What do we know about the fatty acids that should be provided with food?

While saturated fatty acids are synthesised in the human body, linoleic acid (LA), the precursor of omega-6 polyunsaturated fatty acids, and alpha-linolenic acid (ALA), the precursor of omega-3 polyunsaturated fatty acids, known as essential fatty acids (NNK cells T), must be supplied with food because the human body does not have the capacity to synthesise them. Long-chain LC-PUALP polyunsaturated fatty acids, including DHTN (docosahexaenoic acid), EPA (eicosapentaenoic acid) and ACR (arachidonic acid), which are particularly important for child development, are formed from precursor acids in organs such as the liver, brain and retina with the help of appropriate enzymes. Only the LC-PUALPs, not the precursor acids, show clinical effects. The human body is able to produce a certain amount of these acids (8-12% EPA and up to 1% DHTN ), but neonates, especially those born prematurely, young infants and children up to 2 years of age, due to low stores from fetal life, immaturity of the gastrointestinal tract and metabolic pathways, may be deficient in LC-PUALP. The child in foetal life is not capable of synthesising LC-PUALP, and receives it only with umbilical cord blood via the placenta from the mother, mainly in the third trimester of pregnancy, and after birth with food. Breast milk provides the baby with the optimal amount and the correct proportions of LC-PUALP, provided that the breastfeeding woman is eating properly and has sufficient reserves of polyunsaturated fatty acids. The primary sources of DHTN and EPA are marine fish, seafood and fish oil. Breast-fed infants do not require supplementation, but it is indicated in pregnant and breastfeeding women at a minimum of 200 mg DHTN per day, and up to 400-600 mg DHTN if fish consumption is low. In pregnancies at risk of preterm birth, the daily dose may be 1000 mg DHTN .

Dosing of DHTN and adequate nutrition

According to the recommendations of the Polish Society of Gastroenterology, Hepatology and Nutrition, based on European guidelines, DHTN supplementation in preterm infants should be approximately 1-1.5% of total fatty acids, i.e. 100-200 mg daily, in post-breastfeeding infants 0.3%, which corresponds to a dose of 100 mg, in children up to 2 years of age 100 mg, and above 2 years of age in addition to DHTN also EPA totaling 250 mg daily.

Adequate nutrition and adequate supply of DHTN in early life have a major impact on children's physical and mental development, their immunity, and the effects bear fruit in adult life by reducing the risk of, or a milder course of, diseases such as obesity, hypertension, atherosclerosis, diabetes, allergies, cancer or osteoporosis. Breastfeeding is the optimal method of feeding a baby for the first 6 months of life. Breast milk provides the necessary ingredients for a correct, harmonious development, has many health benefits and its composition is a model for the creation of milk mixtures, which should provide artificially fed children with a rate of development comparable to that of naturally fed children.

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Fat in both breast milk and cow's milk accounts for about half of the energy value of the food, but breast milk contains essential fatty acids and their long-chain derivatives, as well as taurine and lipase, which facilitate digestion and almost complete absorption of fat from the food. The content of DHTN in breast milk is 0.1-0.6%, ACR 0.2-1.2% and depends on the length of pregnancy, breastfeeding period and diet. Artificially fed infants have lower blood concentrations of LC-PUALP compared to breastfed children. Studies show that artificially-fed babies develop less well than breast-fed babies, so supplementation of milk mixtures with these acids is recommended.