Abstract
BACKGROUND: The French National survey INCA2 pointed out that the majority of the French population (children, adolescents, adults and elderly) ingest low quantities of n-3 polyunsaturated fatty acid (PUFA) in the form of both precursor (alpha-linolenic acid, ALA) and long-chain (mainly docosahexaenoic acid, DHA). However, we don’t know whether such inadequate n-3 PUFA consumption is also found again in pregnant and lactating women. METHODS: Dietary lipid and PUFA intakes were determined from 28 pregnant and 21 lactating French women by using the most recent set of national robust data on food (National Survey INCA2 performed in 2006 and 2007), and compared with that of 742 women of childbearing age. RESULTS: Main results showed that mean daily intakes of n-3 PUFA were very low in this French woman population because no pregnant and lactating women met recommended dietary intakes (RDIs). Moreover, some of them ingested quantities 4 times (ALA) to 10 times (DHA) lower than RDIs. Very similar dietary intakes were observed in women of childbearing age. CONCLUSION: French pregnant and lactating women did not change their dietary habits to favor ALA and n-3 long-chain PUFA consumption via rich-ALA vegetable oils and fish and oily fish consumption, and have low n-3 PUFA dietary consumption typical of French women of childbearing age. Such PUFA intakes could have adverse impact on long-chain n-3 PUFA incorporation in brain membranes of fetus and infants, but also on cognitive and visual development of infants during the first years of life.
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Key Points
The perinatal period of growth and development requires higher dietary supplies of energy and of n-6 and n-3 PUFA in both maternal and infant diets than in adult life. A low dietary intake of LA impaired growth and caused skin scaliness and hair loss both in the growing rat and the formula-fed infant. Several observational studies have reported positive associations between visual and cognitive development in breastfed infants and DHA concentrations in their mothers’ milk. In contrast, it has been reported in animal models that a low maternal dietary intake of n-3 PUFA (ALA and DHA) during pregnancy and lactation induces in the young significant decrease in brain DHA content and alterations in behavioral performances of learning and visual functions which partly persist in adulthood. Most of current human adult diets in the Western industrialized societies are generally low in n-3 PUFA and mainly as long-chain (EPA, DHA). The aim of the present study was to explore the daily dietary intakes of fatty acids, especially main PUFA, in a small group of pregnant and lactating French women specifically issued from the INCA2 Survey. Intakes were recorded from 28 pregnant and 21 lactating women from different regions of France using a 7-d dietary record and by using a long list of food items (n=1305). They were compared with that of women of childbearing age also issued for the same survey and assessed from 742 women. The data presented here support a global pattern of inadequate n-3 PUFA intake in pregnant and lactating French women similar to that reported in the general population of adult women and men, children and adolescents, and elderly from the same National Survey INCA2 but also from the last INCA3 Survey conducted in 2014–2015. The n-3 PUFA mean intake was low both for ALA and long-chain fatty acids (mainly DHA), and far below the French RDIs i.e. half less than 0.8% EIEA for ALA and 250 mg/d for DHA. Moreover, some pregnant women consumed very low quantities of DHA that are below the amount accumulated daily in fetal tissues during the last trimester of pregnancy. These women consumed also low amounts of ALA with a high LA/ALA ratio which could considerably limit the rate of DHA biosynthesis from ALA. Therefore, such low n-3 PUFA status during pregnancy and lactation is of public health concern because these periods of active DHA accretion in the developing brain of fetus and newborn infants are particularly critical for ensuring optimal development of infant brain and visual systems. Results show that the daily LA intake of the INCA2 French population of pregnant and lactating is adequate for health for optimal growth and development, but remains not completely satisfactory for the prevention of cardiovascular heart diseases. In contrast, the present data on n-3 PUFA daily intakes clearly pointed out that the French population of pregnant and lactating women does not meet the French RDIs for both ALA and long-chain n-3 PUFA (DHA, but also EPA+DHA), similarly as previously reported in the same INCA2 survey population of children, adolescent and elderly. Such low ALA intakes in the French pregnant and lactating women population induced a high LA/ALA mean ratio of about 10 (RDI<5), against 5.4– 8.5 in other countries around the world. Due to the specific low ALA intake in the French general population, this nutritional situation appears different to what is observed in other Western countries and is at the origin of a nonbalanced LA/ALA ratio of 10 and more. Such PUFA imbalance in the maternal diet against n-3 PUFA during perinatal life, i.e. from the beginning of the third trimester of pregnancy up to 2 y of age in human, could alter DHA accretion and function of the developing brain and retina in infants.