have a limited effect on the synthesis.
However, as mentioned, this is very much dependent on the genotype of the baby.
So if the baby is a slow metabolizer, there's very little synthesis.
And since we don't know that in the individual infant, we follow the concept.
Of recommended dietary allowances being defined by the amount that cover the needs of basically all the population, and that's why we say we need to provide sufficient amounts of thydonic acid and DHA with infant formula so that all babies basically have an adequate provision.
OK.
Clear.
Short follow-up question on this.
Someone is wondering if with those precursors, is there a ratio there as to take into account?
Yes, that's slightly different in certain jurisdictions, but there is in the European and in the Codex Alimentarius standards, a defined ratio that should not be exceeded because if you have a very high ratio of linoleic acid to alpha lianic, then the synthesis on the omega 3 side is impaired.
And the other way around as , yeah, OK, Claire, we have quite a few more questions, so I'm hoping we can get through all of them.
There is also a question whether if you can talk about the advantages of giving DHA and ARA at levels recommended in infancy.
Can you maybe give a brief overview of those?
The advantage would be that you have a good likelihood of maintaining an appropriate level in blood and tissues and support related functions, particularly brain development would be of key interest here and you've seen the data from the studies.
Yeah.
And are there any recommendations from the ESPGHAN for DHA?
Yes, thank you.
Do you have they given any recommendations on DHA and ARA in infancy?
Yes, I, I showed you at the end the key message from the last statement of S began in March 2026 where they basically supported the previous recommendations of the European Academy of Pediatrics with a DHA intake of a minimum of 0.3, but preferably 0.5% of fatty acids and an archaronic acid to DHA ratio.
Between 1 and 2 to 1.
So that's what Aspergan has also stated.
OK.
Back to the, precursor question, LA and ALA, someone is wondering if those precursors have any other role aside from converting to the DHA and ARA.
But for alphalinanic acid, that's really not known.
We don't know of a specific function of alphalinolenic acid other than being a precursor of the longer chain metabolites.
And in fact, if you look at the studies on metabolism, alphaleolenic acid has a very high rate of oxidation, which is sort of suggesting that it's not really having.
An important role for the body by itself, otherwise it perhaps would be protected more from oxidation.
Linoleic acid contrast does have functions.
For example, it is an important element of ceramides in our skin lipids, thereby contributing to the barrier function of the skin, and you can see in, in the description of linoleic acid.
Deficiency, that this is one of the symptoms of neuric acid deficiency, that the barrier function is lost and affected babies, for example, have a very high water loss because the barrier function is damaged.
OK, we're, we're almost out of time, but I think we can do one more question.
Can you talk a little bit, and as I mentioned at the start of our, presentation today, any questions that we don't have time to get to today, we can, answer over email.
Final question, Doctor Kulesco, if you can talk a little bit about the future of ARA in infant formula, following this recent contamination that you, talked about, do you foresee any formulas without ARA and, in the future?
It's not something that I would favor based on common knowledge because we don't have any, any data to show us that a formula without arhydonic acid would be appropriate, would be really suitable for infant feeding, and I would take the position that we shouldn't provide infants with sort of experimental formula that have not been appropriately tested, so.
I would argue before you put out a formula with DHA alone, without hydronic acid, based on the data that point to the importance of hydronic acid that we have today, that we need to be proven to be safe and suitable.
I wouldn't exclude that.
In older infants at the end of the first years, it might be possible to do so if the requirement of hydronic acid is lower than in the early days of infancy.
It is, it is potentially possible that this may, may be appropriate, but I would want to see this to be demonstrated.
OK, very clear.
Thank you so much, Doctor Pulasco for your insights and for answering all these questions.
And unfortunately, that is all the time that we have for today.
I want to thank you again, Doctor Pulasco, for your insights, and a big thank you to all of you around the world for joining us today.
Goodbye for now.
Editor, Nutrition Insight
Else Kröner Senior Professor of Paediatrics
Jolanda van Hal
Editor, Nutrition Insight
Prof. Dr. Berthold Koletzko
Else Kröner Senior Professor of Paediatrics
