Lipid intake in infants from birth to 3 years old: review of current guidelines and knowledge gaps.

Abstract

Lipids are essential for child development. Nutritional recommendations are numerous, evolving over time and are often based on expert opinions more than evidence-based medicine. The objective of this review is to critically analyse the evolution of current nutritional recommendations, identify existing knowledge gaps, and propose avenues for improvement to optimize infant nutrition and development. A narrative literature review on Pubmed, EMBASE and Cochrane (2001-2022) has been conducted with keywords: "alpha-linolenic acid, arachidonic acid, children, cholesterol, docosahexaenoic acid, eicosapentaenoic acid, guidelines, infant, LC-PUFA, linoleic acid, lipids and dietary intakes, newborn, palmitic acid, toddler". Among 861 articles identified, 133 were selected. The main current recommendations are issued by AFSSA, ANSES and FAO-WHO. In infants from 0 to 3 years of age the main challenge is to increase lipid intake while maintaining an optimal omega 6/omega 3 ratio. Current recommendations are focused on polyunsaturated fatty acids, emphasising the intake of linoleic, eicosapentaenoic and docosahexaenoic acids without any specific recommendation for arachidonic acid before the age of 6 months. Points of interest, but without any recommendation, are the incorporation of milk fat, cholesterol, monounsaturated fatty acids, and saturated fatty acids for infants under 6 months. In conclusion, this article identifies knowledge gaps regarding the structural aspect of lipids and the integration of new categories of lipids in future recommendations to promote the quality of infant formulas.