22nd September 2017, Volume 130 Number 1462

Michele Eickstaedt, Kathryn L Beck, Cathryn A Conlon

Adequate dietary intakes of long chain polyunsaturated fatty acids (LCPUFAs) are required during pregnancy to support both the mother and foetus.1,2 Omega-3 (n-3) PUFAs include alpha-linolenic acid (ALA: 18:3n-3) and…

Subscriber content

The full contents of this page is only available to subscribers.

To view this content please login or subscribe

Summary

Adequate dietary intakes of long chain polyunsaturated fatty acids (LCPUFAs) such as omega 3 and omega 6 are required during pregnancy to support both the mother and growing baby. An important omega 3 fatty is docasahexaenoic acid (DHA). DHA is mainly found in fish and seafood, however women may restrict their intake of fish and seafood during pregnancy due to concerns regarding food safety and foetotoxic effects of environmental contaminants such as mercury. Most of the 500-plus women in their third trimester of pregnancy who completed an online food frequency questionnaire had low intakes of omega 3 fatty acids including DHA during pregnancy. Women who are currently pregnant or planning to become pregnant should aim to eat a variety of foods from the four food groups every day, including cooked fish. There is little concern with canned tuna, canned salmon, mackerel or sardines, farmed salmon, terakihi, blue cod, hoki, john dory, monkfish, warehou, whitebait and flat fish like flounder, as the mercury levels in these fish are seen as low risk.

Abstract

Aim

To investigate dietary intakes and food sources of polyunsaturated fatty acids in New Zealand pregnant women.

Method

Women (n=596) 16 years plus in trimester three of pregnancy completed an online food frequency questionnaire validated for omega-3 and omega-6 polyunsaturated fatty acids.

Results

Estimated median [25th, 75th percentile] intakes of omega-3 polyunsaturated fatty acids were: 1,300 [790, 2,120] mg/d alpha-linolenic acid (adequate intake 1,000mg/d); 220 [120, 520] mg/d total long chain omega-3 polyunsaturated fatty acids (adequate intake 115mg/d); and 110 [50, 250] mg/d docosahexaenoic acid (recommended 200mg/d). Only 30.9% of participants consumed more than 200mg/d docosahexaenoic acid. Participants taking omega-3 supplements (19.6%) were 16.5 times more likely to meet recommendations for docosahexaenoic acid. Fish and seafood were the main contributors to docosahexaenoic acid (84.8%) intakes, yet only 21.7% of women consumed fish at least twice per week. Intakes of omega-6 polyunsaturated fatty acids were 11,580 [8,840, 15,760] mg/d linoleic acid (adequate intake 10,000mg/d) and 90 [60, 110] mg/d arachidonic acid (upper limit 800mg/d).

Conclusion

Most participants did not meet recommended intakes for docosahexaenoic acid, which may be partly due to low intakes of fish, seafood and omega-3 supplements.

Author Information

Michele Eickstaedt, Public Health Nutritionist, School of Food and Nutrition, College of Health, Massey University, Auckland; Kathryn L Beck, Senior Lecturer, School of Food and Nutrition, College of Health, Massey University, Auckland; Cathryn A Conlon, Senior Lecturer, School of Food and Nutrition, College of Health, Massey University, Auckland.

Acknowledgements

The authors thank all the volunteers who completed this study: PC Tong for helping with data handling, Owen Mugridge for developing the study website, Matt Levin, Peter Jeffery and Steve Chalmers for technical support on issues related to the online NZ-PUFA FFQ and database. 

Correspondence

Dr Kathryn Beck, School of Food and Nutrition, College of Health, Private Bag 102904, North Shore 0745, Auckland.

Correspondence Email

k.l.beck@massey.ac.nz

Competing Interests

Nil.

References

  1. Makrides M. Is there a dietary requirement for DHA in pregnancy? Prostaglandins Leukot Essent Fatty Acids. 2009; 81:171–4. 
  2. Koletzko B, Lien E, Agostoni C, et al. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med. 2008; 36:5–14. 
  3. Nimal Ratnayake W, Galli C. Fat and fatty acid terminology, methods of analysis and fat digestion and metabolism: A background review paper. Ann Nutr Metab. 2009; 55:8–43. 
  4. Cetin I, Alvino G, Cardellicchio M. Long chain fatty acids and dietary fats in fetal nutrition. J Physiol. 2009; 587:3441–51. 
  5. Meyer BJ, Onyiaodike CC, Brown EA, et al. Maternal plasma DHA levels increase prior to 29 days post-LH surge in women undergoing frozen embryo transfer: A prospective, observational study of human pregnancy. J Clin Endocrinol Metab. 2016; 101:1745–53. 
  6. Innis SM. Fatty acids and early human development. Early Hum Dev. 2007; 83:761–6. 
  7. Carlson SE, Colombo J, Gajewski BJ, et al. DHA supplementation and pregnancy outcomes. Am J Clin Nutr. 2013; 97:808–15. 
  8. Coletta JM, Bell SJ, Roman AS. Omega-3 fatty acids and pregnancy. Rev Obstet Gynecol. 2010; 3:163–71. 
  9. NHMRC. Nutrient Reference Values for Australia and New Zealand: Executive Summary. Canberra, Wellington: NHMRC, Ministry of Health; 2006.
  10. Koletzko B, Cetin I, Brenna JT, Perinatal Lipid Intake Working Group. Dietary fat intakes for pregnant and lactating women. Br J Nutr. 2007; 98:873–7. 
  11. Food and Agriculture Organization of the United Nations. Fats and Fatty Acids in Human Nutrition: Report of an Expert Consultation. Geneva: Food and Agriculture Organization; 2010.
  12. Bloomingdale A, Guthrie LB, Price S, et al. A qualitative study of fish consumption during pregnancy. Am J Clin Nutr. 2010; 92:1234–40. 
  13. Ingram MA, Stonehouse W, Russell KG, et al. The New Zealand PUFA semiquantitative food frequency questionnaire is a valid and reliable tool to assess PUFA intakes in healthy New Zealand adults. J Nutr. 2012; 142:1968–74. 
  14. Meldrum S, Simmer K. Docosahexaenoic acid and neurodevelopmental outcomes of term infants. Ann Nutr Metab. 2016; 69:23–8. 
  15. Burdge GC, Calder PC. Conversion of alpha-linolenic acid to longer-chain polyunsaturated fatty acids in human adults. Reprod Nutr Dev. 2005; 45:581–97. 
  16. Makrides M, Gibson RA. Long-chain polyunsaturated fatty acid requirements during pregnancy and lactation. Am J Clin Nutr. 2000; 71:307S–11S. 
  17. Clandinin MT, Chappell JE, Heim T, et al. Fatty acid utilization in perinatal denovo synthesis of tissues. Early Hum Dev. 1981; 5:355–66. 
  18. Cosatto VF, Else PL, Meyer BJ. Do pregnant women and those at risk of developing post-natal depression consume lower amounts of long chain omega-3 polyunsaturated fatty acids? Nutrients. 2010; 2:198–213. 
  19. Jia X, Pakseresht M, Wattar N, et al. Women who take n-3 long-chain polyunsaturated fatty acid supplements during pregnancy and lactation meet the recommended intake. Appl Physiol Nutr Metab. 2015; 40:474–81. 
  20. Innis SM, Elias SL. Intakes of essential n-6 and n-3 polyunsaturated fatty acids among pregnant Canadian women. Am J Clin Nutr. 2003; 77:473–8. 
  21. Friesen RW, Innis SM. Dietary arachidonic acid to EPA and DHA balance is increased among Canadian pregnant women with low fish intake. J Nutr. 2009; 139:2344–50. 
  22. Friesen RW, Innis SM. Linoleic acid is associated with lower long-chain n–6 and n–3 fatty acids in red blood cell lipids of Canadian pregnant women. Am J Clin Nutr. 2010; 91:23–31. 
  23. Donahue SMA, Rifas-Shiman SL, Olsen SF, et al. Associations of maternal prenatal dietary intake of n-3 and n-6 fatty acids with maternal and umbilical cord blood levels. Prostaglandins Leukot Essent Fatty Acids. 2009; 80:289–96. 
  24. Bernard JY, De Agostini M, Forhan A, et al. The dietary n6:n3 fatty acid ratio during pregnancy is inversely associated with child neurodevelopment in the EDEN mother-child cohort. J Nutr. 2013; 143:1481–8. 
  25. Stark KD, Beblo S, Murthy M, et al. Comparison of bloodstream fatty acid composition from African-American women at gestation, delivery, and postpartum. J Lipid Res. 2005; 46:516–25. 
  26. Ministry of Health. Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women: A background paper. Wellington: Ministry of Health; 2006.
  27. Burdge GC, Calder PC. Dietary α-linolenic acid and health-related outcomes: a metabolic perspective. Nutr Res Rev. 2006; 19:26–52. 
  28. Food Standards Australia New Zealand. FSANZ Advice on Fish Consumption. http://www.foodstandards.govt.nz/consumer/chemicals/mercury/documents/mif%20brochure.pdf 2016.
  29. Wu BT, Dyer RA, King DJ, Innis SM. Low fish intake is associated with low blood concentrations of vitamin D, choline and n-3 DHA in pregnant women. Br J Nutr. 2013; 109:936–43. 
  30. Oken E, Kleinman KP, Berland WE, et al. Decline in fish consumption among pregnant women after a national mercury advisory. Obstet Gynec. 2003; 102:346–51. 
  31. Sartorelli DS, Nishimura RY, Castro GSF, et al. Validation of a FFQ for estimating omega-3, omega-6 and trans fatty acid intake during pregnancy using mature breast milk and food recalls. Eur J Clin Nutr. 2012; 66:1259–64. 
  32. Parker G, McClure G, Hegarty BD, Smith IG. The validity of a food frequency questionnaire as a measure of PUFA status in pregnancy. BMC Pregnancy Childbirth. 2015; 15.

Download

The downloadable PDF version of this article is only available to subscribers.

To view this content please login or subscribe