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Visual maturation of term infants fed long-chain polyunsaturated fatty acid–supplemented or control formula for 12 mo^1,2,3

¹ From the Retina Foundation of the Southwest, Dallas, TX (EEB, YSC, DHW, DGB, and DRH), the Department of Ophthalmology (EEB and DGB), UT Southwestern Medical Center, Dallas, TX, and INTA, University of Chile, Santiago, Chile (RDU)

Background: Several studies found a benefit of long-chain polyunsaturated fatty acid (LCP) supplementation for visual or mental development, but others found no benefit. Likely contributors to differences among studies are the amount of LCP supplementation, functional outcomes, and sample size.

Objective: We evaluated LCP supplementation in amounts typical for human milk (based on local and worldwide surveys) in a large cohort of infants by using sweep visual evoked potential (VEP) acuity as the functional outcome.

Design: The study was a double-masked, randomized, controlled clinical trial in 103 term infants. By age 5 d, infants were randomly assigned to receive either formula with no docosahexaenoic acid (DHA) or arachidonic acid (ARA) or formula supplemented with DHA and ARA as 0.36% and 0.72%, respectively, of total fatty acids. Sweep VEP acuity was the primary outcome. Random dot stereoacuity, blood lipid profile, growth, and tolerance were secondary outcomes.

Results: VEP acuity in the LCP-supplemented group was significantly better than that in the control group at ages 6, 17, 26, and 52 wk. Stereoacuity in the LCP-supplemented group was significantly better than that in the control group at age 17 wk but not at ages 39 and 52 wk. By ages 17 and 39 wk, the red blood cell DHA concentration in the LCP-supplemented group was more than double and more than triple, respectively, that in the control group. Growth of infants fed LCP-supplemented and control formulas did not differ significantly, and both diets were well tolerated.

Conclusion: LCP supplementation of term infant formula during the first year of life yields clear differences in visual function and in total red blood cell lipid composition.

Key Words: Docosahexaenoic acid • infant • visual evoked potential • acuity • random dot stereoacuity

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