Omega-3 Fatty acids and neural development to 2 years of age: do we know enough for dietary recommendations?

The omega (omega)-3 fatty acids are essential nutrients, explained by the absence of a Delta-15 desaturase in mammalian cells. The omega-3 fatty acids are found in the diet as alpha-linolenic acid (18:3omega-3) and eicosapentaenoic acid (20:5omega-3), as well as docosahexaenoic acid (DHA), with different functions of each of the omega-3 fatty acids in different cells. One essential role of the omega-3 fatty acids is fulfilled by the 22 carbon DHA (22:6omega-3). Depletion of DHA from brain and retina interferes with normal neurogenesis and neurological function, and visual signaling pathways. Observation and intervention studies with pregnant and lactating women, and with infants fed some formulas show that dietary DHA is associated with higher scores on tests of visual and neural development in infants and children. The estimated average requirement and variability in requirement among individuals both of which are needed to set dietary recommended intakes (DRIs) for the different omega-3 fatty acids are unknown. However, because omega-3 fatty acids are essential, adequate intakes to minimize risk of poor neural development and function can be justified, but dose-response data to provide a safe upper limit with different omega-6 fatty acid intakes are needed. Dietary recommendations do affect the food supply and supplements and are used in labeling, all impacting population health. When scientific information is incomplete, consideration must be given to the implications of recommendations that focus on individual nutrients, rather than dietary patterns such as breast-feeding and consuming fish that promote health and minimize disease risk.