Should Infant Formula Provide Both Omega-3 DHA and Omega-6 Arachidonic Acid?

as 100 mg DHA/day and 140 mg ARA/day [10] . These conclusions were supported by recent recommendations of a global expert group, based on a systematic review of the available scientific evidence [11] . In contrast, an EFSA opinion on the compositional requirements of infant and follow-on formula advised that all infant and follow-on formula should contain relatively high amounts of 20–50 mg DHA/100 kcal, but without the need to provide any ARA [12] . At an assumed mean formula fat content of 5.2 g 100 kcal, this recommendation would lead to a DHA content of 0.38–0.96% of fatty acids, higher than about 0.2–0.3% DHA found in most DHA enriched formulae for term infants marketed in Europe today, which however all contain also preformed ARA at levels equal to or higher than the DHA content. While infant formula providing both DHA and ARA have been evaluated in numerous controlled trials in infants, the use of term infant formula with up to 1% DHA and no ARA is a novel approach that has not been systematically tested for its effects, suitability and safety. ARA is an essential component of all cell membranes. The amount of ARA incorporated into the developing brain during infancy exceeds the deposition of DHA [1, 2] . Although humans can synthesize ARA to some extent from linoleic acid, infants-fed formula without pre-formed The long-chain polyunsaturated fatty acids (LCPUFA), docosahexaenonic acid (22: 6n-3, DHA) and arachidonic acid (20: 4n-6, ARA) are deposited in relatively large amounts in human tissues, including the brain, during pregnancy and infancy [1, 2] . Fetal accretion of both DHA and ARA during pregnancy is facilitated by their preferential materno-fetal transfer across the placenta [3] . After birth, human milk provides both DHA and ARA to breastfed infants [4] . A survey of 65 studies on the composition of human milk from 2,474 women worldwide indicated a mean DHA content of 0.32% (wt/wt; range 0.06–1.4%), while the mean content of ARA was higher with 0.47% (0.24–1.0%) [5] . For more than two decades, DHA along with ARA has been added to infant formulae in an attempt to partly mimic the nutrient supply and functional effects achieved with breast feeding [6, 7] . Current compositional requirements for infant formula in the European Union [8] and globally [9] stipulate the optional addition of DHA to infant formula, provided that the ARA content is equal to or higher than the DHA content [4, 5] , thus following the model of typical human milk composition. Recently, the European Food Safety Authority (EFSA) determined adequate nutrient intakes of LC-PUFA for the majority of infants from birth to the age of 6 months Published online: March 7, 2015