The development of infants born to obese mothers might be related to omega‐3 fatty acid status

In the September 2015 issue of Acta Paediatrica, van der Burg et al. reported the findings of a study on the neuropsychological development of preterm infants born to obese mothers when the children reached the age of two (1). The authors used the Bayley0s Scale of Infant Development II and found a higher risk of adverse indices for mental and motor development, which could not be explained by the newborns’ systemic inflammation, socioeconomic conditions or immaturity. It is well known that long-chain polyunsaturated fatty acids, mainly docosahexaenoic acid (22:6x-3, DHA), are important for neurological development. DHA, in particular, is poorly synthesised, and fish contains long-chain omega-3 fatty acids and is therefore an important part of the human diet. Low levels of DHA have been associated with poor neurological development, but also have implications for the metabolism. In one study, maternal fish intake during pregnancy, which provided omega-3 fatty acids, was associatedwith the cognitive and socio-psychological development of the woman’s offspring when they were tested up to the age of eight (2). To improve cognitive function, many studies that include DHA supplements have been performed during pregnancy and in pretermand term infants, butwith different results. One important factor that may explain these varying results might be that most Western individuals have a high intake of omega-6 fatty acids and the balance between the omega-6 and omega-3 series of fatty acids are important for many physiological functions. However, this was not usually considered in those studies. When this was considered, associations between a perinatal high omega-6 and omega-3 ratio were found to relate to neurological development at seven years of age (3). We have previously reported that DHA was associated with development between 6 and 18 months of age in premature infants, according to the Bayley0s Scale of Infant Development (4). We also found that obese mothers had significantly lower DHA and eicosapentaenoic acid (20:5x3, EPA) in their breast milk than mothers with a normal body weight (5). As the DHA concentration in breast milk is mainly related to maternal DHA status, the finding was probably an indication that these mothers might also have had a low status during pregnancy. Some studies have also shown that obese children and adults have lower DHA concentrations than controls. It would be very valuable if the fatty acid status of obese women could be studied during pregnancy, together with controlled randomised intervention studies that followed up their offspring with regard to both obesity and neurological development. This is of particular importance, because these days many pregnant women do not eat fish at all. This fact is well known in the total population, but seems to be particularly true in obese individuals and therefore needs attention. Maternal obesity is known to have a negative influence on the later development and metabolism of their children, probably by epigenetic mechanisms. This is an urgent issue in the light of the increasing burden of both neurological diseases and the development of the worldwide obesity epidemic.