https://faculty.mtsac.edu/cbriggs/Improvement%20of%20Maternal%20and%20Child%20Nutrition%202013.pdf

Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost?

has grown since The Lancet Series on Maternal and Child Undernutrition in 2008. We did a comprehensive update of interventions to address undernutrition and micronutrient defi ciencies in women and children and used standard methods to assess emerging new evidence for delivery platforms. We modelled the eff ect on lives saved and cost of these interventions in the 34 countries that have 90% of the world’s children with stunted growth. We also examined the eff ect of various delivery platforms and delivery options using community health workers to engage poor populations and promote behaviour change, access and uptake of interventions. Our analysis suggests the current total of deaths in children younger than 5 years can be reduced by 15% if populations can access ten evidence-based nutrition interventions at 90% coverage. Accelerated gains are possible and about a fi fth of the existing burden of stunting can be averted using these approaches, if access is improved in this way. The estimated total additional annual cost involved for scaling up access to these ten direct nutrition interventions in the 34 focus countries is Int$9·6 billion per year. Continued investments in nutrition-specifi c interventions to avert maternal and child undernutrition and micronutrient defi ciencies through community engagement and delivery strategies that can reach poor segments of the population at greatest risk can make a great diff erence. If this improved access is linked to nutrition-sensitive approaches—ie, women’s empowerment, agriculture, food systems, education, employment, social protection, and safety nets—they can greatly accelerate progress in countries with the highest burden of maternal and child undernutrition and mortality.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673613609964.pdf

Maternal and Child Nutrition 2 Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?

Microalgae (including the cyanobacteria) are established commercial sources of high-value chemicals such as β-carotene, astaxanthin, docosahexaenoic acid, eicosahexaenoic acid, phycobilin pigments and algal extracts for use in cosmetics. Microalgae are also increasingly playing a role in cosmaceuticals, nutraceuticals and functional foods. In the last few years, there has been renewed interest in microalgae as commercial sources of these and other high-value compounds, driven in part by the attempts to develop commercially viable biofuels from microalgae. This paper briefly reviews the main existing and potential high-value products which can be derived from microalgae and considers their commercial development with a particular focus on the various aspects which need to be considered on the path to commercialisation, using the experience gained in the commercialisation of existing algae products. These considerations include the existing and potential market size and market characteristics of the product, competition by chemically synthesised products or by ‘natural’ compounds from other organisms such as fungi, bacteria, higher plants, etc., product quality requirements and assurance, and the legal and regulatory environment.

High-value products from microalgae—their development and commercialisation

The brain is highly enriched with fatty acids. These include the polyunsaturated fatty acids (PUFAs) arachidonic acid and docosahexaenoic acid, which are largely esterified to the phospholipid cell membrane. Once PUFAs are released from the membrane, they can participate in signal transduction, either directly or after enzymatic conversion to a variety of bioactive derivatives ('mediators'). PUFAs and their mediators regulate several processes within the brain, such as neurotransmission, cell survival and neuroinflammation, and thereby mood and cognition. PUFA levels and the signalling pathways that they regulate are altered in various neurological disorders, including Alzheimer's disease and major depression. Diet and drugs targeting PUFAs may lead to novel therapeutic approaches for the prevention and treatment of brain disorders.

Polyunsaturated fatty acids and their metabolites in brain function and disease

Global demand for macroalgal and microalgal foods is growing, and algae are increasingly being consumed for functional benefits beyond the traditional considerations of nutrition and health. There is substantial evidence for the health benefits of algal-derived food products, but there remain considerable challenges in quantifying these benefits, as well as possible adverse effects. First, there is a limited understanding of nutritional composition across algal species, geographical regions, and seasons, all of which can substantially affect their dietary value. The second issue is quantifying which fractions of algal foods are bioavailable to humans, and which factors influence how food constituents are released, ranging from food preparation through genetic differentiation in the gut microbiome. Third is understanding how algal nutritional and functional constituents interact in human metabolism. Superimposed considerations are the effects of harvesting, storage, and food processing techniques that can dramatically influence the potential nutritive value of algal-derived foods. We highlight this rapidly advancing area of algal science with a particular focus on the key research required to assess better the health benefits of an alga or algal product. There are rich opportunities for phycologists in this emerging field, requiring exciting new experimental and collaborative approaches.

https://link.springer.com/content/pdf/10.1007%2Fs10811-016-0974-5.pdf

Algae as nutritional and functional food sources: revisiting our understanding

Background Docosahexaenoic acid (DHA) plays an important role in neural function Decreases in plasma DHA are associated with cognitive decline in healthy elderly adults and in patients with Alzheimer's disease Higher DHA intake is inversely correlated with relative risk of Alzheimer's disease The potential benefits of DHA supplementation in age-related cognitive decline (ARCD) have not been fully examined Objective Determine effects of DHA administration on improving cognitive functions in healthy older adults with ARCD Methods Randomized, double-blind, placebo-controlled, clinical study was conducted at 19 US clinical sites A total of 485 healthy subjects, aged ≥55 with Mini-Mental State Examination >26 and a Logical Memory (Wechsler Memory Scale III) baseline score ≥1 standard deviation below younger adults, were randomly assigned to 900 mg/d of DHA orally or matching placebo for 24 weeks The primary outcome was the CANTAB Paired Associate Learning (PAL), a visuospatial learning and episodic memory test Results Intention-to-treat analysis demonstrated significantly fewer PAL six pattern errors with DHA versus placebo at 24 weeks (difference score, −163 ± 076 [−31, −014, 95% CI], P = 03) DHA supplementation was also associated with improved immediate and delayed Verbal Recognition Memory scores ( P P Conclusions Twenty-four week supplementation with 900 mg/d DHA improved learning and memory function in ARCD and is a beneficial supplement that supports cognitive health with aging Trial Registration Clinicaltrialsgov, Identifier: NCT0027813

Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline

Arachidonic acid (ARA, 20:4n-6) is an n-6 polyunsaturated 20-carbon fatty acid formed by the biosynthesis from linoleic acid (LA, 18:2n-6). This review considers the essential role that ARA plays in infant development. ARA is always present in human milk at a relatively fixed level and is accumulated in tissues throughout the body where it serves several important functions. Without the provision of preformed ARA in human milk or infant formula the growing infant cannot maintain ARA levels from synthetic pathways alone that are sufficient to meet metabolic demand. During late infancy and early childhood the amount of dietary ARA provided by solid foods is low. ARA serves as a precursor to leukotrienes, prostaglandins, and thromboxanes, collectively known as eicosanoids which are important for immunity and immune response. There is strong evidence based on animal and human studies that ARA is critical for infant growth, brain development, and health. These studies also demonstrate the importance of balancing the amounts of ARA and DHA as too much DHA may suppress the benefits provided by ARA. Both ARA and DHA have been added to infant formulas and follow-on formulas for more than two decades. The amounts and ratios of ARA and DHA needed in infant formula are discussed based on an in depth review of the available scientific evidence.

/pdf/the-essentiality-of-arachidonic-acid-in-infant-development-1qw4e02id5.pdf

The Essentiality of Arachidonic Acid in Infant Development

Omega-3 and omega-6 long-chain polyunsaturated fatty acids (LCPUFA) are critical for infant and childhood brain development, but levels of the omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are often low in the Western diet. Increasing evidence from both epidemiological and intervention studies, reviewed here, indicates that DHA supplementation, during pregnancy, lactation, or childhood plays an important role in childhood neurodevelopment. Arachidonic acid (ARA) is also important for infant growth and development. Several studies have demonstrated positive associations between blood DHA levels and improvements on tests of cognitive and visual function in healthy children. Controlled trials also have shown that supplementation with DHA and EPA may help in the management of childhood psychiatric disorders, and improve visual and motor functions in children with phenylketonuria. In all studies, DHA and EPA supplementation is typically well tolerated. Further research is needed to determine optimal doses for efficacy at different developmental ages. The potential long-term benefits of early LCPUFA supplementation also require consideration.

Effects of long-chain polyunsaturated fatty acid supplementation on neurodevelopment in childhood: A review of human studies

The utility of multicenter cognitive test methodology and resultant outcomes of supplementation with docosahexaenoic acid in healthy 4-year-old children was evaluated in a randomized, placebo-controlled, double-blind study. Subjects received 400-mg/d docosahexaenoic acid (n = 85) or matching placebo (n = 90) in capsules for 4 months. Cognitive tests included the Leiter-R Test of Sustained Attention, Peabody Picture Vocabulary Test, Day-Night Stroop Test, and Conners' Kiddie Continuous Performance Test. The relationship of docosahexaenoic acid levels in capillary whole blood from a subsample (n = 93) with scores on cognitive tests was evaluated. For each test, results indicated that changes from baseline to end of treatment were not statistically significantly different between the docosahexaenoic acid group and the placebo group. Regression analysis, however, yielded a statistically significant positive (P = .018) association between the blood level of docosahexaenoic acid and higher scores on the Peabody Picture Vocabulary Test, a test of listening comprehension and vocabulary acquisition.

Assessing the Effect of Docosahexaenoic Acid on Cognitive Functions in Healthy, Preschool Children: A Randomized, Placebo-Controlled, Double-Blind Study

The cardiovascular benefits of fish-derived long-chain polyunsaturated fatty acids, docosahexaenoic acid (DHA), and eicosapentaenoic acid are well established. Less studied are specific effects of individual long-chain polyunsaturated fatty acids. Based on data from 16 published clinical trials, this review examines effects of DHA triglyceride (TG) oil derived from algae (algal-DHA) on serum TG levels and related parameters. Study populations included subjects with both normal and elevated TG levels including those with persistent hypertriglyceridemia treated with concomitant 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) therapy. At doses of 1-2 g/d, algal-DHA significantly lowered plasma TG levels (up to 26%) either administered alone or in combination with statins. The reduction in TG levels was markedly greater in hypertriglyceridemic than in normal subjects. Algal-DHA modestly increased plasma levels of both high-density lipoprotein and low-density lipoprotein cholesterol. The increased plasma level of low-density lipoprotein cholesterol was associated with a shift of lipoprotein particle size toward larger, less atherogenic subfractions. In some subjects, blood pressure and heart rate were significantly reduced. Algal-DHA was safe and well tolerated. Unlike fish oil, algal-DHA seldom caused gastrointestinal complaints such as fishy taste and eructation, attributes of importance for patient compliance in high-dose therapy. Regression analysis that showed a linear relationship between baseline TG and magnitude of TG reduction suggests that a study of patients with very high TG levels (>500 mg/dL) is warranted. Future pharmacologic therapies for treating hypertriglyceridemia may include algal-DHA.

/pdf/clinical-overview-of-algal-docosahexaenoic-acid-effects-on-rgckcjycx5.pdf

Alan S. Ryan

Papers

Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline

The Essentiality of Arachidonic Acid in Infant Development

Effects of long-chain polyunsaturated fatty acid supplementation on neurodevelopment in childhood: A review of human studies

Assessing the Effect of Docosahexaenoic Acid on Cognitive Functions in Healthy, Preschool Children: A Randomized, Placebo-Controlled, Double-Blind Study

Clinical overview of algal-docosahexaenoic acid: effects on triglyceride levels and other cardiovascular risk factors.