Many antiinflammatory pharmaceutical products inhibit the production of certain eicosanoids and cytokines and it is here that possibilities exist for therapies that incorporate n−3 and n−9 dietary fatty acids. The proinflammatory eicosanoids prostaglandin E₂ (PGE₂) and leukotriene B₄ (LTB₄) are derived from the n−6 fatty acid arachidonic acid (AA), which is maintained at high cellular concentrations by the high n−6 and low n−3 polyunsaturated fatty acid content of the modern Western diet. Flaxseed oil contains the 18-carbon n−3 fatty acid α-linolenic acid, which can be converted after ingestion to the 20-carbon n−3 fatty acid eicosapentaenoic acid (EPA). Fish oils contain both 20- and 22-carbon n−3 fatty acids, EPA and docosahexaenoic acid. EPA can act as a competitive inhibitor of AA conversion to PGE₂ and LTB₄, and decreased synthesis of one or both of these eicosanoids has been observed after inclusion of flaxseed oil or fish oil in the diet. Analogous to the effect of n−3 fatty acids, inclusion of the 20-carbon n−9 fatty acid eicosatrienoic acid in the diet also results in decreased synthesis of LTB₄. Regarding the proinflammatory ctyokines, tumor necrosis factor α and interleukin 1β, studies of healthy volunteers and rheumatoid arthritis patients have shown ≤90% inhibition of cytokine production after dietary supplementation with fish oil. Use of flaxseed oil in domestic food preparation also reduced production of these cytokines. Novel antiinflammatory therapies can be developed that take advantage of positive interactions between the dietary fats and existing or newly developed pharmaceutical products.

Research from JAMA — Effect of DHA Supplementation During Pregnancy on Maternal Depression and Neurodevelopment of Young Children — A Randomized Controlled Trial

Research from JAMA — Neurodevelopmental Outcomes of Preterm Infants Fed High-Dose Docosahexaenoic Acid — A Randomized Controlled Trial

OBJECTIVE: To identify sensitive periods of postnatal growth for preterm infants relative to neurodevelopment at 18 months9 corrected age. PATIENTS AND METHODS: We studied 613 infants born at <33 weeks9 gestation who participated in the DHA for Improvement of Neurodevelopmental Outcome trial. We calculated linear slopes of growth in weight, length, BMI, and head circumference from 1 week of age to term (40 weeks9 postmenstrual age), term to 4 months, and 4 to 12 months, and we estimated their associations with Bayley Scales of Infant Development, 2nd Edition, Mental (MDI) and Psychomotor (PDI) Development Indexes in linear regression. RESULTS: The median gestational age was 30 (range: 2–33) weeks. Mean ± SD MDI was 94 ± 16, and PDI was 93 ± 16. From 1 week to term, greater weight gain (2.4 MDI points per z score [95% confidence interval (CI): 0.8–3.9]; 2.7 PDI points [95% CI: 1.2–.2]), BMI gain (1.7 MDI points [95% CI: 0.4–3.1]; 2.5 PDI points [95% CI: 1.2–3.9]), and head growth (1.4 MDI points [95% CI: −0.0–2.8]; 2.5 PDI points [95% CI: 1.2–3.9]) were associated with higher scores. From term to 4 months, greater weight gain (1.7 points [95% CI: 0.2–3.1]) and linear growth (2.0 points [95% CI: 0.7–3.2]), but not BMI gain, were associated with higher PDI. From 4 to 12 months, none of the growth measures was associated with MDI or PDI score. CONCLUSIONS: In preterm infants, greater weight and BMI gain to term were associated with better neurodevelopmental outcomes. After term, greater weight gain was also associated with better outcomes, but increasing weight out of proportion to length did not confer additional benefit.

Dietary lipids are key for infants to not only meet their high energy needs but also fulfill numerous metabolic and physiological functions critical to their growth, development, and health. The lipid composition of breast milk varies during lactation and according to the mother's diet, whereas the lipid composition of infant formulae varies according to the blend of different fat sources. This report compares the compositions of lipids in breast milk and infant formulae, and highlights the roles of dietary lipids in term and preterm infants and their potential biological and health effects. The major differences between breast milk and formulae lie in a variety of saturated fatty acids (such as palmitic acid, including its structural position) and unsaturated fatty acids (including arachidonic acid and docosahexaenoic acid), cholesterol, and complex lipids. The functional outcomes of these differences during infancy and for later child and adult life are still largely unknown, and some of them are discussed, but there is consensus that opportunities exist for improvements in the qualitative lipid supply to infants through the mother's diet or infant formulae. Furthermore, research is required in several areas, including the needs of term and preterm infants for long‐chain polyunsaturated fatty acids, the sites of action and clinical effects of lipid mediators on immunity and inflammation, the role of lipids on metabolic, neurological, and immunological outcomes, and the mechanisms by which lipids act on short‐ and long‐term health.