Oxidative Stress in Preterm Infants Fed a Formula Containing Long-Chain Polyunsaturated Fatty Acids (LCPUFA)

Abstract

Our study examined if dietary long-chain polyunsaturated fatty acids (LCPUFA) have an impact on oxidative stress in preterm infants. Serum malonyldialdehyde (MDA), total peroxide concentrations, and total antioxidant capacity were determined at mean (standard deviation [SD]) 34.7 (10.9) days of life in 104 healthy preterm infants (gestational age, 32.6 [2.9] weeks; birthweight; 1605 [285] g) who were randomly assigned to be fed since birth either a formula containing LCPUFA (arachidonic and docosahexaenoic) (group A, n = 50) or a LCPUFA-free formula with identical compositions for other nutrients (group B, n = 54). Clinical and anthropometric characteristics did not differ significantly between the two groups. Mean (SD) serum MDA levels did not differ significantly between groups A (0.23 [0.04] micromol/L) and B (0.22 [0.05] micromol/L). The concentrations of total peroxides were below the detection limits of the assay in 41 of 50 (82%) infants of group A and 43 of 54 (79%) infants of group B and not significantly different between the two infant groups. No difference was observed in serum total antioxidant capacity between groups A (340.0 [46.2] micromol/L) and B (354.7 [46.5] micromol/L). We concluded that supplementation of infant formulas with LCPUFA does not affect lipid peroxidation in healthy preterm infants.

Plasma Oxidative Status in Preterm Infants Receiving LCPUFA Supplementation: A Pilot Study

“…The LCPUFA intervention did not have an effect on growth rate. Similar data were described with SMOFLipid, an emulsion based on fish oil including ARA and DHA [42] or with a combination of ARA:DHA similar to the one used in this study [41]. Although we did not detect an improvement in growth, it is possible that this supplementation might reduce perinatal morbidities or improve neurodevelopment, an aspect which should be evaluated in a larger cohort.…”

“…A tendency toward an increase in Antiox-S was observed at day 28, but did not reach statistical significance (p = 0.069). In a study with a similar intervention (ARA:DHA 1.6:1), supplementation for seven days did not modify total antioxidant capacity in preterm neonates [41]. These data suggest that long periods of supplementation might be needed to produce an effect.…”

Vitamin E Content and Estimated Need in German Infant and Follow-On Formulas With and Without Long-Chain Polyunsaturated Fatty Acids (LC-PUFA) Enrichment

“…In contrast, a study in preterm infants, comparing the effects of formulas with or without LC-PUFA but the same vitamin E content, found a decreased α-tocopherol/total lipid ratio in erythrocytes and lower plasma α-tocopherol contents with LC-PUFA enriched formulas. , Preterm infants are most likely more susceptible to peroxidation, therefore these findings cannot be extrapolated to term infants. Moreover, other studies in preterm infants showed no effect of LC-PUFA enrichment on vitamin E levels or markers of oxidative stress (i.e., total plasma antioxidant capacity (PAC), serum malondialdehyde (MDA), total peroxides and total antioxidant capacity (TAC)). , Interestingly, even antioxidant effects of n-3 fatty acids or LC-PUFA were reported in preterm infants receiving parenteral nutrition enriched with n-3 LC-PUFA plus added vitamin E, compared to a standard soybean-oil-based lipid emulsion or getting LC-PUFA enriched compared to not-enriched formulas. , …”

“…Studies on effects of LC-PUFA enriched formulas for term infants on antioxidant status or markers of peroxidation are rare. Most of such studies relate to low-birth-weight or preterm infants, but only a few relate to term infants. − Gonzáles-Corbella et al did not find differences in α-tocopherol concentrations and vitamin E/LC-PUFA ratios (mg/%) in plasma and red blood cells in term infants fed human milk, or formulas (with or without LC-PUFA). However, formulas contained higher levels of tocopherol …”

Role of Radicals in the Lipid Peroxidation Products of Commercial Infant Milk Formula

“…Exposure to light during tube feeding increases lipid peroxidation in infant formula but not in human milk. It has been observed that supplementing infant formulas with LCPUFA does not affect lipid peroxidation in the plasma of healthy, preterm infants (6). An investigation of the extent to which formula milk and stored breast milk, both commonly used in hospitals, could be pro-oxidant sources for newborn babies, found that there were notable differences in the oxidation parameters of several formula milk brands, particularly concerning the levels of lipid peroxides and total antioxidant capacity.…”