Study On Effect Of Dietary Polyunsaturated Fatty Acid In Children's Health: Lipid Metabolism Influence And The Function Improvement

Part One A study on different n-6:n-3 PUFAs ratio of breast milk for growth and development in infants and childrenObjective●To investigate the influence of two different dietary patterns with maternal fatty acid(FA) intake and different n-6:n-3 PUFAs ratio during pregnancy and lactation on FA composition of breast milk and infants' plasma phospholipids.●To prove the relationship between FA status of breast milk or infants' blood and the infants' growth and development.MethodsMethod design was prospective cohort study.●Two districts with different dietary patterns were selected for study:one was an inland city with traditional Chinese southern dietary pattern;the other was a coastal city with seafood dietary pattern.A 7-day dietary record was completed by women in their last trimester of pregnancy from these two places respectively.The FA composition in maternal diet was calculated and compared using the 2002 Chinese food composition database.●Blood of umbilical cord,day 5,day 42 and 1 year of the infants were obtained. Breast milk samples were collected on day 5,day 42 and month 4.The FA composition of blood and breast milk was analyzed by capillary gas-liquid chromatography to explore the effect of maternal dietary intake with fatty acid(FA) on FA composition of blood,growth and development in infants and children.●Subject anthropometric indices like weight,height,and head circumference were measured at ages 0,5 and 42 days,12,18 and 24 months.Cognitive assessment was completed at 6 months and 1 years of age,using Gesell Developmental Diagnosis.Results1.Sociodemographic characteristics of the samplesThere were no differ for mean maternal age,weight,height,and gestational age, infant's birth weight,birth length,infant sex,No.of para and obstetrical complications (P＞0.05).However,there was differ for BMI,and delivery manner.between two city (p＜0.05).2.The compare of two different dietary patterns on maternal dietary intakes and maternal total fatty acids intakes1) There were no differ of 7 days total dietary intakes of pregnant mothers between the coastal city Wenzhou and the inland city Changzhou.(p＞0.05).The intakes of cereal and sea food were higher in Wenzhou than in Changzhou,while the intakes of milk,red meat,fresh-water food and vegetable oil were lower(p＜0.05).2) There were no significant differences in maternal 7 days total fatty acids intakes between these two areas(p＞0.05).The intakes of total polyunsaturated fatty acids (PUFAs),C16:2,C18:2(LA),C18:3(ALA);C13 and C18(SFAs) as well as C14 and C22(MUFAs)of mothers in Wenzhou were significantly lower than that of Changzhou. The intakes of eicosapentaenoic acid(EPA,C20:5),C22:3,C22:5 and docosahexaenoic acid(DHA,C22:6) were higher than in Changzhou.3.Fatty acid profile of breast colostrums of two cities1) Fatty acid profile of breast colostrumsThe total PUFAs,n-6 and n-3 PUFAs as well LA,ALA,AA/DHA,C18:3n6,MUFA,SFA and USI of breast colostrum in Wenzhou were significantly lower than that of Changzhou(p＜0.05),but DHA,EPA+DHA,AA,C20:3n6,and C16:1n7,C24:1n9 as well C14:0,C16:0,C18:0,C22:0,C24:0 were higher than that of Changzhou(p＜0.05). There were same trend of PUFAs,LA,ALA,AA and DHA but EPA in breast colostrum with diatery PUFAs.2) Fatty acid profile of day 42 breast milkThe total PUFAs,n-6 and n-6/n-3PUFAs ratio as well LA,AA/DHA of day 42 breast milk in Wenzhou were significantly lower than that of Changzhou(p＜0.05),but DHA,EPA+DHA,AA,EPA were higher than that of Changzhou(p＜0.05);there were no differ for SFA;MUFA;ALA,C18:3n6,C20:2n6,C20:3n6,C20:3n9 and USI.3) The changes of PUFAs from breast colostrum to day 42 milkThere was significant increase of n-3PUFAs(p＜0.05),significant decrease of n-6/n-3PUFAs ratio from breast colostrum to day 42 milk in Changzhou and no differ for PUFA,AA,n-6 and DHA,EPA,EPA+DHA,LA,ALA(p＞0.05).There was significant increase of n-3PUFAs,DHA,EPA,EPA+DHA,LA,ALA and PUFAs,significant decrease of n-6/n-3PUFAs ratio and AA from colostrum to day 42 milk in Whangzhou(p＜0.05) and no differ for n-6(p＞0.05).4,Fatty acid profile of blood of two cities1) Fatty acid profile of cord bloodThe total PUFAs,LA,AA,n-6 PUFAs,ALA,AA/DHA,n-6/n-3 and USI,MUFA in cord blood phospholipids of Wenzhou(N=30) were significantly lower than in that of Changzhou(N=123),while EPA was higher than that of Changzhou(p＜0.05).There were no differ in n-3 PUFAs,DHA and EPA+DHA of two sites.2) Fatty acid profile of day 5 bloodThe total PUFAs,AA,n-6 PUFAs,AA/DHA,n-6/n-3 and USI in day 5 blood phospholipids of Wenzhou(N=36) were significantly lower than in that of Changzhou (N=122)(p＜0.05),while SFA and USI was higher than that of Changzhou(p＜0.05). There were no differ in n-3 PUFAs,DHA EPA,EPA+DHA,ALA,LA,n-6/n-3 and MUFA of two sites.3) Fatty acid profile of day 42 bloodThe total PUFAs,AA,n-6 PUFAs,AA/DHA,n-6/n-3 and LA,ALA in day 42 blood phospholipids of Wenzhou(N=14)were significantly lower than in that of Changzhou(N=115)(p＜0.05),while n-3 PUFA,DHA,EPA+DHA,SFA and C16:0, C22:0,C24:0 were higher than that of Changzhou(p＜0.05).There were no differ in EPA,MUFA and USI of two sites.(p＞0.05)4)The changes of PUFAs composition from cord,day 5 to day 42 bloodThere was significant increase of n-3PUFAs(5→42day,p＜0.05),and n-6 (0→5day,p＜0.05).There was significant increase of n-6(day 0→5),and significant decrease(day 5→42) of blood in Whangzhou(p＜0.05).There was significant increase of n-6PUFAs from cord to day 5 to day42 blood in Changzhou(p＜0.05).There was significant increase of n-6/n-3 from cord to day 5 (p＜0.05).5.The correlation of PUFAs between breast milk and blood phospholipidsThere was positive correlation between breast milk and blood PL at day 5 for ALA,DHA and DHA+EPA in Changzhou(n=45,r=0.36,r=0.39,r=0.39,P＜0.05). There was no correlation between breast milk and blood PL at day 5 for LA and AA in Changzhou(P＞0.05).There was positive correlation between breast milk and blood PL at day 42 for LA,ALA,AA,DHA and DHA+EPA in Changzhou(n=45,r=0.50,r=0.49,r=0.46, r=0.42,r=0.46,P＜0.01).6.The effect of fatty acid status of plasma phospholipids during early infancy on growth incomes1) Average weight at birth,day 5,42 and 4 monthsThere was no differ of average weight for infants at birth,day5 and day 42 in Changzhou and Wenzhou(p＞0.05).The average weight of infants at 4 months was significant lower in Wenzhou than in Changzhou(p=0.01)2) The relationships of PUFAs in early life and weight at different intervals●There was negative correlation trend of infant's blood PL DHA and n-3 PUFAs at cord,day 5,day42 and 12 mons with infant's weight at day 42,2,4,6,12 and 18 mons.There were significant negative correlation between cord DHA,n-3 PUFAs and weight of 12 mons;DHA,n-3 PUFAs at day 42 and weight of 6 mons.(P＜0.05, P＜0.05;P＜0.01,P＜0.01)●There was positive correlation trend of infant's blood PL n-6/n-3 PUFAs at cord,day 5,day42 and 12 mons with infant's weight at day 42,2,4,6,12 and 18 mons. There were significant positive correlation between cord n-6/n-3 PUFAs and weight of 12 mons;n-6/n-3 PUFAs at day 42 and weight of 6 mons.(P＜0.05,P＜0.01)3) The relationships of PUFAs in early life and BMI at different intervals●There were significant negative correlation between DHA,n-3 PUFAs of cord, day5,day42 with BMI of 12 mons,significant positive correlation between n-6/n-3 PUFAs of cord,day5,day42 with BMI of 12 mons.●There were significant negative correlation between DHA,n-3 PUFAs of cord, day42 with BMI of 18 mons,significant positive correlation between n-6/n-3 PUFAs of cord,day42 with BMI of 18 mons.7.The effect of fatty acid status of plasma phospholipids during early infancy on infant's DQThere were significant higher of Gesell DQ for the personal/social,language,and motor in Wenzhou than Changzhou at age 6 months.But no differ for adaptive/cognitive.Conclusion1.The significant differences in maternal intakes of FAs depending on their dietary habits and these dietary differences appear to influence the FA composition of breast milk and infant's blood as well the growth and development of infants and children.2.The n-3 PUFA content in plasma phospholipids during early infancy may have great impact on child physical growth in later infancy.Higher blood DHA content and lower the n-6/n-3 ratio in early infancy may help the infants to achieve optimal body weight later.3.The adjusts of dietary structure may affect the changes on composition of dietary PUFAs during pregnancy and lactation,and improve FA composition and n-6/n-3 PUFAs ratio of breast milk and infants' plasma phospholipids.To optimize the infant's growth and development. Part Two A study on effect of dietary supplements with n-3PUFAs in children with ADHD and IQ critical:lipid metabolism influence and the function improvementObjectiveTo investigate the difference of PUFAs and n-6:n-3 PUFAs ratio during two groups children at age 7-12 years old:1) IQ 70-85 VS IQ 115-130,2) with ADHD VS not with ADHD.Meanwhile to conduct the dietary supplements with n-3PUFAs in children with ADHD and IQ critical and analyze effects of lipid metabolism influence and the function improvement including red blood corpuscle PUFAs,IQ,behavior of Attention-deficit hyperactivity disorder and scholastic achievement.Methods1555 primary school students,aged 7-12 years were recruited using cluster sampling from the mid-level district of Zhejiang province.Intelligence and behaviour were assessed using IQ screen test and scale for ADHD(DSMⅣ).The students of IQ 70-85 and IQ 115-130 as well ADHD were diagnosed,their red blood corpuscle PUFAs and n-6:n-3 PUFAs ratio was analyzed,their vision was tested.Randomised,double-blind and controlled design was used for intervention study. The students with IQ 70-85 and with ADHD were divided into intervention and control groups respectively.The egg contained n-3 PUFAs was supplemented to intervention group,and the egg no n-3 PUFAs for control group.The effects of red blood corpuscle PUFAs,IQ,behavior of Attention-deficit hyperactivity disorder and scholastic achievement were assessed.Results1.Sociodemographic characteristics of the samples The study population consisted of 1555 primary school students,aged 7-12 years. After the intelligence being test and behavior questionnaire investigated,finally ADHD students were 79;The students of IQ critical were 48 people(male 26),aged 8～12 years old;Students whose IQ on the outstanding were 50 people(male 24),aged 7～11 years.2.The FA composition of two different IQ groupsRed blood corpuscle AA,C22:4(n-6),EPA,DHA and n-3PUFAs in students whose IQ on the outstanding were significant higher than that of the students of IQ critical, however,n-6/n-3PUFAs ratio,LA and C20:3(n-6) were lower than that of the students of IQ critical.C20:0,C24:0,C15:1,C18:1,C24:1 were higher in the students of IQ critical than students whose IQ on the outstanding.3.Effect of dietary supplements with n-3PUFAs in children with IQ critical:lipid metabolism influenceThe ALA,EPA,DHA and n-3 PUFAs,C20:2(n-6),partly SFA were significant increased;n-6 PUFAs and n-6/n-3 ratio,C20:3(n-6),were significant reduced after intervention with n-3 PUFAs supplement on students of IQ critical.The C15:1,C22:0 were significant increased;C16:0,C18:0,C16:1,C20:1,EPA were significant reduced after intervention with control egg on control students of IQ critical.4.Effect of dietary supplements with n-3PUFAs in children with IQ critical:IQ and vision improvement1) IQ and vision improvement:The IQ score was significant improved after intervention with n-3 PUFAs supplement on students of IQ critical while IQ was also improved after intervention in control group.2)Vision improvement:The vision of left eye was significant improved after intervention with n-3 PUFAs supplement on students of IQ critical while the vision of right eye and control group was no improved after intervention.5.Effect of dietary supplements with n-3PUFAs in children with IQ critical: scholastic achievement improvement The scholastic achievement was significant improved after intervention with n-3 PUFAs supplement on students of IQ critical while there was no differ in control group.6.The compare of blood PUFAs composition of ADHD and normal studentsC15:0,16:0,20:0 were sig.higher,and AA,C20:3(n-6),EPA,n-6 were significant lower in ADHD students than normal group.No differ for DHA,n-3,LA and n-6/n-3.7.The effect of dietary supplements with n-3PUFAs in children with ADHD: lipid metabolism influenceThe DHA and∑n-3PUFAs were significant elevated after intervention with n-3 PUFAs supplement on students of ADHD while n-6/n-3 ratio was significant decreased. But no differ in control group before and after intervention,especially n-3 PUFAs.8.The change of attention behavior before and after dietary supplements with n-3PUFAs in children with ADHDAfter dietary supplements with n-3PUFAs in children with ADHD,the reduction of ADHD was 45 people,reduced percent was 43%.9.The change of vision before and after dietary supplements with n-3PUFAs in children with ADHDAfter dietary supplements with n-3PUFAs in children with ADHD,the students' lfet and right vision with ADHD was significant improved,but no differ in control group.10.The change of scholastic achievement before and after dietary supplements with n-3PUFAs in children with ADHDAfter dietary supplements with n-3PUFAs in children with ADHD,There were no sig.differ for scholastic achievement in intervention and control groups..Conclusion1.The intelligence critical or the intelligence outstanding student had the different composition of n-3 unsaturated fatty acid.There was possible relationship between DHA,n-3PUFAs,the n-6/n-3 unsaturated fatty acid and the intelligence level.To supplemented n-3PUFAs for the IQ critical student may raise their red blood cell n-3 PUFAs level,the IQ score and the scholastic achievement.2.We used the epidemiology and the clinical trial method to observe and examine the sample,the results shown that the PUFAs and n-3 PUFAs level had remarkable difference of students with and no with ADHD.After supplemented n-3PUFAs,DHA and n-3PUFAs remarkable enhanced,but n-6/n-3 ratio obviously reduced;ADHD behavior and the vision had distinct improvement.3.This project may offer research evidence and intervention model for optimizing the intelligence development and improving ADHD behavior;to introduce child nutriology research into the ADHD morbidity and the intervention mechanism research area.The potential value is the project result may improve intelligence level,the ADHD behavior and the school achievement through the dietary management,not merely depends on the medicine to treat and prevent ADHD or IQ critical students.