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The European Food Safety Authority recommendation for polyunsaturated fatty acid composition of infant formula overrules breast milk, puts infants at risk, and should be revised

Crawford MA, Wang Y, Forsyth S, Brenna JT (2015) Prostaglandins Leukot Essent Fatty Acids 102-103 1-3. doi: 10.1016/j.plefa.2015.07.005. Epub 2015 Sep 21. 

Web URL: Read this and related articles on PubMed here

Abstract:

The European Food Safety Authority (EFSA) has concluded from a limited review of the literature that although docosahexaenoic acid (DHA) is required for infant formula, arachidonic acid is not required "even in the presence of DHA" (EFSA Journal, 12 (2014) 3760).

This flawed opinion is grounded in human trials which tested functionality of DHA in neural outcomes and included arachidonic acid ostensibly to support growth.

The EFSA report mistakes a nutrient ubiquitous in the diets of newborn infants, through breast milk and with wide-ranging health and neurodevelopmental effects, for an optional drug targeted to a particular outcome that is properly excluded when no benefit is found for that particular outcome.

Arachidonic acid has very different biological functions compared to DHA, for example, arachidonic acid has unique functions in the vasculature and in specific aspects of immunity.

Indeed, the overwhelming majority of trials include both DHA and arachidonic acid, and test development specific to DHA such as neural and visual development.

DHA suppresses membrane arachidonic acid concentrations and its function. An infant formula with DHA and no arachidonic acid runs the risk of cardio and cerebrovascular morbidity and even mortality through suppression of the favorable oxylipin derivatives of arachidonic acid.

The EFSA recommendation overruling breast milk composition should be revised forthwith, otherwise being unsafe, ungrounded in most of the evidence, and risking lifelong disability.

FAB RESEARCH COMMENT:

World-leading lipid scientists explain here why the European Food Standards Agency has made a VERY serious mistake in its recent recommendation that there is no need for the long-chain omega-6 fat, arachidonic acid (AA) to be added to infant formula - even when this contains the long-chain omega-3 DHA.

As they emphasise, the EFSA recommendation is in fact
  • unsafe, ungrounded in most of the evidence, and risking lifelong disability.
The consequences for formula-fed infants could be very dangerous, should any manufacturers of infant formula now choose to leave out omega-6 AA (which few people have heard of) while continuing to add omega-3 DHA. 

They also point out that the EFSA recommendation is based not on the scientific evidence actually available - but on a very narrow review, which focused only on randomised, double-blind, placebo-controlled trials.
 
Such trials have focused almost exclusively on the effects of omega-3 DHA (essential for brain development and function), NOT on outcomes for which omega-6 AA is absolutely essential. These include cardiovascular development and immunity (among many, many others - as substances made from AA - and DHA - help regulate almost every aspect of brain and body function).

Both AA and DHA are essential for healthy body and brain development. Before birth, these vital long-chain polyusaturated fatty acids are preferentially transferred by the placenta from mother to fetus.

And after birth, both AA and DHA are present in breastmilk.  

Adding only DHA to infant formula could drive down levels of AA, owing to the natural competition between omega-3 and omega-6. Humans need both these essential fats - in the right balance - at any age. But adequate supplies are particularly crucial in early life, as nutrition during this critical period has lifelong consequences for brain and body health.

It can only be hoped that EFSA will admit their error rapidly - and withdraw or amend this misguided recommendation.


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