Acknowledged academic LCPUFA experts challenge EFSA’scomposition of infant formula recommendations with regard to inclusion of arachidonic acid

A new paper from a distinguished group of academic experts on the effects of LCPUFAs on neural development has challenged a 2014 EFSA recommendation on the fatty acid composition of infant formula, which stated that ARA is not required in infant formula, even if DHA is present. The authors pointed out a range of shortcomings in the scientific review that gave rise to the recommendation, including the fact that papers prior to 2000 were not considered, which disqualified many of the key papers including those of the 1982 Nobel Prize winners Bergstrom, Samuelson and Vane. Further, they point out that ARA is ubiquitous in human milk throughout the world and that the consequences of its removal from infant formula are unknown.

A new paper (1) from a distinguished group of academic experts on the effects of LCPUFAs (Long-Chain Polyunsaturated Fatty Acids) on neural development has challenged a 2014 EFSA (European Food Safety Authority) recommendation on the fatty acid composition of infant formulas (2), which stated that arachidonic acid (ARA) is not required in infant formulas, even if docosahexaenoic acid (DHA) is present.

The authors pointed out a range of shortcomings in the scientific review that gave rise to the recommendation, including the fact that papers prior to 2000 were not considered, which disqualified many of the key papers including those of the 1982 Nobel Prize winners Bergstrom, Samuelson and Vane (whose work demonstrated that metabolites derived from ARA were important in the control of blood flow, immune function and reproduction).

ARA is found in all human milk throughout the world, the mean value 0.47% +/-0.13% (range: 0.24–1.0%) expressed in terms of total fatty acids (3). The authors point out that the consequences of the removal of ARA from infant formula that also contain DHA are unknown.

The authors remind us that during the early period of infant development, there is a very rapid development of the vascular system. During that time, ARA is converted to prostacyclins, which ensure that a good blood flow is received by all the developing essential organs. They prevent rogue cell adhesion to the endothelium and ensure vascular relaxation (1). In the brain, DHA is mainly found in the neural synapses and gray matter, whereas ARA is found in the glial cells. ARA is also an important substrate for the formation of adrenic acid in the brain.

Earlier this year, another group of experts headed by Professor Koletzko also expressed concerns about the EFSA’s opinion, commenting that levels of up to 1% DHA without ARA had not been tested for “effects, suitability and safety” (4).

A new European delegated act concerning the composition of infant formula will be published in the Official Journal within a few months. This new regulation will specify what usage is to be made of both ARA and DHA in infant formula production in the future.

1. Crawford, M. A., Wang, Y., Forsyth, S. & Brenna, J. T.; “ The European Food Safety Authority recommendation for polyunsaturated fatty acid composition of infant formula overrules breast milk, puts infants at risk, and should be revised”. Prostaglandins, Leukot. Essent. Fat. Acids 1–3 (2015). doi:10.1016/j.plefa.2015.07.005
2. EFSA NDA Panel; “Scientific opinion on the essential composition of infant and follow-on formula”, EFSA Journal 2014, 12: 3760.
3. Brenna JT, Varamini B, Jensen RG et al., “Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide”; Am J Clin Nutr 2007; 85:1457–1464.
4. Koletzko B, Carlson SE and Van Goudoever JB; “Should Infant formula provide both omega-3 DHA and omega-6 arachidonic acid?”; Ann Nutr Metab 2015; 66:137–138.