DHA and Early Brain Development

  • Researchers have previously shown that long-chain polyunsaturated fatty acids (LCPUFAs) play an important role in brain development1

    Brain grows most rapidly from third trimester through 2 years of age3


    • Brain growth is 85% complete by age 33

    Brain growth chart

    DHA accretion in the brain increases rapidly during this time of rapid brain growth.4


    • Infants obtain DHA in utero primarily through preferential transfer of DHA through the placenta,5 with levels dependent on maternal supply6
    • Following birth, infants receive DHA either through breast milk or formula1,7
      • Worldwide levels of DHA in breast milk vary, with the average at about 0.32%8*
      • Experts recommend DHA in early life to help support brain and eye development16
    • Although DHA can be synthesized by the body from α-linolenic acid, the amount that an infant can synthesize may be limited

    * Average level of DHA worldwide in breast milk is 0.32% + 0.22% (mean + standard deviation of total fatty acids) based on an analysis of 65 studies of 2474 women. 8

    DHA helps support brain and eye development

    Retinal function can be considered a “window to the brain.

    • In the developing embryo, the eye develops in close association with the brain; visual development requires a tight integration of retinal, neural pathway, and cortical function
    • Visual development is, therefore, an extension of brain development, and visual acuity in infancy is one reflection of CNS development2
    • Since DHA concentrations in the retina and neural tissue are among the highest in the body, it is not surprising that DHA plays an important role in brain development9

    DHA in early life helps support cognitive development

    A study published in 2013 involved 81 formula-fed children who were enrolled from birth and through 6 years.10

    • Subjects had been randomized from birth through 12 months to receive one of 4 formulas:
      • Control formula (no DHA/ARA)
      • .32% DHA/.64% ARA
      • .64% DHA/.64% ARA
      • .96% DHA/.64% ARA
    • Every 6-12 months, children were given age-appropriate cognition tests

    Results revealed that

    • Infants fed formula that had 0.32% DHA had improved measures of executive function at 4 and 5 years and improved measures of verbal comprehension at 5 years compared to those who received the control formula.10
    • These results demonstrate that DHA helps support cognitive development

    DHA is important in in preterm infants

    For the preterm infant, the DHA accretion that occurs during the third trimester--when brain mass more than doubles--is abruptly interrupted.11-13

    • Low blood levels of DHA have been associated with decreased respiratory health in preterm infants14
    • These infants, may benefit from DHA to support brain and retinal development, and to help support respiratory health9
    "Nutrition during early life is now recognized not only as a key determinant for immediate neonatal survival, growth, and mental development during infancy, but also as a major conditioning factor for long-term health.” – 2014 Global Expert Recommendations15
    **2014 Global Expert Recommendations for DHA: 16.4 mg – 55 mg per 100 kcal15**

  • Listen to Dr. John Colombo discuss the DIAMOND Study, a trial of LCPUFA postnatal dietary supplementation. This video will review the results of the study and examine cognitive development, testing, and how to properly interpret cognitive tests from infancy to early childhood.

    John Colombo, PhD Professor of Psychology Director, Life Span Research Institute University of Kansas Lawrence, KS


  • ARA = arachidonic acid; DHA = docosahexaenoic acid; LCPUFA = long-chain polyunsaturated fatty acid

    References: 1. Calder J et al, eds. Scientific review: The role of nutrients in immune function of infants and young children; emerging evidence for long-chain polyunsaturated fatty acids. Mead Johnson. 2007;1-40. 2. Morale SE, Hoffman DR, Castañeda YS, et al.Duration of long-chain polyunsaturated fatty acids availability in the diet and visual acuity. Early Hum Dev. 2005;81:197-203. 3. Dobbing J et al. Arch Dis Child. 1973;48:757-767. 4. Martinez M. Tissue levels of polyunsaturated fatty acids during early human development. J Pediatr. 1992; 120:S129-S138. 5. Haggarty P et al. Long-chain polyunsaturated fatty acid transport across the perfused human placenta. Placenta. 1997;18:635-642. 6. Innis SM. Essential fatty acids in growth and development. Prog Lipid Res. 1991;40:39-103. 7. Hoffman DR et al. Visual function in breastfed term infants weaned to formula with or without long-chain polyunsaturates at 4 to 6 months: a randomized clinical trial. J Pediatr. 2003;142:669-677. 8. Brenna JT et al. Am J Clin Nutr. 2007; 85:1457-1464. 9. Birch EE, Hoffman DR, Uauy R, et al. Visual acuity and the essentiality of docosahexaenoic acid and arachidonic acid in the diet of term infants. Pediatr Res. 1998;44:201-209. 10. Colombo J et al. Am J Clin Nutr. 2013;98:403-412. 11. Henriksen C et al. Pediatrics. 2008;121:1137-1145. 12. Clandinin MT et al. J Pediatr. 2005;146:461-468. 13. Haggarty P. Annu Rev Nutr. 2010;30:237-255. 14. Martin CR et al. J Pediatr 2011;159:743-749. 15. Koletzko B et al, eds. Nutritional Care of Preterm Infants: Scientific Basis and Practical Guidelines. Basel, Switzerland: Karger; 2014:1-314. 16 Koletzko B, Lien E, Agostoni C, et al. The roles of long-chain polyunsatureated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med. 2008;36:5-14.

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