Development of visual acuity in relation to plasma and erythrocyte ω-6 and ω-3 fatty acids in healthy term gestation infants

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Abstract
The development of preferential looking acuity was studied prospectively to 3 mo of age in exclusively breastfed and formula-fed term gestation infants. The formula contained (% of total fatty acids) 17.9% linoleic acid (18:2ω-6) and 2.1% α-linolenic acid (18:3ω-3) but no docosahexaenoic acid (22:6ω-3) or arachidonic acid (20:4ω-6). The breast milk contained (x̄ ± SEM) 13.4 ± 0.8% 18:2ω-6, 1.5 ± 0.1% 18:3ω-3, 0.51 ± 0.03% 20:4ω-6, and 0.22 ± 0.02% 22:6ω-3. Preferential looking acuity, assessed by the acuity-card procedure, and plasma phospholipid and erythrocyte phosphatidylcholine and phosphatidylethanolamine fatty acids were determined at 14 d and 3 mo of age. There were no significant differences in acuity at 14 d or 3 mo, despite substantial differences in erythrocyte and plasma lipid 22:6ω-3. Visual acuity was [x̄ (cycles/degree) ± SD (octaves)] 3.93 ± 0.54 and 4.77 ± 0.48 and erythrocyte phosphatidylethanolamine %22:6ω-3 was (x̄ ± SE) 7.6 ± 0.5 and 4.0 ± 0.2 in the 3-mo-old breast-fed and formula-fed infants, respectively. These studies show that feeding formula containing 2.1% 18:3ω-3 (≈1.0% energy) results in development of visual acuity similar to breast-feeding in term infants to ≥ 3 mo of age.