Early nutrition : impact on short- and long-term health by Hans van Goudoever; Stefano Guandalini; Ronald E Kleinman

By Hans van Goudoever; Stefano Guandalini; Ronald E Kleinman

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This review integrates knowledge of the essential and regulatory functions of fatty acids focusing on the ␻-6 and ␻-3 fatty acids to consider the importance of dietary fatty acid quality in early metabolic development and long-term outcome. Dietary Fatty Acids and Their Sources As introduced, maternal diet is one of the most important factors determining the types and amounts of ␻-6 and ␻-3 fatty acids transferred across the placenta and secreted in human milk. There is no doubt that the absence of ⌬12 and ⌬15 desaturase enzymes needed to insert a double bond at the ␻-6 and ␻-3 position, respectively, leads to essentiality of ␻-6 and ␻-3 fatty acids in humans and other animals.

Dr. Klish: You already addressed part of my question in terms of the ratio of omega-3 and omega-6 fatty acid. Because our population has become so dependent on plant oils, it’s very hard to decrease the omega-6 component of that ratio. However, in infant formula, the solution has been to increase the DHA content rather than decrease the omega-6 or linoleic acid content. What would be more appropriate, knowing that 28 Diet Lipid and Programming human milk is composed primarily of saturated fat and has only a small amount of unsaturated fat?

As we know, human milk is 20–25% palmitate, representing about 10–12% of the infant’s energy intake. We have no indication that the saturated fat in human milk has any untoward effect. Dr. Kleinman: Could I ask a follow-up question on the opioid receptors and the increased perception of sweet taste? We know that we are born with an innate preference for sweet and salt. Can diet enhance those preferences or influence the way they change over time? Dr. Mennella: You don’t have to teach children to like sweet or salt; that, as you said, is innate; they are born preferring a much more intense sweetness, and this doesn’t decline until around mid- to late adolescence.

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