We're All Fat Heads
Docosahexaenoic acid or DHA is an omega-3 long chain fatty acid, the primary structural fatty acid in the gray matter of the brain and retina of the eye. DHA is essential for brain and eye function.
Humans obtain DHA from their diets, initially through the placenta, then from breast milk, and later through dietary sources, such as fish, red meats, animal organ meats and eggs. Popular fish like tuna, salmon and sardines are rich sources.
The human body also synthesizes small amounts of DHA. In recent years, scientists have developed techniques to extract DHA from microalgae, the fish's original source of this valuable nutrient. This sea vegetable oil form closely matches the DHA that is found in human breast milk.
The human body does not adequately synthesize DHA. Therefore, it is necessary to obtain it from dietary sources. The average American's diet, however, is low in DHA because of declining consumption of red meat, animal organs and eggs.
Because DHA is important for signal transmission in the brain, eye and nervous system, many Americans concerned with maintaining mental acuity are searching for a pure, safe way to supplement their DHA levels.
Until recently, the primary source of DHA dietary supplements has been fish oils.
However, scientists have developed a process that extracts DHA from microalgae under tightly controlled manufacturing conditions, yielding a highly, purified form of DHA. Unlike most fish oils, Neuromins™ DHA is a single nutrient source of DHA.
For example Neuromins DHA does not contain eicosapentaenoic acid (EPA), which is not recommended for infants, children and certain adults. Neuromins™ DHA is also free of chemical pollutants and toxins.
DHA or DHEA?
DHA and DHEA are two completely different substances. DHA is docosahexaenoic acid, an omega 3 long chain fatty acid that is the primary structural fatty acid in the gray matter of the brain and retina of the eye. DHA is essential for mental and visual function.
People normally get DHA in their diet. DHEA is short for dehydroepiandrosterone, a hormone made by the adrenal glands, located just above the kidneys.
How Does DHA Work in the Body?
Sixty percent of the brain is fat, and DHA is the most abundant fat in both the brain and retina of the eye. Cells in the brain, retina, and other parts of the nervous system have connecting arms on their membranes that transport electrical currents between cells, sending messages to the body.
DHA assures the optimal flexibility of nerve cell membranes essential for the transmission of these signals.
Low levels of DHA have been correlated with changes in disposition, memory loss, visual and other neurological conditions, and research is underway to determine whether there is a connection.
Patients taking DHA showed a 65% improvement in dementia symptoms in a study performed at the Gunma National University Medical Department in Japan.
Although it does not apply to normal human beings, the role of DHA is profoundly illustrated by cases in which children have no DHA as a result of certain genetic disorders that prevent them from making it.
These children lose brain and eye function altogether.
DHA and Infant Development
Adequate dietary intake of DHA is particularly important for pregnant and nursing women. Significant brain and eye development occurs in utero and continues during the first year after birth.
Infants rely on their mothers to supply DHA for the developing brain and eyes initially through the placenta and then through breast milk. DHA is the most abundant omega-3, long chain fatty acid in breast milk, and studies show that breast-fed babies have IQ advantages over babies fed formula without DHA.
Women need sufficient stores of DHA for the proper nourishment of their babies during pregnancy and lactation. Evidence points to the need for them to build up their stores ahead of the actual need.
The DHA content of average U.S. adults has declined as a result of dietary changes, and the DHA level in breast milk of U.S. women is one of the lowest in the world. A woman's store of DHA depletes further during pregnancy, due to demand by the developing infant.
To maximize DHA supply infants should be breast fed if possible. Where they cannot be breast fed, they should still take every possible nutritional advantage.
According to its 1994 report, Fats and Oils in Human Nutrition, a Joint Expert Committee of the World Health Organization and U.N. Food and Agriculture Organization recommends that all infant formulas contain DHA.
Is DHA Safe?
DHA has been evaluated by an independent panel of experts and found to be Generally Recognized as Safe (GRAS) for adults, including pregnant and lactating women.
Because of its purity, DHA also has been incorporated into infant formulas in Europe.
As we consume foods lower in fat, we may be getting inadequate amounts of several beneficial fats essential to our well being, scientists now say.
Ironically, the push to "eat healthier" by reducing overall fat consumption may leave Americans more vulnerable than ever to mental problems such as depression and dementia, and may cause impaired brain development in babies.
The seeming about face in the scientific view of fat is the result of a deeper understanding of various fats and how our bodies use them. As we learn more about the "good" fats, we also are learning how to combine a low fat diet with the nutrients essential for mental well being.
The Importance of DHA
Few, people realize that the primary building material in the brain is fat. Indeed, a full 60 percent of the brain is composed of fats, of which DHA (docosahexaenoic acid); a long-chain polyunsaturated omega-3 fatty acid is the most abundant. DHA is also the most abundant fat in the retina of the eye.
Human consumption of DHA and the DHA levels present in humans has declined in the last 50 years as we have attempted to improve our diets. Most of us are eating fewer high fat foods such as eggs, lard and organ meats, all of which contain DHA.
Yet our intake of fatty acids determines to a large extent the make up and function of brain cell membranes. For example, DHA provides brain cell membranes with the flexibility necessary for efficient signal transmissions.
Adult Requirements for DHA
The human body can produce DHA from another fatty acid, though it does not produce it efficiently. Furthermore, studies suggest that direct consumption of DHA is important for mental health and well being. This is a growing concern as the U.S. population ages.
A recent survey by the Biotechnology Industry Organization found that more Americans fear the loss of mental, than of physical powers. There is more at stake here than the occasional forgetfulness that goes with aging.
Epidemiological research in the United States and elsewhere shows a correlation between reduced intake of this fatty acid and the increased incidence of depression and dementia. An article was published in the American Journal of Clinical Nutrition in 1995, by Dr. Joseph R. Hibbeln and Dr. Norrnan Salem, Jr. of the National Institute of Health.
It noted the documented increase in depression in North America during the last 100 years, the period during which DHA consumption has declined. Countries where DHA levels have remained constant have not experienced these increases in depression.
Commenting that the "many stresses of modem life contribute" to the prevalence of this disease, Hibbeln and Salem add that relative deficiencies of DHA may also intensify vulnerability to depression. Alcoholism and post-partum depression likewise may be affected by declines in DHA.
Chronic alcohol consumption can reduce DHA levels in the brain, and delivery of an infant reduces DHA levels in the mother's blood. Several studies have noted a similar correspondence between the decline in an individual's level of DHA and the incidence of Alzheimer's disease.
The brains of Alzheimer's patients show lower levels of DHA and of arachidonic acid another long-chain polyunsaturated fatty acid than do the brains of healthy geriatric patients. This decline is accompanied by an increase in other fatty acids.
A change in the proportion of DHA relative to other fatty acids in the brain is likely to diminish mental functioning.
The Importance of DHA for Infants
Perhaps the most significant research on DHA involves infant brain development.
During the late stages of fetal development and immediately following birth, the human brain grows very rapidly. The DHA content of the fetal brain increases three to five times during the final trimester of pregnancy and triples yet again during the first 12 weeks of life.
It is therefore worrisome that studies show that pregnant women today have lower levels of DHA in the blood than pregnant women did previously and that DHA levels in the breast milk of American women are not among the lowest in the world.
In addition, following a pregnancy, the level of DHA in the mother's blood is depleted and takes time to return to pre-pregnancy levels.
Premature babies are especially at risk for DHA deficiency as are U.S. infants who are not breast-fed, due to the fact that U.S. infant formula is not enriched with DHA. One study has shown that the IQs of formula-fed infants are eight points lower, on average than those of breast fed babies.
The development of both the retina and visual cortex are similarly dependent on DHA. The retina develops rapidly during the final months of pregnancy and the first six months of infancy. One study found that the eyesight of full term babies fed DHA enriched formula was measurably more acute than that of babies fed formula without DHA.
The difference in vision was equivalent to one line on an eye chart. These are among the reasons an expert panel of the world Health Organization has recommended that all infant formula be enriched with DHA, as it is in some European and Asian countries.
The U.S. Food and Drug Administration is currently reviewing a proposal that DHA be required in formula.
Correcting DHA Deficiencies
Significantly, the same studies that show reductions in blood DHA levels in American women reveal that women whose diets include regular consumption of fish, a rich source of DHA, have not experienced declining DHA levels.
For those who do not eat fish regularly, DHA supplements may be advantageous. Until recently, however, the only DHA supplements available were derived from fish oils, some of which have been reported to contain toxins and chemical pollutants.
Now, as a result of a scientific breakthrough, it is possible to supplement the diet with a safe, natural, single nutrient form of DHA derived from microalgae, the original source of DHA for fish. A pure, vegetable source of DHA, extracted through a proprietary process developed so that consumers can get the "good" fat they need for optimal health without the worry.
DHA and Depression
Preliminary research suggests there is a correlation between low levels of fatty acid and depression as well as dementia.
Preliminary studies on docosahexaenoic acid (DHA) suggest that this long chain fatty acid may have promise in the treatment of several neurological disorders, including Alzheimer's disease and depression. DHA is the primary structural fatty acid in the gray matter of the brain and retina of the eye and is essential for brain and eye development.
Epidemiological research in the United States and elsewhere shows a correlation between reduced DHA levels in the blood and depression. In the Hibbeln and Salem article they documented an increase in depression in North America during the last century, a period during which consumption of DHA declined.
Commenting that the many stresses of modem life contribute to the prevalence of depression, they add that relative deficiencies in omega-3 essential fatty acids such as DHA may also intensify vulnerability to depression.
Hibbeln and Salem point to the lower rates of major depression in societies consuming large amounts of fish, a key dietary source of DHA. In an intensive cross national collaborative study of rates of depression, North American and European populations showed cumulative rates of depression 10 times greater than a Taiwanese population that consumes a diet rich in fish.
The authors note that alcoholism and postpartum depression are also associated with low DHA levels in the blood. Chronic alcohol intoxication depletes DHA levels in the brain, which Hibbeln and Salem suggest may facilitate the development of depressive symptoms.
They also speculate that the depletion of DHA levels in a woman's blood after childbirth may be one of the factors leading to an increased risk of post-partum depression.
DHA and Alzheimer's Disease
Researchers have discovered a similar correlation between low DHA levels and Alzheimer's disease.
In a study published in 1991 in Lipids, a team of Swedish scientists found that levels of DHA were lower in brain samples of patients with Alzheimer's disease compared to healthy geriatric patients. The decrease in polyunsaturated fatty acids was accompanied by an increase in other fatty acids.
The researchers noted that changes in saturated and polyunsaturated fatty acid ratio are likely to influence cellular function, which in mm may cause certain neural deficiencies.
Another study published found that lower levels of polyunsaturated fatty acids, including DHA, were correlated with Alzheimer's disease.
In a recent Japanese study, patients with Alzheimer's dementia who received supplemental DHA were shown to improve memory in a placebo controlled trial.
Lower Incidence of Fetal Low Birth Weight
Nutritional oils containing DHA and AA, arachidonic acid, have been introduced in the U.S. by Iams Eukanuba Milk Replacer Puppy Formula and Milk Replacer Formula for Kittens. Iams, a leading pet food manufacturer, is the first U.S. Company to supplement its formula products with these oils.
Allan Lepine, Ph.D., a researcher, said his work has shown that dog and cat milks contain substantial amounts of DHA and AA. Also puppies and kittens receiving milk enriched with these fatty acids grow more rapidly and more efficiently that is they need less milk for healthy growth.
These animals have muscle and bone structures comparable to those who were nourished by their mothers. Animals who did not receive the nutrients did not fare as well.
The British Nutrition Foundation, the Joint Expert committee on Human Nutrition of the United Nations Food and Agriculture Organization and World Health Organization (FAO/WHO) and several other expert committees outside the U.S. have recommended that DHA and AA be included in all infant formulas.
More and more countries have DHA and AA-supplemented infant formulas and now even U.S. puppies and kittens can benefit from these essential mothers' milk nutrients. The U.S. remains behind much of the rest of the developed world in regards to providing DHA and AA that are currently found in breast milk to formula fed infants.
An increasing number of countries, now numbering 36 and including the United Kingdom, Spain, Israel and Australia, already have available supplemented pre-term or term infant formulas with DHA and AA.
A study published in Pediatric Research demonstrated that pre-term infants who were fed a DHA and AA supplemented egg phospholipid formula exhibited a 17.6% reduction in the incidence of Necrotizing Enterocolitis (NEC). NEC is a serious life threatening gastrointestinal disease found predominantly in very low birth weight infants.
In its mildest form, NEC appears as a feeding intolerance accompanied by abdominal pain and distension, but can rapidly escalate into severe inflammation and degradation of the intestinal lining which may require surgery and could result in lifelong complications.
Approximately 4,000 infant deaths per year in the U.S. alone are caused by NEC.
The vegetable oils containing two essential long chain polyunsaturated fatty acids, DHA and AA, which are fundamental building blocks of the brain and the retina. DHA and AA are naturally delivered to infants through breast milk.
Numerous studies have been published recently demonstrating the importance of DHA and AA in infant nutrition.
An Essential Nutrient for Brain and Eye Function
Research reflects what was always suspected, breast-milk contains a nutrient essential for visual development. An important component of human breast milk is found in such foods as fatty fish, eggs and organ meats.
Over the last 50 years the average American has reduced intake of dietary sources of DHA according to the USDA Economic Research Service. Breast-milk DHA levels have declined as a result. Low levels of DHA have been correlated with changes in disposition, memory loss, visual and other neurological conditions.
DHA comprises about 60% of the rod outer segments of the eyes. The percentage of DHA in retinal tissue increases rapidly in the last half of pregnancy.
Cell membranes of the retina and visual cortex, highly enriched in DHA, develop rapidly during the last trimester, which is the period of most rapid eye development as well as in the first 6 months of infancy.
Brain tissue is about 60% fat, 25% of which is DHA. DHA is vital throughout pregnancy.
In the first few weeks of embryonic development when brain cell division is most active as well as in the last trimester when the DHA content of the cerebrum and cerebellum increases 3-5 fold. A significant, rapid, increase in brain DHA content continues from birth through two years of age.
Achieving Optimal Eye and Brain Function
Beyond development, the eyes and the brain need plentiful stores of DHA to function optimally. Cells in the retina, brain and other parts of the nervous system have connecting arms that transport electrical currents, sending visual information from the retina to the brain and messages from the brain throughout the body.
DHA supplementation ensures the optimal composition of cell membranes necessary for the most effective transmission of these signals. DHA is correlated with improved visual and mental function.
In 1996 Birch and a team of researchers studied term babies and found that babies fed formula without DHA had poorer vision than babies who were given a DHA supplement. He described these visual advantages as equivalent to about one line on an eye chart.
Studies also show that children who were breast fed perform better on cognitive function tests later in life, by up to 6 IQ points, than those who were formula fed even after taking into account all confounding factors associated with developmental test performance.
Low DHA Levels Yield Disadvantages
Studies have shown that pre-term infants, born without the benefit of the maternal delivery of DHA during the period of most rapid brain growth, the last trimester of pregnancy, did not perform as well on cognitive mental tests later in life. They scored up to 20 IQ points lower than those who were breast-fed.
Specific behavioral and learning problems have also been shown to correlate significantly with low DHA levels. Dyslexia, a learning disorder marked by impairment of the ability to recognize and comprehend written words, has been correlated with suboptimal DHA levels.
In 1995 a Stordy reported that DHA supplementation in adult dyslexics improved rod dark adaptation or night vision. Stordy also reported anecdotal evidence that DHA supplementation improves dyslexics' reading ability and behavior.
Children with Attention Deficit Hyperactivity Disorder or ADHD also have low DHA levels and experience essential fatty acid deficiency symptoms including hyperactivity and short attention span. Studies are under way to determine whether DHA supplementation can alleviate these symptoms.
Several neurological and visual disorders have also been correlated with low DHA levels, and research is under way to determine whether there is a connection.
Baby's Sources of DHA
A mother's blood supplies the fetus with large amounts of DHA throughout pregnancy including the period of most rapid brain and eye development in the last trimester.
After birth, the baby's DHA levels may depend on whether mom chooses to breast feed or formula feed. A breast fed baby's DHA levels depend on mom's breast milk levels of DHA. After birth, infants receive DHA from their mother's breast milk in which DHA is the most predominant omega-3 long-chain fatty acid.
This nutritional source for nursing infants comes at a time when significant brain and eye development is occurring.
A woman's blood and breast milk DHA levels depend on her diet. Dietary sources of DHA include fatty fish, eggs and organ meats. The fewer DHA rich foods a woman eats, the lower are the levels of DHA in her blood during pregnancy and in her breast milk during lactation.
It is important for women to eat DHA rich foods before, during and after pregnancy to assure that their babies are delivered optimal levels of this essential fatty acid they need.
Women should include sufficient DHA in their diets to ensure that their breast milk contains enough DHA.
Eating 4-5 servings of cooked fatty fish weekly probably satisfies this DHA requirement. DHA levels in the breast-milk of U.S. women are among the lowest in the world and typically deliver 1/2 to 2/3 of the minimum DHA recommended for infants by an expert committee of the World Health Organization and the U.N. Food and Agriculture Organization (FAO).
Studies have shown that supplementation of 200 mg of DHA each day raises the DHA levels in the breast-milk of women to the levels recommended by the WHO/FAO Expert Committee.
Women should supplement before conception, throughout the nine months of pregnancy, during breast-feeding and afterwards.
Pregnancy and breast feeding deplete a woman's stores of DHA, and it takes time to rebuild these stores.
In a testimony prepared for the FDA Review of Infant Formula Nutrient Requirements in 1996, Margit Hamosh, Professor of Pediatrics and Chief, Division of Developmental Biology and Nutrition, Georgetown University Medical Center, summarizes why mothers should supplement with DHA.
Given the relatively low dietary intake of DHA in the American diet, and the lower milk DHA levels during early lactation in well nourished American women as compared to similar populations in European countries, it would be prudent to supplement pregnant and lactating women with DHA.
In order to prevent depletion of maternal long chain polyunsaturated fatty acids during pregnancy and lactation, as well to ensure an adequate supply of these essential fatty acids to the infant through mother's milk.
Formula Fed Baby's and Formula Levels of DHA
Some women are unable to breast-feed their babies, so they resort to formula feeding. Since infant formulas in the United States do not yet contain DHA, formula fed infants in the U.S. are deprived of this important fatty acid.
The rate of brain growth in the perinatal period is so rapid that the baby's capacity to synthesize DHA from an essential fatty acid precursor present in some formulas is insufficient to keep up with the demand by the growing brain and nervous system.
Studies show that the brain DHA levels of babies fed formula without DHA are significantly lower than in breast-fed babies. Europe's largest infant formula manufacturer, Nutricia, as well as American Home Products and Novartis have incorporated DHA into their pre-term infant formulas.
At the present time, pre-term formulas containing this single nutrient, vegetarian source of DHA are available in Belgium, The Netherlands, Finland, UK, Spain, Australia, Portugal and Saudi Arabia, and more countries in Europe and Asia are expected to follow shortly.
WHO Recommends DHA in Formula
An expert committee convened by the World Health Organization and Food and Agriculture Organization has recommended that all pre-term and term infant formulas should contain DHA at the levels found in human breast milk.
The British Nutrition Foundation and the European Society of Pediatric Nutrition have made similar recommendations. According to the FAO/WHO Expert Committee a 20mg DHA/kg bodyweight should be added to full-term infant formulas.
Approximately 0.38% of the 3.5% fat content in many full-term formulas, and 40mg DHA/kg bodyweight should be added to pre-term infant formulas. This is approximately 0.6% of the 4% fat content in many pre-term formulas in order to match this recommended level each day.
Until now, fish oils have been the primary source of DHA nutritional supplements, but a recent scientific advance has yielded the world's only single nutrient vegetable form of DHA. It is a highly purified form of DHA extracted from microalgae, fish's original source, and represents the closest match to the DHA found in mother's milk.
This single-nutrient, vegetarian source of DHA does not contain eicosapentaenoic acid (EPA) found in fish oils which is not recommended for pregnant and lactating women or their infants.
This vegan DHA is so safe it has been included in infant formulas in Europe. An independent panel of experts in nutrition and toxicology in the U.S. has found it safe for use by adults including pregnant and lactating women.
Similar safety conclusions were reached by the United Kingdom's Committee on Toxicology and the Ministry of Health of the Netherlands.