The influence of a vegetarian diet on the fatty acid composition of human milk and the essential fatty acid status of the infant.

Vegan and vegetarian diets supply higher amounts of linoleic acid than those of omnivores. Intakes of alpha-linolenic acid (18:3n-3) are variable, depending on the oils used, but are generally high in vegans. Docosahexaenoic acid (22:6n-3) (DHA) is absent from vegan and many vegetarian diets. Cord plasma and cord artery phospholipid levels of Hindu vegetarians contained less DHA and more docosapentaenoic acid (22:5n-6) compared with those of omnivore control subjects. These differences in fatty acid composition were not statistically related to differences in birth weight, head circumference, or length. In human milk from vegans, vegetarians, and omnivores, the mean percentage in total fatty acids of 18:2n-6 was 23.8%, 19.7%, and 10.9%, respectively; that of 18:3n-3 was 1.36%, 1.25%, and 0.49%, respectively; and that of 22:6n-3 was 0.14%, 0.30%, and 0.37%, respectively. The proportion of DHA in erythrocyte total lipids of infants breast-fed by vegans was 1.9% compared with 3.7% in infants fed a milk formula containing butterfat as the sole source of fat and 6.2% in infants breast-fed by omnivores at 14 weeks postpartum. The ratio of linoleic/alpha-linolenic acid in the diet was predictive of the proportion of eicosapentaenoic acid but not that of DHA in infant red blood cell lipids. It is concluded that the intakes of linoleic acid and DHA are the major determinants of the proportion of DHA in plasma and red blood cell lipids.