PUFA’s are the polyunsaturated fatty acids and the EFA’s are essential fatty acids. Over the past few days we have been going over the benefits of these, especially of DHA and EPA, before and during pregnancy and while nursing. The omega-6′s are in abundant supply in the typical US diet due to the high consumption of dairy products, meats, animal and vegetable oils used in fried foods.

However, there is a relative deficiency of omega-3′s in the typical US diet. Most individuals are only taking in 20-60% of the omega-3′s they need. This has a great and lifelong impact on the fetus. The consensus report prepared by the CHF (Child Health Foundation) has recommended that during pregnancy, breastfeeding and early childhood omega-3 fatty acids need to be supplemented. It is widely known that omega-6′s are currently in high supply and due to the imbalance of the typical US diet, mother transfers plenty of AA (arachidonic acid) to the fetus.

Excessive omega-6′s have harmful effects since they mediate inflammation, tightening of vessels and smooth uterus muscle and clotting. AA (arachidonic acid) which is an omega-6, is converted to cyclooxygenase (Cox), prostacyclin, prostaglandins and thromboxane A2. It is thought that Thromboxane when found in increased amounts and early in pregnancy could result in preeclampsia. While AA can be converted to Thromboxane A2, EPA can not be converted to Thromboxane and on the contrary helps increase the levels of Prostacyclin. Prostacyclin which relaxes smooth muscles is promoted by EPA and helps dilate vessels, reduce activation of platelets, relaxes smooth muscles and does not promote inflammation. This also accounts for the beneficial effects of fish oil inpromoting cardiovascular health in general.

This is very important because it has implications beyond pregnancy and significant public health impact. Furthermore when omega-3 and omega-6 ‘s are insufficient, something called omega-9′s are produced in the body which are very dangerous and harmful.


There is an omega 9 called Mead’s acid which has 20 carbon atoms and can only be oxidized by lipooxygenase, in cases of diabetes reduces protacyclin, causes vessel damage and clots. This also happens in pregnancy with diabetes. Babies that are exposed to high glucose levels in utero can develop injury to their small vessels and are also at high risk for birth defects such as spina bifida and anterior abdominal wall and chest defects.

EFA’s specifically DHA and EPA help promote heart and circulatory health. DHA and EPA in breast milk help confer benefits to the baby in the area of motor skills, language, IQ, cognition and lower disease risk. Breastfeeding benefits the mother by helping with uterine contraction to reduce bleeding after the delivery, promotes bonding with her baby, cuts her risk of getting ovarian cancer and reduces her chances of having breast cancer after menopause DHA helps reduce uterine contractility by reducing the synthesis and activity of MMP (matrix metalloproteinases) which are involved in cervical ripening and are related to PPROM (preterm premature rupture of membranes).

DHA, EPA together with folic acid, tetrabiopterin and vitamin C are now found to enhance nitric oxide (NO) production. This confers benefits by reducing CAD (coronary artery disease), PAD (peripheral artery disease), atherosclerorosis, hyperlipidemia and also helps protect the brain and nervous system against degenerative diseases. Low levels of DHA following delivery are also found to be associated with postpartum depression, so this is another reason for supplementation.


1) Das UN. Long chain PUFA’s in the growth and development of the brain and memory. Nutrition.2003;19:62-65. 2) Das UN. Folic acid says NO to vascular diseases. Nutrition. 2003;19:686- 692.