Context
Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are long-chain polyunsaturated fatty acids commonly added to infant formula. Their concentrations and ratios may vary between products. Circulating levels of DHA and ARA in red blood cells (RBC) are often used as markers of fatty acid status during infancy.
This randomized controlled trial evaluated whether formulas containing different ARA concentrations result in equivalent DHA and ARA status in healthy term infants.
Study Overview
Design: Double-blind, randomized, controlled trial (multicenter, U.S.)
Population: 80 healthy, full-term, formula-fed infants (10–18 days old at enrollment)
Comparison:
Formula with 25 mg ARA/100 kcal (17 mg DHA/100 kcal)
Formula with 34 mg ARA/100 kcal (17 mg DHA/100 kcal)
Formula with 34 mg ARA/100 kcal plus prebiotic blend (PDX/GOS; 4 g/L)
Primary Outcome: Total red blood cell (RBC) DHA and ARA concentrations at 120 days of age
Follow-up: 14 to 120 days of age
Funding: Study funded by Mead Johnson Nutrition
Evidence Type: Industry-sponsored randomized controlled equivalence trial
Key Findings
RBC DHA and ARA concentrations at 120 days were within the predefined equivalence range (85–118%) across formula groups.
No statistically significant differences in RBC DHA or ARA levels between groups.
Growth measures (weight, length, head circumference) were similar between groups through 120 days.
No clinically meaningful differences in tolerance or medically confirmed adverse events.
Buccal epithelial fatty acid measurements showed weak or inconsistent correlation with RBC measures.
Limitations
Small sample size (n = 80).
Short follow-up duration (120 days).
Primary outcome focused on biochemical equivalence rather than clinical neurodevelopment outcomes.
Study funded by the formula manufacturer.
RBC fatty acid status used as surrogate marker rather than direct neurodevelopment assessment.
Neutral Interpretation
The available evidence suggests biochemical equivalence in RBC DHA and ARA status between formulas containing 25 mg and 34 mg ARA per 100 kcal; however, long-term clinical implications remain uncertain.
Full Citation
Hoffman DR, Harris CL, Wampler JL, et al.
Growth, tolerance, and DHA and ARA status of healthy term infants receiving formula with two different ARA concentrations: Double-blind, randomized, controlled trial.
Prostaglandins, Leukotrienes and Essential Fatty Acids. 2019.
PMID: 31186150
Available via PubMed: https://pubmed.ncbi.nlm.nih.gov/31186150/
Disclosure
This summary is based on a published randomized controlled trial.
The study was funded by Mead Johnson Nutrition.
This content is provided for informational purposes only and does not constitute medical advice.