22/08/2021
SIROY DHA
(PURE DHA DROPS 100mg per ml & Soft gel Capsule form200mg)
Pure DHA preparation is widely available in western countries. However supplementing Pure DHA as per guidelines is difficult in India, as Pure DHA in form of drops was not available till date. SIROY LIFE SCIENCES have made this supplementation possible by making in pure form of DHA drops; 100mg per ml named as SIROY DHA in 30ml pet bottle .
Available in form of drops 100mg per ml and Soft gel capsule 200mg and also available DHA 100mg with Vitamin D 400IU per ml.
What is DHA?
Essential fatty acids (EFA) are being discussed for their important role in brain development and functioning as well as their cardio vesicular protective role. There is also a growing evidence of their role in protection from infection and allergy disorders Anti inflammatory - Role in atopy, asthma. It is important to understand the differences amongst the various EFA and also to understand role of one versus the other. Here we will be discussing some basic facts about essential fatty acids and their role in infant nutrition & psychoneuroimmune development, Part of phospholipid membrane of Brain cells; Signal transduction, neurotransmission and neurogenesis) Anti inflammatory - Role in atopy, asthma, allergy disorders.
How does it work?
Fats provide the main source of energy for infants and young children. It is not only important to provide flavor and texture to the food but is needed by all cell membranes including neuronal connections. It is also important for absorption of fat soluble vitamins and provides us with the EFA. EFA are so called because they can’t be manufactured in the body and are essential for body’s growth. Mammalian cells are unable to insert double bonds more proximal to methyl terminal of fatty acid than the 7th carbon. The most abundant essential fatty acids are:
Linolenic acid (LA) 18 carbon: 2 n-6 (means it has 18 carbons ; two double bonds ; last double bond at 6th carbon from the methyl terminal of the fatty acid)
α Linolenic acid (ALA) 18 carbon: 3 n-3
By the process of desaturation and chain elongation, LA is converted to Arachidonic acid 20 carbon: 4 n-6 (AA) and ALA is converted to Eicosapetanenoic acid 20 carbon: 5 n-3 (EPA) and Docosahexaenoeic acid 22 carbon: 6 n-3(DHA). This conversion is affected by many factors like age, alcohol intake, smoking and certain drugs. At extreme of ages and in pregnancy, this conversion is not sufficient enough to meet the increased needs for brain, retina development or to meet the fetal requirements. To summarize, Omega 3 fatty acids are ALA, EPA and DHA and Omega 6 fatty acids are LA and AA.
Brief History on DHA:
It has been seen documented as early as 1950 that infants given skimmed milk and hydrogenated coconut oil failed to gain wt and develop typical skin lesions c.f. those given small amounts of corn oil as well. Similarly in 1960 it was shown that the use of parenteral nutrition with proteins and glucose alone led to poor growth and altered visual functions compared to PN+n-6 fatty acids emphasizing the importance of EFA.
All EFA are not same:-
There are important differences between Omega 6 and Omega 3 fatty acids and some of the differences are very important from clinical point of view.
Omega 6 LCPUFA (Eicosanoids) are more potent, are proinflammatory and adipogenic
Omegas 3 LCPUFA (Eicosanoids) on the other hand are anti inflammatory and decreases fat deposition. Fish oil (EPA & DHA) has been used in Rheumatoid arthritis emphasizing its anti inflammatory properties. There are various differences between EPA and DHA as well. DHA has been shown to prevent CVS disease by reducing blood vessel inflammation and atherosclerosis1.There are less heart diseases in Eskimos and Japanese fisherman which has been attributed to higher blood DHA/EPA levels c.f. Omega 6 LCPUFA in them. Triglyceride levels fall more with 26% in DHA (26%) compared to EPA (21%). So evidence is in favor of DHA compared to EPA for the beneficial effects seen with Omega 3 fatty acids. More over EPA concentration in mother’s milk in negligible making its importance very doubtful in infant nutrition.
When to recommend:-
Recommendation for first 6 months of life: Understanding that “Mother’s
Milk Is the Best for the Baby” one need to look at the lipid composition in mother’s milk first to draw some logical conclusions.
50% of energy as lipids
12% LA, 0.6% AA (12.6% Omega 6 FA), 0.5% ALA, 0.3% DHA (0.8%Omega 3 FA)
Actual amount of LCPUFA depend on maternal diet.
Baby should be given exclusive mother’s milk for first six months of life and mother’s diet should have sufficient amounts of EFA and especially DHA. But Indian diet is very inadequate for Omega 3 FA content.
Ratio of Omega 6: Omega 3 FA in various diets across the world:
Ideal diet
Indian Diet
USA
Japan
5-10:1
30-70:1
12:1
2:1
The main reason for poor Omega 3 FA in Indian diet is lack of animal products especially fish and excess intake of animal milk and milk products. There are a number of vegetable sources of EFA and one must have knowledge so that the same can be advised to the mother.
Omega 3 fatty acids Omega 6 fatty acids
Flaxseed or linseed Sunflower
Rapeseed or canola Safflower
Peanut Sesame
Olive Palmolive
Perilla Corn
Walnut Primrose
Soya Borage
Green leafy vegetables, dry fruits Invisible fats
Fish / Fish oil
Sources of Omega 3/6 fatty acids
Supplementation of DHA during Pregnancy:-
It has shown to improve cord Omega 3 levels and neonatal short follow up 3- 6 months has not shown any benefits (Malcom et al. Helland et al but long term follow up till 4 yrs has shown beneficial effects on mental ability2 Some studies also show less atopy and lower type I IDDM in supplemented infants. We must remember that these studies are done in west in mothers with better DHA content in their diet and if we reciprocate the results for Indian mother with poor DHA content in their diet, the beneficial effects are bound to be more.
Pregnancy & LCPUFA DHA accretion occurs in III rd trimester mainly and the transfer depends on the age of the mother (at elderly age transfer would be less), primi or second gravida (primi expected to have better transfer), interval between the pregnancies (less the interval, less is the transfer in the second baby), Maternal diet (Fish, Marine products) and alcohol intake (reduces DHA transfer).
Supplementation during Lactation:-
It has also shown to improve breast milk DHA content but clinical effects shown in different studies are not consistent. In Indian Context, DHA supplementation should help the neurodevelopment of the infants and children.
Infant Nutrition and EFA:-
All infants should be fed on exclusive mother’s milk for first six months and in case mother’s milk is not sufficient, alternative milk with sufficient amounts of EFA should be provided. As unmodified bovine milk (cow or buffalo or goat) does not contain any EFA, the only option is a balanced infant formula with ratio of LA/ALA between5:1 to 15:1.
DHA supplementation in term formula:-
Cochrane (2001) reviews after analyzing 10 trials have concluded that there are contradictory results on beneficial effects on developmental indices. Certain trials show better problem solving (finding a hidden toy)3 or higher scores on Bayley Mental Development Index until 17 weeks of age4 while others show no benefits5 / Transient benefit6 There is some effect seen in reduction of BP and Type I DM with no documented side effects.
LCPUFA and preterm formula:-
There is no ambiguity as far as preterm milk formula and their supplementation is concerned. Meta analysis by San Giovanni show better visual acuity at 2&4 months. There is strong recommendation by AAP that preterm formulae should contain both AA and DHA.
Infant nutrition 6months to one year:-
Recommendations for fat intake
First 6 months
40-60% of total energy
Omega 6: omega 3 ratio 5-10:1
Siroy Life Sciences Pvt. Ltd. is a Pharmaceutical and Nutraceutical company engaged in manufacturing and trading in Nutraceutical and Pharmaceutical products based out of Delhi.
