Langkettige Omega-3-Fettsäuren in der Perinatalzeit: Empfehlungen zur Zufuhr

Zusammenfassung

Die frühe Kindheit ist eine kritische Zeit des Wachstums und der Organentwicklung, welche von einer angemessenen Nährstoffversorgung abhängen. Langkettige mehrfach ungesättigte Fettsäuren (long-chain polyunsaturated fatty acids, LC-PUFA) sind essenzielle Komponenten der Strukturlipide in Hirn und Retina und beeinflussen die frühkindliche Entwicklung. Gefördert von der Europäischen Kommission entwickelten die Perinatal Lipid Nutrition Group (PeriLip) und das Early Nutrition Programming Project (EARNEST) auf der Basis systematischer Literaturanalysen und eines formellen Konsensusverfahrens evidenzbasierte Konsensempfehlungen zur Nahrungsfettzufuhr für schwangere und stillende Frauen mit Unterstützung zahlreicher internationaler wissenschaftlicher Fachgesellschaften. Es wird gefolgert, dass es keine Evidenz für den Nutzen einer im Vergleich zur Empfehlung für die Allgemeinbevölkerung veränderten Zufuhr an Fett (% der Energie) und des Anteils an gesättigten, einfach und mehrfach ungesättigten Fettsäuren in der Nahrung in Schwangerschaft und Stillzeit gibt. Empfohlen wird jedoch eine regelmäßige Zufuhr langkettiger Omega-3-Fettsäuren vor dem Hintergrund einer deutlichen Risikoreduktion für frühe Frühgeburten und zur Förderung einer optimalen visuellen und kognitiven Entwicklung des Fötus und des Neugeborenen. Eine mittlere Aufnahme von mindestens 200 mg pro Tag Docosahexaensäure (DHA) während der Schwangerschaft und in der Stillzeit sollte erreicht werden. Diese Zufuhrmenge kann durch den Verzehr von 1–2 Portionen fettreichem Meeresfisch pro Woche erreicht werden. Für gesunde Säuglinge ist Stillen die bevorzugte Ernährung. Ist ausschließliches Stillen nicht möglich, wird eine Flaschennahrung empfohlen mit einem DHA-Gehalt von 0,2–0,5 % des Fettgehalts und einem Gehalt von Arachidonsäure (AA) der mindestens dem DHA-Gehalt entspricht. Bei Schwangeren sollte nach inadäquaten Ernährungsgewohnheiten gefahndet und bei Bedarf eine individuelle Beratung angeboten werden.

Abstract

Fetal and infant growth and tissue development depend on a balanced nutrient supply. Long-chain polyunsaturated fatty acids (LC-PUFA) are essential compounds of structural lipids in brain and retina and are important for pregnancy and infant outcomes. Supported by the European Commission, the Perinatal Lipid Nutrition Project (PeriLip) and The Early Nutrition Programming Project (EARNEST) developed evidence consensus recommendations on dietary fat intake in pregnancy and lactation based on a systematic review of available evidence and a formal consensus process, which were also supported by several international scientific organizations. It is concluded there is no evidence to support changes in the dietary intake of fat (% of energy) and of the relative contribution of saturated, monounsaturated and polyunsaturated fatty acids in pregnancy and lactation, as compared to recommended intakes for the general population. However, a regular supply of long-chain omega-fatty acids is recommended in view of a significant risk reduction of early preterm birth as well as support of optimal visual and cognitive development of the fetus and child. An average daily intake of at least 200 mg docosahexaenoic acid (DHA) during pregnancy and lactation should be approached. This recommended intake can be met by consuming one to two portions of oily sea fish per week. For healthy term infants, breastfeeding is the preferred feeding. If exclusive breastfeeding cannot be achieved, an infant formula should be provided with DHA levels between 0.2 and 0.5 weight percent of total fat, and with the minimum amount of arachidonic acid (AA) equivalent to the DHA content. Dietary inadequacies should be screened for during pregnancy, and individual counselling be offered if needed.

Schlüsselwörter

Alpha-Linolensäure - Docosahexaensäure - Eicosapentaensäure - essenzielle Fettsäuren

Keywords

alpha-linolenic acid - docosahexaenoic acid - eicosapentaenoic acid - essential fatty acids

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