Publications
339 results found
Ghebremeskel K, Crawford MA, Lowy C, et al., 2000, Arachidonic and docosahexaenoic acids are strongly associated in maternal and neonatal blood., Eur J Clin Nutr, Vol: 54, Pages: 50-56, ISSN: 0954-3007
BACKGROUND: The red cell membrane fatty acid composition has frequently been used as an index of essential fatty acid (EFA) nutrition. After birth there is a decline in plasma arachidonic acid (AA) and docosahexaenoic (DHA) acids in babies fed on conventional formula which contains only the parent linoleic and alpha-linolenic acids. In human studies, the red cell phosphoglyceride composition appears to be more constant than that of plasma. In infants fed fish oil without AA, the AA proportions fall in the plasma but much less so in the red cells. This result might be considered to mean that there is no need for preformed AA. On the other hand, in a study where the levels of AA fell there was reduction of infant growth. Indeed, where cell membrane composition does change there is often an associated alteration in physiological functions of membranes. We therefore felt it worth investigating the balance between AA and DHA in a physiological situation where plasma levels are known to change, namely in pregnancy. PURPOSE: The aim of the study was to investigate a relationship between blood phosphoglyceride AA and DHA in pregnant women and neonates. SUBJECTS: Health pregnant women from London, England (n=193) and their term babies (n=45); healthy pregnant women from Seoul, South Korea (n=40) and their term babies (n=40); and preterm neonates (n=72) from London. METHOD: Blood samples were taken from British and Korean pregnant women during the third trimester, and from term and preterm babies at birth. These samples were taken for routine monitoring purposes in Korea and were a part of a study on pregnancy outcome for which ethical permission was granted from the East London and The City Health Authority and Lambeth, Southwark and Lewisham Health Authority. Approval was also obtained from the Ethical Committee of the Asan Medical Centre, Seoul, South Korea. RESULTS: AA and DHA correlated in plasma choline phosphoglycerides (CPG) of the British mothers (r=0.52 P<0.0001)
Crawford M, 2000, Placental delivery of arachidonic and docosahexaenoic acids: implications for the lipid nutrition of preterm infants., Am J Clin Nutr, Vol: 71, Pages: 275S-284S, ISSN: 0002-9165
Arachidonic (AA) and docosahexaenoic (DHA) acids are major components of cell membranes and are of special importance to the brain and blood vessels. In utero, the placenta selectively and substantially extracts AA and DHA from the mother and enriches the fetal circulation. Studies indicate that there is little placental conversion of the parent essential fatty acids to AA and DHA. Similarly, analyses of desaturation and reductase activity have shown the placenta to be less functional than the maternal or fetal livers. There appears to be a correlation with placental size and plasma AA and DHA proportions in cord blood; therefore, placental development may be an important variable in determining nutrient transfer to the fetus and, hence, fetal growth itself. In preterm infants, both parenteral and enteral feeding methods are modeled on term breast milk. Consequently, there is a rapid decline of the plasma proportions of AA and DHA to one quarter or one third of the intrauterine amounts that would have been delivered by the placenta. Simultaneously, the proportion of linoleic acid, the precursor for AA, rises in the plasma phosphoglycerides 3-fold. An inadequate supply of AA and DHA during the period of high demand from rapid vascular and brain growth could lead to fragility, leakage, and membrane breakdown. Such breakdown would predictably be followed by peroxidation of free AA, vasoconstriction, inflammation, and ischemia with its biological sequelae. In the brain, cell death would be an extreme consequence.
Crawford M, Galli C, Visioli F, et al., 2000, Role of plant-derived omega-3 fatty acids in human nutrition., Ann Nutr Metab, Vol: 44, Pages: 263-265, ISSN: 0250-6807
An international workshop on the role of plant-derived omega-3 fatty acids in human nutrition took place in Milan on February 9, 2000. The meeting was sponsored by the Nutrition Foundation of Italy and was organized by its Scientific Director, Dr. Andrea Poli. It was attended by experts in polyunsaturated fatty acids and human lipid nutrition. This is the first meeting devoted to the health aspects of alpha-linolenic acid, the omega-3 fatty acid contained in plant-derived edible products, as distinct from the more widely studied long-chain omega-3 products typically present in fish and fish-derived products. This report, which is based on updated scientific evidence presented and discussed at the workshop, was prepared by the international expert panel.
Doyle W, Crawford MA, Srivastava A, et al., 1999, Interpregnancy nutrition intervention with mothers of low-birthweight babies living in an inner city area: A feasibility study, Journal of Human Nutrition and Dietetics, Vol: 12, Pages: 517-527, ISSN: 0952-3871
Background: Inadequate maternal nutrition around the time of conception is reported to be associated with nongenetic congenital abnormalities and with low birthweight. Aim: To evaluate the effectiveness of nutrition counselling during the interpregnancy interval for women who have had a low-birthweight baby, who live in an inner city area, and whose diets have been assessed as inadequate. Method: Mothers who had a low-birthweight baby and planned to have another baby were recruited into a pilot preconception nutrition counselling trial. Seven-day diet diaries were used to assess the dietary intakes of mothers before and after exposure to counselling. Results: Of 152 mothers interviewed, 111 (73%) agreed to participate; 77 (51%) participants completed 7-day diet diaries; of these, the calculated micronutrient intake of 70 (91%) was arbitrarily defined as 'inadequate', meeting fewer than four of 16 Reference Nutrient Intakes (RNIs). Forty-one (59%) of the 70 mothers with an 'inadequate' diet completed a second diary after 6 months exposure to nutrition counselling. Following the counselling period, the intake of few nutrients increased above the 5% level, although the trend was towards an improved dietary intake. Conclusions: Dietary counselling on its own in the interpregnancy period is unlikely to improve nutritional status of mothers in this inner city population.
Crawford MA, 1999, Genetically modified foods., Lancet, Vol: 353, ISSN: 0140-6736
Ghebremeskel K, Bitsanis D, Koukkou E, et al., 1999, Maternal diet high in fat reduces docosahexaenoic acid in liver lipids of newborn and sucking rat pups., Br J Nutr, Vol: 81, Pages: 395-404, ISSN: 0007-1145
The effect of a maternal diet high in fat, similar to Western foods, and of diabetes on liver essential fatty acid composition of the mother and the newborn and sucking pups was investigated. Female Sprague-Dawley rats were fed on either a low-fat (42 g/kg) or a high-fat (329 g/kg) diet for 10 d before mating, throughout pregnancy and post-partum. On the first day of pregnancy, diabetes was induced by intravenous administration of streptozotocin in half the animals from the two diet groups. Half the pups were killed at birth, and the remaining pups and mothers at days 15 and 16 respectively. At birth, there was a significant reduction in the proportions of docosahexaenoic acid (DHA) in the liver phosphoglycerols and neutral lipids of the pups of both high-fat control and diabetic mothers compared with those of low-fat control and diabetic mothers. Diabetes decreased arachidonic (AA) and linoleic acid values in both the low- and high-fat groups at birth. The sucking pups of both the high-fat control and diabetic mothers exhibited a significant reduction in DHA and a concomitant compensatory increase in AA and a lowering in DHA-AA balance. In the mothers, the high-fat diet significantly increased the proportions of DHA in ethanolamine phosphoglycerols but had no observable effect in choline phosphoglycerols and neutral lipids. In the fetus the DHA level (g/100 g total fatty acids) was disproportionately reduced by the maternal high-fat diet. The adverse effect of the high-fat diet on the level of DHA (g/100 g total fatty acids) was greater in the neonate (and by implication the fetus) than in the sucking pups or mothers. It is concluded that a distortion of the biochemistry is induced in the offspring through a maternal high-fat diet, without genetic predisposition.
Crawford MA, Bloom M, Broadhurst CL, et al., 1999, Evidence for the unique function of docosahexaenoic acid during the evolution of the modern hominid brain., Lipids, Vol: 34 Suppl, Pages: S39-S47, ISSN: 0024-4201
The African savanna ecosystem of the large mammals and primates was associated with a dramatic decline in relative brain capacity associated with little docosahexaenoic acid (DHA), which is required for brain structures and growth. The biochemistry implies that the expansion of the human brain required a plentiful source of preformed DHA. The richest source of DHA is the marine food chain, while the savanna environment offers very little of it. Consequently Homo sapiens could not have evolved on the savannas. Recent fossil evidence indicates that the lacustrine and marine food chain was being extensively exploited at the time cerebral expansion took place and suggests the alternative that the transition from the archaic to modern humans took place at the land/water interface. Contemporary data on tropical lakeshore dwellers reaffirm the above view with nutritional support for the vascular system, the development of which would have been a prerequisite for cerebral expansion. Both arachidonic acid and DHA would have been freely available from such habitats providing the double stimulus of preformed acyl components for the developing blood vessels and brain. The n-3 docosapentaenoic acid precursor (n-3 DPA) was the major n-3-metabolite in the savanna mammals. Despite this abundance, neither it nor the corresponding n-6 DPA was used for the photoreceptor nor the synapse. A substantial difference between DHA and other fatty acids is required to explain this high specificity. Studies on fluidity and other mechanical features of cell membranes did not reveal a difference of such magnitude between even alpha-linolenic acid and DHA sufficient to explain the exclusive use of DHA. We suggest that the evolution of the large human brain depended on a rich source of DHA from the land/water interface. We review a number of proposals for the possible influence of DHA on physical properties of the brain that are essential for its function.
Cunnane SC, Menard CR, Likhodii SS, et al., 1999, Carbon recycling into de novo lipogenesis is a major pathway in neonatal metabolism of linoleate and alpha-linolenate., Prostaglandins Leukot Essent Fatty Acids, Vol: 60, Pages: 387-392, ISSN: 0952-3278
Recent reports indicate that recycling of the beta-oxidized carbon skeleton of linoleate and alpha-linolenate into newly synthesized cholesterol and fatty acids in the brain is quantitatively significant in both suckling rats and pre- and postnatally in rhesus monkeys. The recycling appears to occur via ketones which are not only readily produced from these 18 carbon polyunsaturates but are also the main lipogenic precursors for the developing mammalian brain. Since the neonatal rat brain appears not to acquire cholesterol or long chain saturated or monounsaturated fatty acids from the circulation, ketones and ketogenic precursors seem to be crucial for normal brain synthesis of these lipids. Cholesterol is plentiful in brain membranes and it has also been discovered to be the essential lipid adduct of the 'hedgehog' family of proteins, the appropriate expression of which determines normal embryonic tissue patterning and neurological development. Insufficient cholesterol or inappropriate expression of 'sonic hedgehog' has major adverse neurodevelopmental consequences typified in humans by Smith-Lemli-Optiz syndrome. Hence, we propose that the importance of alpha-linolenate and linoleate for normal neural development arises not only from being precursors to longer chain polyunsaturates incorporated into neuronal membranes but, perhaps equally importantly, by being ketogenic precursors needed for in situ brain lipid synthesis.
Ghebremeskel K, Bitsanis D, Koukkou E, et al., 1999, Post-natal modulation of heart and liver phosphoglyceride fatty acids in pups., Ann Nutr Metab, Vol: 43, Pages: 365-373, ISSN: 0250-6807
BACKGROUND: Maternal dietary fats alter tissue fatty acids of the fetus and suckling pups. However, the possible change in tissue composition in response to the high oxygen tension extrauterine milieu independent of diet is not well understood. METHODS: We have compared the fatty acids of heart and liver choline (CPG) and ethanolamine (EPG) phosphoglycerides of rat offspring at birth and post-natal day 15. Sprague-Dawley rats were fed a breeding diet prior to mating, pregnancy and lactation. A proportion of each litter was sacrificed and the liver and heart were obtained for analysis. Changes in fatty acid composition specific to tissue (heart and liver) and phosphoglyceride (CPG and EPG) occurred post-natally. RESULTS: Relative levels of palmitate and oleate decreased and those of stearate increased in both the heart and liver phosphoglycerides of the suckling pups. There was a reduction in arachidonate/linoleate ratio primarily due to the increase in linoleic acid. With the exception in the heart EPG, the levels of arachidonic acid did not decrease concomitantly. Although the fatty acid composition of the diet did not change between pregnancy and lactation, docosahexaenoic and total n-3 increased in heart CPG and EPG and liver CPG of the suckling pups. Evidently, membrane fatty acid modulation, independent of maternal dietary fat, occurs in the extrauterine environment. It seems to favour the accretion of linoleic, arachidonic, docosahexaenoic and total n-3 fatty acids. CONCLUSION: Since there appears to be some parallel between the very preterm human neonate and rat pups with regard to nutrient store at birth and the neonatal developmental time window, our results may have relevance for the understanding of fatty acid metabolism and turnover in the human neonate.
Clandinin MT, 1998, Dietary lipids and evolution of the human brain., Br J Nutr, Vol: 80, Pages: 299-300, ISSN: 0007-1145
Crawford MA, 1998, Cheap sell for ill health., Lancet, Vol: 351, Pages: 1741-1742, ISSN: 0140-6736
Crawford MA, Lowy C, Koukkou E, et al., 1998, Sex ratio of offspring of diabetics., Lancet, Vol: 351, Pages: 1515-1516, ISSN: 0140-6736
James WH, 1998, Sex ratio of offspring of diabetics., Lancet, Vol: 351, ISSN: 0140-6736
Gurr MI, 1998, Dietary lipids and evolution of the human brain., Br J Nutr, Vol: 79, Pages: 389-392, ISSN: 0007-1145
Crawford MA, Costeloe K, Ghebremeskel K, et al., 1998, Erratum: The inadequacy of the essential fatty acid content of present preterm feeds (European Journal of Pediatrics (1998) 157:1 (S23-S27)), European Journal of Pediatrics, Vol: 157, ISSN: 0340-6199
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Crawford MA, Costeloe K, Ghebremeskel K, et al., 1998, The inadequacy of the essential fatty acid content of present preterm feeds, European Journal of Pediatrics, Vol: 157, ISSN: 0340-6199
Arachidonic (AA) and docosahexaenoic (DHA) acids are major components of endothelial, pulmonary and neuro-visual cell membranes. Preterm babies may be born with deficits of both AA and DHA. There is evidence that their endogenous anti-oxidant enzymes defence systems have only reached half the activity expected at term. Yet they are exposed to an oxygen tension greater than physiologically anticipated at this time, and the superoxide dismutase shows no evidence of significant catch-up. After birth, present enteral and parenteral feeds for the preterm baby result in a further drop of AA and DHA plasma proportions to a quarter or third of the intra-uterine expectation. At the same time, the proportion of linoleic acid (LA), the precursor for AA, rises in the plasma phosphoglycerides four-fold, thus denying the preterm infant the provision with which the placenta would have perfused the fetus to meet the very rapid demand for endothelial and neural growth. From the biochemistry it is predictable that this situation could lead to fragile cell membranes, leakage, rupture with peroxidation resulting in the formation of inflammatory and vasoconstrictive agents. Conclusion The essential fatty acid content of current entral and parental feeds for preterm infants is incorrectly formulated. © Springer-Verlag 1998.
Crawford MA, Costeloe K, Ghebremeskel K, et al., 1998, The inadequacy of the essential fatty acid content of present preterm feeds., Eur J Pediatr, Vol: 157 Suppl 1, Pages: S23-S27, ISSN: 0340-6199
UNLABELLED: Arachidonic (AA) and docosahexaenoic (DHA) acids are major components of endothelial, pulmonary and neuro-visual cell membranes. Preterm babies may be born with deficits of both AA and DHA. There is evidence that their endogenous anti-oxidant enzymes defence systems have only reached half the activity expected at term. Yet they are exposed to an oxygen tension greater than physiologically anticipated at this time, and the superoxide dismutase shows no evidence of significant catch-up. After birth, present enteral and parenteral feeds for the preterm baby result in a further drop of AA and DHA plasma proportions to a quarter or third of the intra-uterine expectation. At the same time, the proportion of linoleic acid (LA), the precursor for AA, rises in the plasma phosphoglycerides four-fold, thus denying the preterm infant the provision with which the placenta would have perfused the fetus to meet the very rapid demand for endothelial and neural growth. From the biochemistry it is predictable that this situation could lead to fragile cell membranes, leakage, rupture with peroxidation resulting in the formation of inflammatory and vasoconstrictive agents. CONCLUSION: The essential fatty acid content of current enteral and parenteral feeds for preterm infants is incorrectly formulated.
Broadhurst CL, Cunnane SC, Crawford MA, 1998, Rift Valley lake fish and shellfish provided brain-specific nutrition for early Homo., Br J Nutr, Vol: 79, Pages: 3-21, ISSN: 0007-1145
An abundant, balanced dietary intake of long-chain polyunsaturated fatty acids is an absolute requirement for sustaining the very rapid expansion of the hominid cerebral cortex during the last one to two million years. The brain contains 600 g lipid/kg, with a long-chain polyunsaturated fatty acid profile containing approximately equal proportions of arachidonic acid and docosahexaenoic acid. Long-chain polyunsaturated fatty acid deficiency at any stage of fetal and/or infant development can result in irreversible failure to accomplish specific components of brain growth. For the past fifteen million years, the East African Rift Valley has been a unique geological environment which contains many enormous freshwater lakes. Paleoanthropological evidence clearly indicates that hominids evolved in East Africa, and that early Homo inhabited the Rift Valley lake shores. Although earlier hominid species migrated to Eurasia, modern Homo sapiens is believed to have originated in Africa between 100 and 200 thousand years ago, and subsequently migrated throughout the world. A shift in the hominid resource base towards more high-quality foods occurred approximately two million years ago; this was accompanied by an increase in relative brain size and a shift towards modern patterns of fetal and infant development. There is evidence for both meat and fish scavenging, although sophisticated tool industries and organized hunting had not yet developed. The earliest occurrences of modern H. sapiens and sophisticated tool technology are associated with aquatic resource bases. Tropical freshwater fish and shellfish have long-chain polyunsaturated lipid ratios more similar to that of the human brain than any other food source known. Consistent consumption of lacustrine foods could have provided a means of initiating and sustaining cerebral cortex growth without an attendant increase in body mass. A modest intake of fish and shellfish (6-12% total dietary energy intake) can provide more
Crawford MA, Costeloe K, Ghebremeskel K, et al., 1997, Are deficits of arachidonic and docosahexaenoic acids responsible for the neural and vascular complications of preterm babies?, Am J Clin Nutr, Vol: 66, Pages: 1032S-1041S, ISSN: 0002-9165
We review evidence suggesting that pre- or postnatal deficits of arachidonic acid (AA) and docosahexaenoic acid (DHA) together with underdeveloped antioxidant protection contribute to neurovisual developmental disorders and other complications of premature birth. These two synergistic deficits occur at a time when 70% of energy is focused on brain development and when the brain and blood vessels are growing at high speed. The types of essential fatty acids fed to preterm babies bear no relation to what the infant would have received had it remained a fetus. This failure to meet essential fatty acid requirements exacerbates the AA and DHA deficits seen at birth; furthermore, the immature superoxide defenses remain depressed until the expected date of delivery. Deficits of these systems, which are required for cell membranes, the endothelium, and neural tissue, could provide the biochemical prerequisite for the membrane disorders to which these babies are at high risk: intraventricular hemorrhage, periventricular leucomalacia, retinopathy of prematurity, and bronchopulmonary dysplasia. Although poor vascular development during fetal and neonatal life may be repaired, the structural and antioxidant deficits identified in preterm babies may impair blood vessel development with long-term consequences. The conclusion drawn from this review is that present parenteral and enteral lipid nutrition for preterm babies is flawed and could be pathogenic. Full-term milk composition is the basis for the design of preterm infant foods, but full-term milk is different from the placental product that is rich in AA and DHA. Preterm lipid nutrition should be revised to be more in line with placental lipid transfer to the fetus.
Crawford MA, 1997, Health inequality: the UK's biggest health issue., Lancet, Vol: 349, ISSN: 0140-6736
Suzuki H, Manabe S, Wada O, et al., 1997, Rapid incorporation of docosahexaenoic acid from dietary sources into brain microsomal, synaptosomal and mitochondrial membranes in adult mice., Int J Vitam Nutr Res, Vol: 67, Pages: 272-278, ISSN: 0300-9831
This study examined the incorporation of docosahexaenoic acid (DHA) from several dietary sources into the brain tissue and intracellular organelles in mice which had been fed a 5% palm oil (low n-3 fatty acid level) diet for 8 or 11 weeks. The percentages of DHA in the tissues of mice fed 5% representative oils for 30 days or 5% purified n-3 fatty acid diets for 6 days were analyzed using gas chromatography. The percentage of DHA in the brain was ranked in the following order: the salmon oil diet group > the sardine oil diet group > > the perilla oil diet group > > the lard and palm oil diet groups for the 30 day feeding trial; and the DHA diet group > > the eicosapentaenoic acid and alpha-linolenic acid diet groups for the 6 day feeding trial. The percentage of arachidonic acid showed a more dramatic decrease than that of docosapentaenoic acid. These results reflected the plasma fatty acid concentrations, but were not as pronounced as the changes observed in the plasma. The majority of the DHA incorporated into the brain was recovered in microsomal, synaptosomal, and mitochondrial fractions separated by density gradient centrifugation. These membrane fractions took up DHA within several days. These results suggest that the intake of DHA itself increases the DHA level of brain membranes more rapidly than intake of the precursors in animals fed a low n-3 fatty acid level diet.
Stewart JS, Jeffrey B, 1996, Beef safety and publication of scientific information., Lancet, Vol: 347, ISSN: 0140-6736
Crawford M, 1996, Beef safety and publication of scientific information., Lancet, Vol: 347, ISSN: 0140-6736
Phylactos AC, Leaf AA, Costeloe K, et al., 1995, Erythrocyte cupric/zinc superoxide dismutase exhibits reduced activity in preterm and low-birthweight infants at birth., Acta Paediatr, Vol: 84, Pages: 1421-1425, ISSN: 0803-5253
In a comparative study in term, preterm and low-birthweight infants, the mean activity and standard error of the mean for copper/zinc superoxide dismutase (Cu/Zn SOD) in cord erythrocytes from five term small for gestational age infants was 0.94 +/- 0.10 SOD units (mg protein)-1. This value was significantly lower than the activity (2.34 +/- 0.24) in nine term, appropriate for gestational age (AGA) babies (p < 0.005). In 15 preterm (AGA) infants, the activity at birth (1.05 +/- 0.07 SOD units (mg protein)-1) was also significantly lower (p < 0.001) relative to term AGA babies. An increased level of activity (1.59 +/- 0.09) was detected in the red cells of eight preterm AGA infants on their expected date of delivery compared with (0.87 +/- 0.06) at birth (p < 0.001). However, the activity (1.59 +/- 0.09) was still lower than that detected in term AGA babies (2.34 +/- 0.24; p < 0.02). Similar findings were obtained when enzymatic activity was expressed in units per millilitre of packed erythrocytes. The low activity of Cu/Zn SOD in preterm and low-birthweight babies may render them susceptible to diseases associated with membrane lipid peroxidation.
Harbige LS, Yeatman N, Amor S, et al., 1995, Prevention of experimental autoimmune encephalomyelitis in Lewis rats by a novel fungal source of gamma-linolenic acid., Br J Nutr, Vol: 74, Pages: 701-715, ISSN: 0007-1145
The effects of oral administration of linoleic- and gamma-linolenic-acid-rich oils on the clinical and histopathological manifestations of experimental autoimmune encephalomyelitis (EAE) were investigated in Lewis rats 7 d post-inoculation. gamma-Linolenic-acid-rich fungal (Mucor javanicus) oil at 500 mg/kg body weight abrogated clinical and histological signs of EAE although at doses of 200 and 1000 mg/kg body weight it was only effective in delaying the onset of clinical disease. Linoleic-acid-rich safflower-seed (Carthamus tinctorius) oil at 500, 750 and 1000 mg/kg body weight decreased the severity of clinical EAE disease in a dose-dependent manner. The effects in healthy animals of orally administered gamma-linolenic-acid-rich fungal oil (500 mg/kg body weight) and linoleic-acid-rich safflower-seed oil (1000 mg/kg body weight) on splenic lymphocyte proliferative responses to the T-cell mitogen concanavalin-A (Con A), membrane fatty acid composition and lymphocyte sub-sets were also studied. Both treatments enhanced the T-cell proliferative response to Con A. There was no significant effect on the proportion of splenic CD8+ or CD4+ lymphocytes. Compositional studies on splenic phosphoglyceride fatty acids of oil-treated animals suggest the above responses were associated with increases in spleen dihomo-gamma-linolenic and arachidonic acids.
Crawford M, 1995, Dietary polyunsaturated fatty acids and aortic plaques., Lancet, Vol: 345, ISSN: 0140-6736
Suzuki H, Tamura M, Wada S, et al., 1995, Comparison of docosahexaenoic acid with eicosapentaenoic acid on the lowering effect of endogenous plasma cholesterol in adult mice, Fisheries science, Vol: 61, Pages: 525-526, ISSN: 0919-9268
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Craweord MA, Ghebremeskel K, Phyeactos A, 1995, The biochemistry of unsaturated fatty acids and development of preterm infants, Pages: 3-6, ISSN: 0007-0947
Very low birthweight is associated with a high risk of developmental disorders, particularly mental retardation, bronchopulmonary dysplasia, blindness, deafness, cerebral palsy and autism. The lower the birthweight, the shorter the gestation and the greater the exposure to oxygen, the greater is the risk of disorder(s). Very low birthweight babies are born with low circulating levels of arachidonic and docosahexaenoic acids, which are needed for neural and vascular development. They also have low levels of vitamins A and E and of enzymatic activity. Deficiency in these fatty acids is not compensated for by postnatal feeding. There is a possibility that these birth deficits play a role in the aetiology of disorders associated with low birthweight.
Ghebremeskel K, Leighfield M, Leaf A, et al., 1995, Fatty acid composition of plasma and red cell phospholipids of preterm babies fed on breast milk and formulae., Eur J Pediatr, Vol: 154, Pages: 46-52, ISSN: 0340-6199
UNLABELLED: Fatty acids of plasma and red cells of preterm babies, gestational age 28-33 weeks, weighing less than 2200 g were studied between birth and the expected date of delivery (EDD). Babies were fed either mothers' breast milk, or if they were unable, or chose not to breast-feed, randomly assigned to milk formula A or B. Milk B had 26% oleic acid, 0.5% docosahexaenoic acid (DHA) and 0.12% arachidonic (AA); A had 13% oleic acid, less than 0.05% AA and no DHA. The proportions of gamma linoleic and the other fatty acids, and the ratio of linoleic acid (LA)/alpha linolenic acid (ALA) were comparable in the two formulae. Diet and/or physiological adaptation seemed to be responsible for the significant changes in the proportions of certain fatty acids between birth and EDD. Incorporation of DHA in formula B increased its concentration in plasma and red cells, and reduced the conversion of LA to AA. With respect to maintenance of DHA status, milk B was superior to milk A but did not match breast milk. CONCLUSION: Fortification of formula with DHA without concomitant incorporation of AA may precipitate AA insufficiency and may have developmental implications.
Ghebremeskel K, Burns L, Burden TJ, et al., 1994, Vitamin A and related essential nutrients in cord blood: relationships with anthropometric measurements at birth., Early Hum Dev, Vol: 39, Pages: 177-188, ISSN: 0378-3782
Following the advice given by the Department of Health to women who are, or may become pregnant, not to eat liver and liver products because of the risk of vitamin A toxicity, the concentrations of vitamins A and E, and copper, magnesium and zinc in cord blood were investigated. The study was conducted in Hackney, an inner city area of London. Esters of vitamin A were not detected in any of the samples, indicating that there was no biochemical evidence of a risk of toxicity. Indeed, vitamin A correlated significantly with birthweight, head circumference, length, and gestation period. There was also a significant positive relationship between zinc and birthweight. In contrast, copper showed a negative correlation with birthweight and head circumference. Vitamin E and magnesium were not associated with any of the anthropometric measurements, although magnesium showed an increasing trend with birthweight. The data suggest that most of the mothers of the subjects studied may have been marginal with respect to vitamins A and E and zinc. In those with low birthweight babies. a higher intake would have improved their nutritional status and possibly the outcome of their pregnancy. For these low-income mothers, liver and liver products are the cheapest and the best source of vitamins A and E, haem iron, B vitamins and several other essential nutrients; hence the advice of the Department of Health may have been misplaced.
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