Summary: Evaluating ARA Requirements For Formula Development

Summary: Evaluating ARA Requirements For Formula Development

In the past few years the European Commission has issued that arachidonic acid (ARA) is now an optional nutrient to add to formula while docosahexaenoic acid (DHA) is required at levels higher than ever before (1). This has brought up a major concern when trying to make formula that best represents human breast milk content. Many scientists and health experts find the requirements for high DHA content without a requirement for any ARA to be problematic and in need of further research. While the actual mg amount of ARA in human breast milk may vary, the relative percentage of fatty acid content made up by ARA is around 0.50% (2). This raises serious questions about making ARA an optional nutrient in infant formula. The role of ARA in the human body is primarily as an essential fatty acid needed for tissue and muscle repair. ARA is an omega-6 fatty acid, part of a group of fatty acids responsible for pro-inflammatory signals and pathways to allow for healing (3). Oftentimes omega-3 acids get the spotlight due to their counter effects and ability to be anti-inflammatory, however the reality is that a balance of both omega-6 and omega-3 fats are needed in the human diet. The optimal ratio of omega-6 to omega-3 in the diet is a topic that is debated, however most studies have shown optimal health benefits in a range of 2:1 up to 5:1 (4). One study utilised a randomised control trial for infants consuming ARA with a control group consuming corn oil. The resulting data showed that 24 month old toddlers had significantly better neurodevelopment (as measured by Bayley III assessment scores) when they were given ARA during early life diet (5). Another randomised controlled study examined a group of infants given ARA and DHA compared to a group with no supplementation. The study administered these fatty acids between 0 to 12 months of age and followed up when the children were 9 years of age. Brain imaging techniques showed greater connectivity and communication between the prefrontal regions and the parietal regions of the brain as well as significantly more white matter in the brains of infants given the ARA and DHA fats (6). The suggested connections between ARA and improved brain development and the fact that ARA is naturally found in human breast milk has led to many scientists and nutrition experts calling for a reconsideration of making ARA optional in formulas. Kendamil currently adds ARA to its formula and feels both nature (human breast milk) and science (studies) have backed ARA as an essential part of early childhood dietary regimen. At Kendamil we strive to offer the best possible product for mothers that do not breastfeed. Part of this mission includes carefully following evidence from well designed research when determining how to best formulate our infant formula products. The natural presence of ARA in human breast milk, the current evidence that indicates the benefits of ARA in infant diets and the general concern over these new regulations all give reason to why Kendamil currently feels it is important to add ARA to our product lines. References:
  1. Tounian P, Bellaïche M, Legrand P. ARA or no ARA in infant formulae, that is the question. Arch Pediatr. 2021 Jan;28(1):69-74. doi: 10.1016/j.arcped.2020.10.001. Epub 2020 Oct 22. PMID: 33268182.
  2. Koletzko B. Human Milk Lipids. Ann Nutr Metab. 2016;69 Suppl 2:28-40. doi: 10.1159/000452819. Epub 2017 Jan 20. PMID: 28103608.
  3. Innes JK, Calder PC. Omega-6 fatty acids and inflammation. Prostaglandins Leukot Essent Fatty Acids. 2018 May;132:41-48. doi: 10.1016/j.plefa.2018.03.004. Epub 2018 Mar 22. PMID: 29610056.
  4. Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother. 2002 Oct;56(8):365-79. doi: 10.1016/s0753-3322(02)00253-6. PMID: 12442909.
  5. Lepping RJ, Honea RA, Martin LE, Liao K, Choi IY, Lee P, Papa VB, Brooks WM, Shaddy DJ, Carlson SE, Colombo J, Gustafson KM. Long-chain polyunsaturated fatty acid supplementation in the first year of life affects brain function, structure, and metabolism at age nine years. Dev Psychobiol. 2019 Jan;61(1):5-16. doi: 10.1002/dev.21780. Epub 2018 Oct 11. PMID: 30311214; PMCID: PMC6317998.
  6. Devlin AM, Chau CMY, Dyer R, Matheson J, McCarthy D, Yurko-Mauro K, Innis SM, Grunau RE. Developmental Outcomes at 24 Months of Age in Toddlers Supplemented with Arachidonic Acid and Docosahexaenoic Acid: Results of a Double Blind Randomized, Controlled Trial. Nutrients. 2017 Sep 6;9(9):975. doi: 10.3390/nu9090975. PMID: 28878181; PMCID: PMC5622735.