Impact of early dietary intake and blood lipid composition of long-chain polyunsaturated fatty acids on later visual development

J Pediatr Gastroenterol Nutr. 2000 Nov;31(5):540-53. doi: 10.1097/00005176-200011000-00016.


Background: In contrast to human milk, current infant formulas in the United States do not contain omega3 and omega6 long-chain polyunsaturated fatty acids. This may lead to suboptimal blood lipid fatty acid profiles and to a measurable diminution of visual function in developing term infants. The need for docosahexaenoic acid and arachidonic acid supplementation in the infant diet was evaluated in a double-blind, randomized clinical trial.

Methods: Healthy term infants were randomized to diets of (1) commercial formula, (2) docosahexaenoic acid-enriched formula (0.35% of total fatty acids), or (3) docosahexaenoic acid- (0.36%) and arachidonic acid- (0.72%) enriched formula. Eighty-seven infants completed the 17-week nutritional trial, and 58 were observed until 52 weeks of life. A reference group was exclusively breast fed for at least 17 weeks (n = 29). Outcome measures included electroretinographic responses, visual evoked potentials, and blood fatty acid analysis in infants at birth and at 6, 17, and 52 weeks of age.

Results: Commercial formula-fed infants had 30% to 50% lower content of docosahexaenoic acid in total red blood cell lipids during the 17-week feeding trial compared with breastfed infants. Significant differences persisted at the 1-year follow-up. Arachidonic acid content was consistently reduced in the commercial formula group by 15% to 20%. Infants fed long-chain polyunsaturated fatty acid-enriched formulas had docosahexaenoic acid and arachidonic acid blood lipid profiles resembling those of human milk-fed infants. Infants receiving this enriched formula had more mature electroretinographic responses than commercial formula-fed infants at 6 weeks of age. Human milk-fed and docosahexaenoic acid-enriched formula-fed infants had better visual acuity than commercial formula-fed infants at both 17 and 52 weeks of age. Early (17-week) fatty acid profiles in blood lipids were correlated with later (52-week) visual function development in study infants.

Conclusions: Results from this clinical trial demonstrate that long-chain polyunsaturated fatty acid supplementation of formula in term infants produces blood lipid fatty acid profiles that are similar to those observed in breast-fed infants. This supplementation leads to better visual function later in life (i.e., 1 year of age) than that shown by infants fed commercial formula.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Arachidonic Acid / administration & dosage
  • Arachidonic Acid / blood
  • Arachidonic Acid / pharmacology*
  • Bottle Feeding
  • Breast Feeding
  • Cohort Studies
  • Docosahexaenoic Acids / administration & dosage
  • Docosahexaenoic Acids / blood
  • Docosahexaenoic Acids / pharmacology*
  • Double-Blind Method
  • Electroretinography
  • Erythrocytes / chemistry
  • Evoked Potentials, Visual / drug effects*
  • Evoked Potentials, Visual / physiology
  • Fatty Acids / analysis
  • Fatty Acids / blood*
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / analysis
  • Fatty Acids, Omega-6
  • Fatty Acids, Unsaturated / administration & dosage
  • Fatty Acids, Unsaturated / analysis
  • Female
  • Fetal Blood / chemistry
  • Humans
  • Infant
  • Infant Food* / analysis
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Lipids / blood
  • Lipids / chemistry
  • Retina / drug effects
  • Retina / physiology
  • Visual Acuity / drug effects*
  • Visual Acuity / physiology


  • Fatty Acids
  • Fatty Acids, Omega-3
  • Fatty Acids, Omega-6
  • Fatty Acids, Unsaturated
  • Lipids
  • Docosahexaenoic Acids
  • Arachidonic Acid