Get The Best Start To Life Omega-3 On Allergic Outcomes

Wednesday, September 13th, 2017

With the first 1,000 days of life presenting a unique window of opportunity for long-term positive effects on a baby’s health, Dr Kai Lin Ek and Dr Dietrich Rein, scientific marketing managers, BASF nutrition & health, show how the right start can provide the best defence against developing allergic diseases.

Besides metabolic programming, there is increasing evidence that early life nutrition exerts effects on some areas in immunological programming as well. There is a global escalation in the prevalence of allergic diseases and while the cause may have mixed etiology, it is widely accepted that this allergy epidemic is attributable to a changing environment, including lifestyle factors and diet.

Benefits Of Omega-3 From Conception To Childhood

During the first 1,000 days of life, from conception until the child turns two, long-chain omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are fundamental building blocks to a growing infant’s neural system and signalling molecules for immune response.

For the mother, pregnancy is characterised by tissue remodelling and growth, and hence associated with elevated systemic inflammation. Therefore, this period presents a high demand for DHA and EPA by both the foetus and mother.

While the rate of DHA accretion in foetal brain only starts to accelerate from the last trimester onwards, initiating events of allergic diseases occur earlier in immune development, with antigen-specific reactivity detected in cord blood at birth and as early as 23 weeks into gestation in the foetus.

Given that humans are inefficient at synthesising EPA and DHA, maternal supplementation with pre-formed DHA and EPA omega-3s should be undertaken throughout a mother’s pregnancy.

Avoiding The Atopic Or Allergic March

The atopic or allergic march as defined by the World Allergy Organisation (WAO) refers to the natural history of atopic manifestations, which is characterised by a typical sequence of immunoglobulin E (IgE) antibody responses and clinical symptoms which may appear early in life, persist over years or decades, and often remit spontaneously with age.

The following describes common atopy and allergic diseases and where long chain omega-3 intake can have an effect:

Atopic dermatitis—an allergic skin inflammation disease induced by an immune reaction to pollen, dust and allergyinducing foods. An inverse association of fish and omega-3 intake during pregnancy and lactation with eczema in the offspring up to two years of age has been observed; maternal DHA and EPA supplementation during gestation suppressed dermatitis symptoms in the offspring.

Allergic rhinitis—more commonly known as hay fever, it is IgE mediated, and is the irritation and inflammation inside the nose caused by an overreaction of the immune system to airborne allergens. An observational study in British women showed that higher fish consumption is associated with a decreased risk of confirmed hay fever and eczema cases in the children.

Asthma—a common inflammatory airway and lung disease in children often associated with a coarse wheezing sound. High-frequency maternal fish intake (2-3 times a week) versus none was associated with lower asthma diagnosis in a large Danish study of children up to seven years of age. When mothers supplemented with fish oil from the third trimester, there were lower asthma and respiratory tract infections.

Immune sensitisation—the induction of an allergic response is usually confirmed by a skin prick test. Four to eight percent of children under three have food allergies to one of the allergens from cows’ milk, eggs, peanuts and tree nuts (CDC 2008 and US Census Bureau 2010). Randomised controlled trials show convincing evidence for reduced skin prick allergic responses to allergens in infants at 12 and 24 months of age where mothers supplemented with long-chain omega-3 fatty acids.

How Does Long-Chain Omega-3 Make A Difference During Pregnancy And Lactation?

To provide a more complete picture, Best et. al consolidated and reviewed the results from 13 observation studies and seven randomised controlled trials. Prenatal daily supplementation with 0.8-3.1 g DHA and EPA during the last 10–20 weeks of pregnancy provides a protective effect against allergic outcomes in infants and children up to school age.

Pregnant women at risk of having an allergic infant can also benefit. A recent Swedish study showed that a daily supplementation of 2.7 g of EPA and DHA from 25 weeks of gestation up to three months of lactation was associated with fewer IgE-related allergies in the children up to the age of two years.

Metabolic programming and epigenetics have opened up new opportunities for understanding nutrient mechanisms affecting child development. Supported by recent findings, there appears to be a window of opportunity to positively influence the development of the infant immune system via supplying a sufficient amount of long-chain omega-3s from gestation through to infancy.

The Right Partner For The Best Start

With more than 150 years of experience in the human nutrition industry, BASF is one of the key partners in the industry. Under its brand Newtrition, they offer a premium range of health nutrients. Relevant nutrients in early life nutrition include key vitamins, lutein as well as omega-3 as part of the product and solutions portfolio.

BASF’s omega-3s in both oil and powder formats have unparalleled purity and cover almost all possible application areas with minimal complexity and high compliance.

To support their customers and partners, they offer technical application service and development as well as tailor-made trainings in their globally linked Newtrition Labs around the world.

From the desk of Early Life Nutrition Expert, Associate Professor Dr Beverly Muhlhausler, who heads the Obesity and Metabolic Health Division and is Deputy Director of the FOODplus Research Centre at the University of Adelaide.

What factors do you think play a role in increasing the prevalence of allergic diseases in early life?

There is a wide range of factors that have been implicated, including increasing exposure to environmental pollutants, against a background of reduced exposure to pathogens (or bacteria) in the first six months.

Another major factor is the substantial increase in the ratio of omega-6 to omega-3 fats in the typical diets of many industrialised countries. This is important because omega-6 fatty acids have pro-inflammatory properties, whereas omega-3 fatty acids have anti-inflammatory actions and downregulate immune responses and suppress the pathways that lead to the development of allergies.

At critical periods in development, exposure to excess levels of omega-6 relative to omega-3 fats can permanently shift the immune system towards a state of reduced tolerance and thus predisposition to allergies, in infancy and childhood.

What are the other key areas of development with regards to long chain omega-3 fatty acids and early life nutrition?

One of the most exciting effects of omega-3 supplementation during pregnancy is increasing the length of gestation and reducing the risk of early preterm birth. This effect has been consistently reported in many large clinical studies and systematic reviews.

There are also potential cardio-protective properties of increased omega-3 fatty acid exposure before birth and in infancy on later heart health.

In an Australian study, continued omega-3 fatty acid supplementation from six months to five years of age could protect individuals from the structural and functional cardiovascular deficits associated with being born small for gestational age.

Preterm and especially very preterm infants, are at particular risk of omega-3 deficiency since they miss out on the major period of omega-3 accretion in the third trimester of gestation.

While some studies have shown that increasing the supply of omega-3 fats in the early postnatal period can be beneficial for long-term neurodevelopmental outcomes in these infants, the effects are highly dependent on dose and timing. Much more research is required before we can make clear recommendations for this infant population.