Abstract: Omega-3s are essential to support the healthy development of your baby's brain, eyes, and nervous system. There are three main types of omega-3s: ALA, DHA, and EPA. Research finds that those who intake higher omega-3s during pregnancy have positive health outcomes for both mom and baby. These health outcomes include reduced incidence of postpartum depression, higher childhood IQ, and reduced brain aging. Much of these positive outcomes occur as a result of the anti-inflammatory properties of omega-3s. Omega-3 fatty acids are also essential for heart health and your baby's immune system development. Foods rich in omega-3s include fish, flaxseeds, and walnuts. Remember to follow safety recommendations for seafood consumption, particularly while pregnant, to reduce the risk of mercury exposure!

Review of Omega-3, DHA, and EPA

Your baby's brain is growing at an impressive rate throughout the third trimester; therefore, it's important to nourish that growth accordingly. Getting enough healthy fats, like omega-3s, is essential during the third trimester when your baby's brain is rapidly developing. 

When it comes to fat, the quality and type of fat you consume matter. Fat is naturally energy-dense and provides a lasting feeling of fullness. Omega-3s are polyunsaturated fats that you should regularly incorporate into your diet, especially to boost your baby's brain development.

There are 11 types of omega-3s, but the three most important types are Alpha-linolenic acid (ALA), DHA, and EPA.

Omega-6s are another polyunsaturated fatty acid. The two main types of omega-6s are linoleic acid and arachidonic acid. Arachidonic acids from a biologically active lipid called eicosanoids. Eicosanoids regulate numerous bodily functions, including blood pressure, inflammation, and reproduction. One of the omega-3s, EPA, forms its own eicosanoids. The EPA eicosanoids counteract omega-3 eicosanoids, which is why a balanced ratio of omega-3s to omega-6s is essential. Most Americans have excessively more omega-6s than omega-3s. 

Besides supplementation, you can get enough omega-3s from fatty fish, such as salmon, herring, sardines, trout, fish eggs, or mussels. Even if your fish source contains a small amount of mercury, it also contains high amounts of selenium. This mineral readily binds with mercury, preventing it from exerting toxic effects in the body. Smart fish consumption is a great source of valuable nutrients for pregnancy and beyond. Omega-6 fats found in processed foods from vegetable oils should be limited significantly. Avoid products made with soy, canola, cottonseed, safflower, peanut, or corn oils. These oils are also commonly used in restaurants, so the more home-cooking, the better.

Back in week 14, we unraveled what omega-3s are, why you need them, how much you should be intaking, and sources of omega-3-rich products. We learned  during pregnancy, and while breastfeeding, experts recommend consuming 12 oz of fish/week and supplementing with at least 200 mg/day of DHA.

This week we will uncover

• The relationship between omega-3s and your baby’s brain development
• How omegas-3s during pregnancy influence the moms' mood and brain health
• Inflammation as it relates to brain health, and omega-3s role in prevention

Did you know? Women can convert more ALA to EPA/DPA, especially women of childbearing age, due to the greater need for these fatty acids in the growing fetus and greater estrogen levels. 

Healthy Fats for Eye and Brain Development 

The brain is a fatty organ. In fact, a quarter of its dry weight is lipids! The rapid neural development in late-stage pregnancy requires fat to support the development of the brain and eyes. Omega-3s, specifically DHA and EPA, are associated with increased dopamine, serotonin, neuronal cell size, visual function, memory, and learning behaviors. DHA accounts for ~15% of the fatty acids in your brain! 

One study investigated mother fish consumption during pregnancy and evaluated the neurocognitive outcomes of their children nine years later. The study found that the 9-year-old whose mothers consumed fish (both fatty and non-fatty) had increased verbal IQ and reduced risk of hyperactivity. Furthermore, there is an association between low omega-3s and autism, bipolar disorder, and depressive disorders. This aligns with the fact that the brain cell membrane activity collects DHA in their structure, allowing for increased activity of receptors and synaptic function. 

In addition to neuronal function, omega-3s contribute to the development of the retina. The eye's retina selectively gathers up and holds DHA for its use and increases the expression of photoreceptor cells and genes. Moreover,  DHA increases the activation of a protein receptor called rhodopsin. Rhodopsin is a g-coupled protein receptor that is responsible for seeing the color purple, as well as supporting night vision. Since the 3rd trimester is key to development, preterm infants have a greater need for omega-3s because this is when these fatty acids get incorporated into neuronal and retinal tissues.

Did you know? The DHA content of your baby's brain triples during the first three months of life, and the fatty acid continues to impact the brain's development post-birth for someone's lifespan .

Omega-3 and Inflammation 

The anti-inflammatory functions of DHA can prevent brain aging, such as retaining memory, improving learning, and even reducing/prolonging the shrinkage of nerve cells. Additionally, the anti-inflammatory properties of omega-3s are what support improved brain development and neurotransmitter function at a younger age. 

As mentioned above, mood disorders such as autism, hyperactivity, bipolar, and depressive disorders are associated with deficient omega-3s. Much of this has to do with increased inflammation, particularly an increased ratio of omega-6s to omega-3s. In fact,  the high inflammation associated with the ratio of omega-6s to omega-3s, contribute to the high rates of depression in Western cultures! 

Proinflammatory cytokines reduce the neurotransmitter levels of serotonin, dopamine, GABA, and norepinephrine in the brain. The reduction of these neurotransmitters predisposes people to a variety of mood disorders.

Research finds that a diet low in omega-3s influences the metabolism of these neurotransmitters:

• the genes that regulate these neurotransmitters,
• the genes and proteins which regulate inflammation

This means omega-3s influence neurotransmitters both directly and indirectly through inflammatory processes! 

Omega-3 and Mother's Mood

Let’s be honest, having a baby is exhausting! Tiredness, irritability, forgetfulness, and brain fog are all natural consequences of having a baby, but how do you know when it's too much?  Without adequate omega-3s, most notably DHA, what is called "mom brain" can occur. This is characterized by reduced cognitive function, depression, and greater susceptibility to stress.

Not only are omega-3s associated with reduced “mom brain,” but also reduced risk of postpartum depression. Research shows that adequate DHA and EPA intake reduces the risk of postpartum depression by regulating neurotransmitter function and inflammation. Similar to research mentioned throughout this article, studies have shown that women with a higher omega-6 to omega-3 ratio are more likely to experience postpartum depression than those with a lower ratio/higher intake of seafood. 

Did you know? Most research reports mothers' DHA levels to be decreased by as much as 50% postpartum, much of which is not replenished until upwards of 26 weeks after delivery!

Summary

Omega-3s are essential to support the healthy development of your baby's brain, eyes, and nervous system. There are three main types of omega-3s: ALA, DHA, and EPA.

Research finds that those who intake higher omega-3s during pregnancy have positive health outcomes for both mom and baby. These health outcomes include reduced incidence of postpartum depression, higher childhood IQ, and reduced brain aging. Much of these positive outcomes occur as a result of the anti-inflammatory properties of omega-3s. Omega-3 fatty acids are also very important for heart health and the development of your baby's immune system. 

Foods rich in omega-3s include fish, flaxseeds, and walnuts. Remember to follow safety recommendations for seafood consumption, particularly while pregnant, to reduce the risk of mercury exposure!

References: 

1. DiNicolantonio JJ, O'Keefe JH. The Importance of Marine Omega-3s for Brain Development and the Prevention and Treatment of Behavior, Mood, and Other Brain Disorders. Nutrients. 2020;12(8):2333. Published 2020 Aug 4. doi:10.3390/nu12082333
2. Gale CR, Robinson SM, Godfrey KM, et al. Oily fish intake during pregnancy--association with lower hyperactivity but not with higher full-scale IQ in offspring. Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2008 Oct;49(10):1061-1068. DOI: 10.1111/j.1469-7610.2008.01908.x. PMID: 18422546.
3. Levant B. N-3 (omega-3) Fatty acids in postpartum depression: implications for prevention and treatment. Depress Res Treat. 2011;2011:467349. doi:10.1155/2011/467349
4. Makrides M, Collins CT, Gibson RA. Impact of fatty acid status on growth and neurobehavioural development in humans. Matern Child Nutr. 2011;7(SUPPL. 2):80-88. doi:10.1111/j.1740-8709.2011.00304.x
5. Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. Omega-3 fatty acid addition during pregnancy. Cochrane Database Syst Rev. 2018;11(11):CD003402. Published 2018 Nov 15. doi:10.1002/14651858.CD003402.pub3
   Shindou H, Koso H, Sasaki J, et al. Docosahexaenoic acid preserves visual function by maintaining correct disc morphology in retinal photoreceptor cells. J Biol Chem. 2017;292(29):12054-12064. doi:10.1074/jbc.M117.790568