Abstract 1639 Poster Session III, Monday, 5/3 (poster 67)

Background. In several published, randomized trials of preterm and term infants, infants fed formula with the n-3 fatty acid DHA had higher neural development than infants fed formula containing the DHA precursor, α-linolenic acid, but no preformed DHA. However, preterm infants fed DHA also experienced lower growth in several trials, the possible result of not including the n-6 fatty acid ARA, a necessary factor for growth. This study evaluated whether ARA with DHA prevented the lower growth seen with DHA alone. Methods. This multicenter, randomized, double-masked trial compared first-year growth of term (39-41 wk PMA), AGA infants fed formula without DHA and ARA (Control, C) with that of infants fed experimental formulas with DHA (0.3% of total fatty acids) and ARA (0.6% of total fatty acids). One experimental formula contained fish oil DHA and fungal oil ARA (S-FF). The other contained algal oil DHA and fungal oil ARA (S-AF). Effects of DHA and ARA on visual acuity (Teller Acuity Card procedure, TAC) and the Bayley Scales of Mental (MDI) and Psychomotor Development (PDI) were assessed as secondary aims. At baseline (0.5 mo), 377 infants were divided among the three groups with 335 of these infants (112 C, 113 S-FF, 110 S-AF) returning to be studied at 2 mo, and 322 infants (107 C, 109 S-FF, 106 S-AF) returning to be studied at 4 mo. Results. S-FF and S-AF had higher weight gain between 0.5 mo and 2 mo (34.4 g/d, p=0.041 and 35.2 g/d, p=0.007, respectively) than C (32.1 g/d). Similarly, S-FF (28.4 g/d, p=0.031)and S-AF (29.1 g/d, p=0.002) gained more rapidly than C (26.7 g/d) between 0.5 and 4 mo. Body weights of S-FF and S-AF were somewhat higher (not significantly) than C at 6, 9 and 12 mo; the means for length and head circumference were virtually identical in all three diet groups at all study ages. Visual acuity did not differ at any of the assessment ages (4, 6 or 12-mo). Mean 12-mo MDI and PDI scores were S-AF > S-FF > C, but did not reach significance for an effect of diet with 93 C, 86 S-FF and 97 S-AF studied at 12 mo (p=0.31 and p=0.15, respectively). Summary. Infants fed the experimental formulas with DHA and ARA gained weight more rapidly than the control group from 0.5 to 4 mo of age, and weighed somewhat more than the control group through 12 mo of age. MDI and PDI scores were higher in the experimental groups than the control, but did not reach statistical significance as the study was designed to detect a 5-pt or larger effect of diet. While visual acuity was not higher at 4, 6 or 12 mo, several other studies have found higher acuity at 2 mo but not at these ages in infants fed DHA Conclusions. Supplementation with DHA and ARA increased early weight gain and may have improved first year neural development of term infants. Feeding fish or algal and fungal oil sources of DHA and ARA for the first year had no adverse effects on growth and development.

Mead Johnson Research Center, Evansville, IN