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American Journal of Clinical Nutrition, Vol. 71, No. 1, 120-129, January 2000
© 2000 American Society for Clinical Nutrition


Original Research Communication

A randomized trial of different ratios of linoleic to {alpha}-linolenic acid in the diet of term infants: effects on visual function and growth1,2,3

Maria Makrides, Mark A Neumann, Brett Jeffrey, Eric L Lien and Robert A Gibson

1 From the Department of Paediatrics & Child Health, Flinders University of South Australia and Flinders Medical Centre, Bedford Park (Adelaide), Australia, and Wyeth Nutritionals International, Radnor, PA.

Background: There are nutritional recommendations that the ratio of linoleic to {alpha}-linolenic acid (LA:ALA) in formula for term infants be between 5:1 and 15:1. These recommendations were made in the absence of data on functional or clinical outcomes.

Objective: We compared the fatty acid status, visual evoked potential (VEP) acuity, and growth of term infants fed formula containing an LA:ALA of 10:1 or 5:1 with those of a breast-fed reference cohort.

Design: Formula-fed infants were allocated randomly in a double-blind fashion to receive formula with an LA:ALA of either 10:1 (16.9:1.7; n = 36) or 5:1 (16.3:3.3; n = 37) from near birth to 34 wk of age. Increased ALA was attained by replacing soy oil with low–erucic acid canola oil. A parallel group of breast-fed infants was also recruited. Infant growth and fatty acid status were assessed at 6, 16, and 34 wk of age. VEP acuity was assessed at 16 and 34 wk.

Results: Infants fed the 5:1 formula had greater docosahexaenoic acid (DHA) concentrations in plasma and erythrocyte phospholipids than did infants fed the 10:1 formula, but DHA concentrations of infants fed the 5:1 formula remained less than those in breast-fed infants. The VEP acuity of all formula-fed and breast-fed infants was not significantly different at 16 and 34 wk of age. At birth, infants fed the 5:1 formula were heavier, were longer, and had a greater head circumference than infants assigned to the 10:1 formula group; this differential was maintained throughout the trial. The rate of gain in weight, length, and head circumference was not significantly different between the 2 formula-fed groups, although breast-fed infants had lower weight and length gains than did formula-fed infants between 16 and 34 wk of age.

Conclusion: Lowering the LA:ALA in formula from 10:1 to 5:1 by using low–erucic acid canola oil resulted in a modest increase in plasma DHA but had no effect on VEP acuity or growth rate.

Key Words: {alpha}-Linolenic acid • ALA • linoleic acid • LA • docosahexaenoic acid • DHA • growth • visual evoked potential • VEP • infants • breast milk • infant formula


Related articles in AJCN:

Considerations of statistical power in infant studies of visual acuity development and docosahexaenoic acid status1
Elizabeth A Tolley and Susan E Carlson
AJCN 2000 71: 1-2. [Full Text]  



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