Estimating intake of omega-3 fatty acids during pregnancy

by

Rebecca Mary Elizabeth Filipowicz

The essential omega 3 (n-3) fatty acid alpha-linoleic acid (ALA) and the n-3 fatty acids eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) are important structural components of cell membranes. During pregnancy a steady supply of n-3 fatty acids is required to support positive fetal development (1-4) and maternal health (5-9). Over the past decade, extensive clinical research has focused on the role of DHA during pregnancy because it is incorporated into fetal brain grey matter and retina cell membranes more than any other n-3 fatty acid (4). Previous clinical research shows DHA intake during pregnancy supports positive fetal visual acuity and motor skills. No known studies have the primary objective of determining the association of the food frequency questionnaire (FFQ) estimated intakes with some other dietary assessment tool and blood biomarkers for total and individual n-3 fatty acids in pregnant women from non-coastal communities. The objective of the present study was 1) to determine the ability of the semi-quantitative FFQ to estimate intake of total n-3, ALA, EPA, DPA, and DHA and 2) to examine the relationship between the semi-quantitative FFQ and weighed 3-day diet record (3dDR) intake with plasma phospholipids (PLs) and RBC esterified fatty acids (phoshatidylethanolamine (PE) and phosphatidylcholine (PC)) for total and individual n-3 fatty acids (ALA, EPA, DPA, and DHA) in pregnant women from two non-coastal communities. It was hypothesized that 1) a significant association between the FFQ and 3dDR for total and individual n-3 fatty acid estimated intakes would be found and 2) total and individual n-3 fatty acid intakes estimated from the FFQ would show strong correlations with RBC PE and PC total and individual n-3 fatty acid compositions. Intake of total and individual n-3 fatty acids were estimated using the FFQ and weighed 3dDR in 136 healthy, pregnant women between 15-34 weeks gestation during a prospective observational study. A subset of subjects of64 pregnant women (25-31 weeks of gestation) were used to determine the associations between the FFQ and weighed 3dDR and blood biomarkers. Spearman's correlations indicated a significant positive association between the FFQ and weighed 3dDR for intake of total n-3 (rho=0.98), ALA (rho=0.27), EPA (r=0.56) and DHA (r=0.66) (P<0.01). Spearman's correlations coefficients between the intakes estimated from the FFQ and plasma PL for EPA and DHA (rho=0.33 and rho=0.46, respectively), and RBC PE and PC for total n-3 (rho=0.39 and rho=0.27, respectively), EPA, (rho=0.45 and rho=0.36, respectively) and DHA (rho=0.56 and rho=0.47, respectively) were significant. DHA intake obtained from the 3dDR exhibited a significant positive association for plasma PL (rho=0.34) and RBC PE and PC (rho=0.40 and rho=0.42, respectively). The 3dDR DPA estimated intake was not associated with blood biomarkers. In conclusion, the semi-quantitative FFQ is an appropriate dietary assessment tool to estimate intake of total n-3, ALA, EPA and DHA and correlates well with the weighed 3dDR and blood biomarkers.

References

1. Makrides M. Is there a dietary requirement for DHA in pregnancy? Prostaglandins Leuko Essent Fatty Acids. 2009;81:171-174.

2. Villa PM, Laivuori H, Kajantie E, Kaaja R. Free fatty acid profiles in preeclampsia. Prostaglandins Leukot Essent Fatty Acids. 2009;81(1):17-21.

3. McKoy SJB,Beal JM, Miller Shipman SB, Payton ME, Watson GH. Risk factors for postpartum depression: a retrospective investigation at 4-weeks postnatal and a review of the literature. J Am Osteopath Assoc. 2006;106(4):193-198.

4. Reese AM, Austin MP, Owen C, Parker G. Omega-3 deficiency associated with perinatal depression: Case control study. Psychiatry Res. 2009;166(2):254-259.

5. De Vriese SR, Christophe AB, Maes M, Lowered serum n-3 polyunsaturated fatty acid (PUFA) levels predict the occurrence of postpartum depression: further evidence that lowered n-PUFAs are related to major depression. Life Sci. 2003;73:3181-3187.

6. Innis SM. Dietary (n-3) fatty acids and brain development. J Nutr. 2007;137:855-859.

7. Innis SM. Perinatal biochemistry and physiology of long-chain polyunsaturated fatty acids. J Pediatr. 2003;143(suppl):S1-S8.

8. Innis SM. Essential fatty acid transfer and fetal development. Placenta. 2005;26(suppl):S70-S75.

9. Innis SM. Fatty acids and early human development. Early Hum Dev. 2007;83:761-766.