Effect of GLA and DHA in Pregnancy


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Effect of GLA and DHA in Pregnancy

  1. 1. Effect of DHA & GLA in pregnancy
  2. 2. Essential fatty acid (EFA) They are polyunsaturated fatty acid needed by the body for maintenance of optimal health. They cannot be synthesized by the human body and is therefore must be obtained from dietary source. (Indian J Pediatr 2005; 72 (3) : 239-242) There are 2 types of EFA: Omega-3 fatty acid & Omega-6 fatty acid Linoleic acid (18:2)LA Gamma-linolenic acid (18:3)GLA Diho-gamma- linolenic acid (20:3)DOGLA Archidonic acid (20:4) AA Adrenic acid (22:4) Docosapatothenic acid (22:5)DPA Alpha-linolenic acid (18:3) ALA Ecosapatothenic acid (20:5)EPA Docosapatothenic acid(22:5)DPA Docosahexaenoic acid (22:6)DHA Omega-6 fatty acid Omega-3 fatty acid
  3. 3. <ul><li>Role of EFA in pregnancy </li></ul><ul><li>Formation of healthy cell membranes </li></ul><ul><li>Proper development and functioning of the brain and nervous system </li></ul><ul><li>Production of hormone-like substances like prostaglandins </li></ul><ul><li>Responsible for regulating blood pressure, blood viscosity, vasoconstriction, </li></ul><ul><li>immune and inflammatory responses. </li></ul>
  4. 4. Docosahexaenoic acid (DHA) <ul><li>DHA is a carboxylic acid with a 22- carbon chain & 6 cis double bonds (C 22 H 32 O 2 ) </li></ul><ul><li>DHA is predominant component of brain </li></ul><ul><li>It is found in all tissues most abundant in neural, retinal & CV conducting tissue. </li></ul><ul><li>It facilitates synaptic transmission & supports myelination </li></ul><ul><li>It influences the speed that information is acquired & processed </li></ul>(Canad J Psychiatry 2003:48: 195-203) DHA and its Psycho-motor functions Vision 60% of PUFA in retina is DHA Cognitive functions like Learning & memory, Language coordination, Problem solving 40% of PUFA in brain is DHA
  5. 5. DHA is important throughout life <ul><li>DHA in pregnancy: </li></ul><ul><li>(Early Human Dev 1980, 4: 121-129) </li></ul><ul><li>Pregnancy fetus depends upon maternal sources of DHA from lipid Stores, maternal </li></ul><ul><li>diet & nutritional supplements. </li></ul><ul><li>Placenta selectively transports DHA from mother to fetus </li></ul><ul><li>During third trimester accretion of DHA in fetus liver, brain and retina at the rate of </li></ul><ul><li>0.59g/day </li></ul>
  6. 6. <ul><li>Indian J Pediatr 2005; 72(3) : 239-242) </li></ul><ul><li>Pregnant women must take adequate amount of DHA in their diet through </li></ul><ul><li>nutritional supplements in order to optimize their own health & also the health </li></ul><ul><li>& mental development of their offspring's. </li></ul><ul><li>(Pediatrics 2003:111 (1) : e39-44, Am J Clin Nutr 2001; 73 : 316-322) </li></ul><ul><li>DHA supplementation in mother increases the mental performance of their </li></ul><ul><li>children </li></ul><ul><li>(Obselet Gynecol 2003; 101 (3): 469-479) </li></ul><ul><li>DHA supplementation increases the duration of gestation & birth weights </li></ul><ul><li>during pregnancy </li></ul><ul><li>(J Epidemiol Comm Hlth 1993; 47 (6) : 436-440) </li></ul><ul><li>DHA supplementation enhances Uteroplacental perfusion, oxygen delivery, </li></ul><ul><li>vasodilatation and thinning of blood in pregnant women & reduces the risk of </li></ul><ul><li>toxemia in pregnant women </li></ul>Health benefits of DHA supplementation in pregnancy
  7. 7. Recommendations Health and Welfare Canada 1990 : omega-3 fatty acid (ALA) 0.5% of total energy Food and Nutrition Board, USA, 2002 adequate Intakes (AI) for Omega-3 Fatty Acids 10% AI from DHA+EPA 1.4 - All ages Pregnancy 1.1 1.6 14-18 yrs Children 1.2 1.2 9-13 yrs Children 0.7 0.7 1-3 yrs Children 0.9 0.9 4-8 yrs Children 1.1 1.6 19 yrs & older Adults 1.3 - All ages Breastfeeding 0.5 0.5 7-12 months Infants 0.5 0.5 0-6 months Infants Females (g/day) Males (g/day) Age Life Stages
  8. 8. National Institutes of Health (NIH) 1999 (DHA) 0.35 % by weight of daily total fat WHO & FAO pregnancy (AI) 2.6 g omega-3 fatty acid & 100-300 mg DHA daily (Prostaglandin Leukot Essent Fatty Acid 2000; 63: 119-121) Recommendations 300 mg/day Lactation 300 mg/day Pregnancy 150 mg/day Young children (3 years) 0.1% of total energy (2000 Kcal/day) Adult
  9. 9. DHA supplementation <ul><li>Major sources of DHA are animal sources such as fish but they contain traces of contaminants. </li></ul><ul><li>Vegetarian diets are poor sources of DHA (Prostaglandins, Leukotrienes and essential Fatty Acids, 81, (2),137-141) </li></ul><ul><li>Most of the DHA is destroyed while cooking </li></ul><ul><li>Pregnant woman can ensure adequate intake of DHA by adding to their diet a nutritional supplement that contains DHA. </li></ul>
  10. 10. Gamma lenolenic acid (GLA) <ul><li>GLA is a carboxylic acid with a 18- carbon chain & 3 cis double bonds (C 18 H 30 O 2 ) </li></ul><ul><li>Importance of GLA in pregnancy </li></ul><ul><li>(J. Clin. Endocrinol. 1975, Meta., 40, 108-115) </li></ul><ul><li>Plasma angiotensin II (AII) concentration rise from early in gestation </li></ul><ul><li>( Am. J. Obset. Gynec., 1961, 82, 246-251, ; 1965, 91, 837-842 ) </li></ul><ul><li>Vascular reactivity to AII is reduced in pregnancy </li></ul><ul><li>(Br. J. Clin. Pharmac. 1985, 19, 335-342) </li></ul><ul><li>This is due to higher circulating level of vasodilator prostaglandin found in the </li></ul><ul><li>body </li></ul><ul><li>(Am. J. Obstet. Gynec., 1968, 100, 218-221,; J. Clin. Invest., 1973, 52, 2682-2689) </li></ul><ul><li>In pregnancy induced hypertension (PIH) , vascular sensitivity to AII becomes </li></ul><ul><li>greater </li></ul>
  11. 11. <ul><li>(Prostaglandins, 1980, 20, 105-110,; Prostaglandins Medicine, 1979, 3, 223-234,; </li></ul><ul><li>Lancet,1980, ii, 702) </li></ul><ul><li>In PIH there is a diminished vascular capacity to synthesize prostaglandin </li></ul><ul><li>(Br. J. Clin. Pharmac. 1985, 19, 335-342) </li></ul><ul><li>Dietary supplementation with lenolenic acid, GLA for prostaglandin production is </li></ul><ul><li>associated with a diminution in pressor response to AII </li></ul><ul><li>(Br. J. Clin. Pharmac. 1985, 19, 335-342) </li></ul><ul><li>GLA supplementation helps in prevention of PIH </li></ul><ul><li>GLA Supplementation during pregnancy </li></ul><ul><li>FDA has not developed any RDA for GLA </li></ul><ul><li>(Br. J. Clin. Pharmac. 1985, 19, 335-342) </li></ul><ul><li>Dietary supplementation with 32mg of GLA for a week is associated with diminution in pressor response to AII in pregnant women </li></ul>
  12. 12. <ul><li>Dietary GLA supplementation </li></ul><ul><li>( J. Nutr, 1998, 128: 1411-1414) </li></ul><ul><li>GLA supplementation is needed when there is a reduced capacity of LA conversion </li></ul><ul><li>to GLA in the body </li></ul><ul><li>(Eur. J. Clin. Nutr, 1997, 51: 619-624,; Gamma-linolenic acid. Rev. Contemp. Physiol, 1990, 1: 1-41,; Ann. Intern. Med. 1993, 119: 897-873) </li></ul><ul><li>This can be due to some patho physiological/physiological states like diabetes, </li></ul><ul><li>cardiovascular disease etc </li></ul><ul><li>Dietary GLA have superior biopotancy compared to LA </li></ul><ul><li>( J. Nutr, 1998, 128: 1411-1414) </li></ul><ul><li>Most of the time after GLA supplementation DGLA accumulates in the body </li></ul><ul><li>instead of AA </li></ul>
  13. 13. <ul><li>( J. Nutr, 1998, 128: 1411-1414) </li></ul><ul><li>The increased level of DGLA attenuates the biosynthesis of AA metabolites (series 2 </li></ul><ul><li>prostaglandin) which is a pro inflammatory prostaglandin </li></ul><ul><li>( J. Nutr, 1998, 128: 1411-1414) </li></ul><ul><li>GLA bypasses a key regulatory rate limiting enzymatic step (delta 6 desaturase) that </li></ul><ul><li>controls the PUFA (n-6 series) production. </li></ul><ul><li>(Atherioscler. Thromb. Vasc. Biol. 1995. 15: 1397-1403,; Atheritis Rheum. 1996, 39: 1808-1817) </li></ul><ul><li>Metabolites of GLA elongation product, DGLA exert clinical efficacy in a variety of </li></ul><ul><li>diseases including suppression of chronic inflammation, vasodialation and lowering </li></ul><ul><li>blood pressure </li></ul>
  14. 14. GLA metabolism (J Nutr 128: 1411-1414, 1998) LA is converted into GLA (delta 6 desaturase enzyme) GLA is elongated into DGLA DGLA is converted into AA (delta 5 saturase enzyme) DGLA produces prostaglandin-1 series which are anti-inflammatory DGLA produces 15-(S)-hydroxy-S,11, 13 eicosatrienoic acid which controls the production of AA metabolite which are proinflammatory