Dojčenie a zraková ostrosť u detí

Niektoré štúdie upozorňujú na možný pozitívny vplyv dojčenia na zrakovú ostrosť u detí. Tento pozitívny efekt prirodzenej výživy by mohol byť podmienený unikátnym zložením mastných kyselín v materskom mlieku. Výsledky zatiaľ nie sú jednoznačné, definitívne objasnenie tejto otázky si vyžiada ďalšie práce.

Breast-feeding and optimal visual development. 
Birch E, Birch D, Hoffman D, Hale L, Everett M, Uauy R 
Retina Foundation of the Southwest, Dallas, TX 75231.
The goal of the present study was to determine whether dietary supply of omega-3 essential fatty acid (EFA) influences visual development in healthy pre-term and full-term infants. Visual status was examined in human milk-fed infants (ample dietary omega-3 EFA supply) and corn oil-based formula-fed infants (no dietary omega-3 EFA; standard formula prior to 1987). At 57 weeks postconception (4 months adjusted age), both pre-term and full-term human milk-fed infants had significantly better visual evoked potential (VEP) and forced-choice preferential-looking (FPL) acuity than formula-fed infants. Acuity was correlated with a dietary omega-3 sufficiency index from red blood cell membranes obtained at 57 weeks postconception. At 36 months, full-term human milk-fed children had significantly better random dot stereo acuity and letter matching ability than formula-fed children. Stereo acuity and performance on the letter matching test were correlated with a dietary omega-3 sufficiency index from red blood cell membranes obtained at 4 months. These results suggest that dietary omega-3 fatty acids play an important role in visual development.

Visual acuity and erythrocyte docosahexaenoic acid status in breast-fed and formula-fed term infants during the first four months of life. 
Jorgensen MH, Hernell O, Lund P, Holmer G, Michaelsen KF 
Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark.
It has been recognized that preterm infants have a more rapid development of visual acuity if fed human milk or a formula enriched with the long-chain polyunsaturated fatty acid (LCPUFA) docosahexaenoic acid (DHA) compared to a standard formula devoid of LCPUFA. Few studies have addressed whether the same is also true in term infants. The aim of the present study was to follow visual acuity and fatty acid composition in red blood cells (RBC) for the first 4 mon of life in 17 breast-fed and 16 formula-fed term infants. The formula used did not contain LCPUFA, but contained 1.7 wt% alpha-linolenic acid, and the linoleic/alpha-linolenic acid ratio was 8.5. The increase in visual acuity measured by Teller acuity cards developed more rapidly in breast-fed infants compared to formula-fed infants (P < 0.001). This was parallelled by a decrease in DHA of RBC in formula-fed infants, and with a significantly lower level at two and four months as compared to breast-fed infants. The content of DHA in milk from the breast-feeding mothers was high compared to other Western countries. The difference in visual acuity between the two feeding groups could be due to differences in DHA status as reflected by the RBC levels, but other explanations are possible. Intervention studies are required to verify if development of visual acuity in term formula-fed infants is dependent on the DHA level of formula

Visual acuity and the essentiality of docosahexaenoic acid and arachidonic acid in the diet of term infants. 
Birch EE, Hoffman DR, Uauy R, Birch DG, Prestidge C 
Retina Foundation of the Southwest, Dallas, Texas 75321, USA.
The need for a dietary supply of docosahexaenoic acid (DHA) and arachidonic aid (AA) in term infants was evaluated in a double-masked randomized clinical trial of the effects of supplementation of term infant formula with DHA (0.35% of total fatty acids) or with DHA (0.36%) and AA (0.72%) on visual acuity development. One hundred and eight healthy term infants were enrolled in the study; 79 were exclusively formula-fed from birth (randomized group) and 29 were exclusively breast-fed (gold standard group). Infants were evaluated at four time points during the first 12 mo of life for blood fatty acid composition, growth, sweep visual evoked potential (VEP) acuity, and forced choice preferential looking acuity. Supplementation of term infant formula with DHA or with DHA and AA during the first 4 mo of life yields clear differences in total red blood cell (RBC) lipid composition. Supplementation of term infant formula with DHA or with DHA and AA also yields better sweep VEP acuity at 6, 17, and 52 wk of age but not at 26 wk of age, when acuity development reaches a plateau. The RBC lipid composition and sweep VEP acuity of supplemented infants was similar to that of human milk-fed infants, whereas the RBC lipid composition and sweep VEP acuity of unsupplemented infants was significantly different from human milk-fed infants. Differences in acuity among diet groups were too subtle to be detected by the forced choice preferential looking protocol. Infants in all diet groups had similar rates of growth and tolerated all diets well. Thus, early dietary intake of preformed DHA and AA appears necessary for optimal development of the brain and eye of the human infant.

  Visual acuity and blood lipids in term infants fed human milk or formulae. 
Innis SM, Akrabawi SS, Diersen-Schade DA, Dobson MV, Guy DG 
Department of Paediatrics, University of British Columbia, Vancouver, Canada.

This multicenter, parallel group study determined plasma phospholipid and red blood cell (RBC) phosphatidylcholine and phosphatidylethanolamine fatty acids, plasma cholesterol, apo A-1 and B, growth and visual acuity (using the acuity card procedure) in term infants fed from birth to 90 d of age with formula containing palm-olein, high oleic sunflower, coconut and soy oil (22.2% 16:0, 36.2% 18:1, 18% 18:2n-6, 1.9% 18:3n-3) (n = 59) or coconut and soy oil (10.3% 16:0 18:6% 18:1, 34.2% 18:2n-6, 4.7% 18:3n-3) (n = 57) or breast-fed (n = 56) with no formula supplementation. Different centers in North America were included to overcome potential bias due to differences in n-6 or n-3 fatty acids at birth or in breast-fed infants that might occur in a single-site study. Plasma and RBC phospholipid docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6), cholesterol and apo B were significantly lower in the formula- than breast-fed infants.There were no differences in looking acuity or growth among the breast-fed and formula-fed infants. No significant relations were found between DHA and looking acuity, or AA and growth within or among any of the infant groups. This study provides no evidence to suggest the formula provided inadequate n-6 or n-3 fatty acids for growth and looking acuity for the first 3 mon after birth.