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Featured Recipe: Fennel-Crusted Salmon on White Beans

Compounding the problem, adds Jacobson, is that our diets are rich in another type of fatty acid: arachidonic acid (AA), an omega-6 polyunsaturated fatty acid found in animal fats and formed in the body when we consume linoleic acid from vegetable oils in foods. There’s nothing inherently bad about AA—it’s important for normal growth. But Jacobson and others believe that our prehistoric ancestors evolved to eat a more balanced ratio of omega-6 to omega-3 fatty acids. Today, few people eat enough fish to achieve this balance; the ratio is currently about 10:1 in the U.S. Since AA competes with DHA for space in the membrane and affects other functions in the brain, some experts suggest an abundance of AA is less optimal for cognitive development in babies (and may be associated with early cognitive decline in older adults—more on that later).

Unless they stick to the “eat fish at least twice a week” dietary guideline, it’s hard for most Americans to meet DHA recommendations without supplements. This is why many infant formulas are now fortified with DHA (breast milk can be a great source of DHA, if the mom eats fish or takes supplements herself). Jacobson hints that supplementing formula, however, could be a case of too little too late—in his Inuit study he saw no beneficial effect of breast milk that contained high levels of DHA on the cognitive performance in infancy, although there could still be some beneficial effects on cognitive function in childhood. In the majority of studies that have demonstrated beneficial effects from DHA-enhanced infant formula, he notes, “most of the effects have been limited to preterm babies”—e.g., those who missed getting their full in utero complement of the nutrient. Does this mean that the typically DHA-poor American diet places infants at risk? Jacobson is quick to assure me there is no reason to assume that it does. “You don’t want to oversell the problem, but our data suggest that greater quantities of prenatal DHA intake could be beneficial.”

Milk vs. formula?

DHA is not the only critical substance for developing babies’ brains. Researchers have known for some time that iron is also key, but recently they have been discovering just how long the effects of a deficiency can last. Babies are born with a solid store of iron, but by 5 or 6 months they’ve used much of it up and can’t get enough from breast milk to sustain their ever-growing bodies: they need to take it in from the outside world in food or supplements. Studies show that being deficient at points within the 5- to 12-month age block irrevocably slows academic, social and emotional development. Even if children are fortified with iron soon after the deficiency is detected, they never catch up, and can still show signs of cognitive delay even 10 years later.

Iron is not only needed to transport oxygen to the brain in the bloodstream, but it also helps myelinate, or insulate, nerve fibers so signals travel faster—and helps create the neurotransmitters that relay signals between neurons. Until the early 1970s when manufacturers began adding iron to formula, more than 30 percent of infants were iron-deficient; since fortification, that number has plummeted. (At last count, about 7 percent of toddlers were iron-deficient.) But with the rise in breastfeeding, exclusively breast-fed infants are now at risk, especially as they’re transitioning to solid foods. Breast milk is still the best food (bar none) for infants, but physician groups recommend using rice cereal fortified with iron or supplementing with a vitamin drop during and after that critical transition to solid foods around 5 or 6 months.

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