By Joseph Hazan,M.D., FACOG
PUFA’s are the polyunsaturated fatty acids
and the EFA’s are essential fatty
acids.
Over the past few days we have
been going over the benefits of these,
especially of DHA and EPA, before and
during pregnancy and while nursing.
The omega-6’s are in abundant supply
in the typical US diet due to the high
consumption of dairy products, meats,
animal and vegetable oils used in
fried foods. However, there is a relative
deficiency of omega-3’s in the
typical US diet.
Most individuals are only taking in
20-60% of the omega-3’s
they need.
This has a great and lifelong impact
on the fetus.
The consensus report prepared by the
CHF (Child Health Foundation) has
recommended that during pregnancy,
breastfeeding and early childhood
omega-3 fatty acids need to be supplemented.
It is widely known that omega-6’s are currently
in high supply and due to the
imbalance of the typical US diet, mother transfers
plenty of AA (arachidonic acid) to the fetus.
Excessive omega-6’s have harmful effects since they
mediate inflammation, tightening of vessels and
smooth uterus muscle
and clotting. AA (arachidonic acid)
which is an omega-6, is converted to
cyclooxygenase (Cox), prostacyclin,
prostaglandins and thromboxane A2.
It is thought that Thromboxane when
found in increased amounts and early
in pregnancy could result in preeclampsia.
While AA can be converted to
Thromboxane A2, EPA can not be converted
to Thromboxane and on the
contrary helps increase the levels of
Prostacyclin.
Prostacyclin which relaxes smooth muscles
is promoted by EPA and helps
dilate vessels, reduce activation of platelets,
relaxes smooth muscles and
does not promote inflammation.
This also accounts for the beneficial effects
of fish oil inpromoting cardiovascular
health in general.
This is very important because it has
implications beyond pregnancy
and significant public health impact.
Furthermore when omega-3 and omega-6 ‘s
are insufficient, something called
omega-9’s are produced in the body which
are very dangerous and harmful.
WHAT ARE OMEGA-9’s?
There is an omega 9 called Mead’s
acid which has 20 carbon atoms and can
only be oxidized by lipooxygenase,
in cases of diabetes reduces protacyclin,
causes vessel damage and clots.
This also happens in pregnancy with
diabetes. Babies that are exposed to high
glucose levels in utero can develop
injury to their small vessels and are also
at high risk for birth defects such
as spina bifida and anterior abdominal
wall and chest defects.
EFA’s specifically DHA and EPA help
promote heart and circulatory health.
DHA and EPA in breast milk help confer
benefits to the baby in the area of
motor skills, language, IQ, cognition and
lower disease risk.
Breastfeeding benefits the mother by helping
with uterine contraction to reduce bleeding
after the delivery, promotes bonding with her
baby, cuts her risk of getting
ovarian cancer and reduces her chances
of having breast cancer after menopause
DHA helps reduce uterine contractility
by reducing the synthesis and
activity of MMP (matrix metalloproteinases)
which are involved in cervical
ripening and are related to PPROM
(preterm premature rupture of
membranes).
DHA, EPA together with folic acid,
tetrabiopterin and vitamin C are now
found to enhance nitric oxide (NO)
production.
This confers benefits
by reducing CAD (coronary artery disease),
PAD (peripheral artery
disease), atherosclerorosis, hyperlipidemia
and also helps protect
the brain and nervous system
against degenerative diseases.
Low levels of DHA following delivery
are also found to be associated with
postpartum depression, so this is another
reason for supplementation.
REFERENCES
1) Das UN. Long chain PUFA’s in the
growth and development of the brain
and memory. Nutrition.2003;19:62-65.
2) Das UN. Folic acid says NO to vascular
diseases.
Nutrition. 2003;19:686-
692.
