Use of docosahexaenoic acid and arachidonic acid enhancing the growth of preterm infants

Information

  • Patent Application
  • 20040143013
  • Publication Number
    20040143013
  • Date Filed
    November 14, 2003
    20 years ago
  • Date Published
    July 22, 2004
    19 years ago
Abstract
A method for enhancing the growth of preterm infants involving the administration of certain long chain polyunsaturated fatty acids. It is preferred that the infants are administered an infant formula containing a combination of docosahexaenoic acid and arachidonic acid.
Description


BACKGROUND OF THE INVENTION

[0002] (1) Field of the Invention


[0003] The present invention concerns enhancing the growth of preterm infants involving administration of infant formula containing a combination of docosahexaenoic and arachidonic acid.


[0004] (2) Description of the Related Art


[0005] The long chain polyunsaturated fatty acids (LC PUFA) have been shown to be important in infant development. Particularly, arachidonic acid (ARA) and docosahexaenoic acid (DHA) are LC PUFA that are of special interest in infant nutrition because they are found in high concentrations in the brain (Sastry P S, Lipids of nervous tissue: composition and metabolism. Progress Lipid Res 1985;24:69-176) and the retina (Fliesler S J and Anderson R E. Chemistry and metabolism of lipids in the vertebrate retina. Progress Lipid Res 1983;22:79-131). ARA (20:4n-6) and DHA (22:6n-3) are derived from the parent essential fatty acids linoleic acid (18:2n-6) and α-linolenic acid (18:3n-3) through alternate desaturation and elongation and accumulate rapidly in fetal neural tissue during the last months of gestation and the first months of postnatal life (Makrides M, Neuman M A, Byard R W, Simmer K, Gibson R A. Fatty composition of the brain, retina and erythrocytes in breast- and formula-fed infants. Am J Clin Nutr 1994;60:189-94).


[0006] Unlike term infants, preterm infants do not fully benefit from the maternal and placental LC PUFA supply during the last trimester of pregnancy. Even though preterm infants are capable of synthesizing both DHA and ARA from their 18 carbon precursors (Carnielli V P, Wattimena D J L, Luijendijk I H T, Boerlage A, Degenhart H J, Sauer P J J. The very low birth weight premature infant is capable of synthesizing arachidonic and docosahexaenoic acids from linoleic and linolenic acids. Pediat Res 1996;40:169-174), it remains unclear whether the rate of synthesis is adequate to meet the optimal needs for central nervous system accretion in the absence of a dietary supply of these fatty acids. Preterm infants are dependent on their own dietary supply of linoleic and α-linolenic acids through either human milk, which also contains small but significant amounts of ARA and DHA or through commercially available artificial formulas, none of which in the United States contain ARA end DHA.


[0007] It has been demonstrated in recent studies (Hoffman D R and Uauy R. Essentiality of dietary ω-3 fatty acids for premature infants: Plasma and red blood cell fatty acid composition. Lipids 1992;27:886-95) that the fatty acid composition of red blood cell membrane lipids in infants receiving formulas supplemented with DHA (0.35% of total fatty acids) was similar to human milk-fed infants. In the same study, Birch (Birch D G, Birch E E, Hoffman D R Uauy R D. Retinal development in very-low-birth-weight infants fed diets differing in Omega-3 fatty acids. Investigation Ophthalmology Visual Science 1992;33:2365-76) found that retinal function improved with the provision of a dietary supply of DHA in very low birth weight infants.


[0008] The first year growth of preterm infants fed standard formula compared to marine oil LC PUFA supplemented formula was studied by Carlson et al. (Carlson S E, Cooke, R J, Werkman S H, Tolley E A. First year growth of preterm infants fed standard compared to marine oil n-3 supplemented formula Lipids 1992:27:901-907). The experimental formulas provided 0.2% of total fatty acids as DHA and also provided 0.3% as EPA (20:5n-3). This EPA concentration is higher than found in human milk while the DHA level is similar to human milk. Beginning at 40 weeks from conception, marine oil supplemented infants compared to controls had significantly lower weight, length, and head circumference. From this study, Carlson (Carlson S E, Werkman S H, Peeles J M, Cooke R J, Tolley E A. Arachidonic acid status correlates with first year growth in preterm infants. Proc Natl Acad Sci USA 1993;90:1073-77) hypothesized that dietary ARA could improve first year growth of preterm infants, in the context of restoring growth to the level of control formula containing no LC PUFA.


[0009] In another study (Montalto, F B, et al., Pediatric Research, Vol 39, page 316A, abstract no. 1878) it was shown that male infants fed marine oil supplemented formula (containing DHA but essentially no ARA) had, by 4 to 6 months, lower head circumference, length, weight and fat free mass than standard formula fed infants. A third study also showed decreased weight at 9 and 12 months corrected age in preterm infants fed marine oil supplemented formula (with LC PUFA) to 2 months corrected age compared with control formula containing no LC PUFA (Carlson S E, et al., Am. J. Clin. Nutr., 63 pp 687-97, 1996).


[0010] The prior art has demonstrated that infants with altered tissue LC PUFA levels, resulting from a lack of LC PUFA in their diets, may be at risk for neurological problems, may also have reduced scores on cognitive tests, and may have lower retinal development than human milk-fed infants. Worldwide regulatory organizations such as the WHO/FAO Expert Committee on Fats and Oils in Human Nutrition have recommended that LC PUFA be included in preterm infant formula. These recommendations have been made despite the negative effects observed of DHA supplements on growth. There has been no demonstration in the literature that ARA and DHA, particularly when added to infant formula, enhances the growth of infants above that demonstrated by control formulas not containing ARA and DHA.



SUMMARY OF THE INVENTION

[0011] It has unexpectedly been discovered that preterm infants receiving infant formula supplemented with both DHA and ARA demonstrate enhanced growth. The present invention is directed to enhancing the growth of preterm infants comprising administering to said infants a growth enhancing amount of DHA and ARA.



DETAILED DESCRIPTION OF THE INVENTION

[0012] As reported in a review of preterm infant growth by Carlson, S E, (The Jrnl of Pediatrics, vol 125, pp 533-8,1994) “After adjusting for postconceptional age, preterm infants show a decline (rather than a catch-up) in the normalized weight from approximately 2 to 4 months past expected term.”


[0013] Several prior art studies have documented the value of administering DHA to infants. However, when DHA, either as the primary LC PUFA or combined with EPA, is administered to preterm infants, said infants suffer from decreased growth. It has been suggested that ARA may be beneficial to growth; however, heretofore the growth effects of administering both DHA and ARA to preterm infants have been unknown. It has been surprisingly discovered that administering the combination of ARA and DHA results in enhanced growth of infants relative to infants fed DHA alone. It has also been discovered that preterm infants administered an infant formula containing ARA and DHA exhibit enhanced growth relative to preterm infants fed control formula without DHA and ARA, such as those formulas currently used in modem nurseries. It has further been discovered that practice of the method of the invention results in growth of preterm infants catching up in an unexpected short time to a reference group of normal term breast fed infants.


[0014] The time to achieve growth similar or equivalent to normal term breast fed infants by practice of the method of the invention is less than 9 months corrected age; preferably less than 6 months corrected age, more preferably less than 4 months corrected age, even more preferably less than 2 months corrected age, and most preferably no greater than term corrected age.


[0015] The method of the invention requires a combination of DHA and ARA. The weight ratio weight of ARA:DHA can be about 1:2 to about 5:1, preferably about 1:1 to about 3:1, and more preferably about 2:1.


[0016] In the method of the invention the combination of DHA and ARA is preferably administered as part of an infant formula. The infant formula for use in the present invention is preferably nutritionally complete and typically contains suitable types and amounts of lipid, carbohydrate, protein, vitamins and minerals. The amount of lipid or fat typically can vary from about 3 to about 7 g/100 kcal. The amount of protein typically can vary from about 1 to about 5 g/100 kcal. The amount of carbohydrate typically can vary from about 8 to about 12 g/100 kcal. Protein sources can be any used in the art, e.g., nonfat milk, whey protein, casein, soy protein, hydrolyzed protein, amino acids, and the like. Carbohydrate sources can be any used in the art, e.g., lactose, glucose, corn syrup solids, maltodextrins, sucrose, starch, rice syrup solids, and the like. Lipid sources can be any used in the art, e.g., vegetable oils such as palm oil, soybean oil, palmolein, coconut oil, medium chain triglyceride oil, high oleic sunflower oil, high oleic safflower oil, and the like. Conveniently, commercially available infant formula can be used. For example, Enfamil®, Enfamil® Premature Formula, Enfamil® with Iron, Lactofree®, Nutramigen®, Pregestimil®, ProSobee® (available from Mead Johnson & Company, Evansville, Ind., U.S.A.), Similac®, Isomil®, Alimentum®, Neocare®, and Similac® Special Care (available from Ross Laboratories, Columbus, Ohio, U.S.A.), may be supplemented with suitable levels of ARA and DHA at the proper ratios and used in practice of the method of the invention.


[0017] The form of administration of the DHA and ARA in the method of the invention is not critical, as long as a growth enhancing amount is administered. Most conveniently, the DHA and ARA are supplemented into infant formula which is then fed to the infants. Alternatively, the DHA and ARA can be administered as a supplement not integral to the formula feeding, for example, as oil drops, sachets, in combination with other nutrient supplements such as vitamins, and the like.


[0018] The growth enhancing amount of DHA is typically about 2.5 mg/kg of body weight/day to about 60 mg/kg of body weight/day, preferably about 6 mg/kg of body weight/day to about 40 mg/kg of body weight/day, more preferably about 12 mg/kg body weight/day to about 30 mg/kg body weight/day, and even more preferably about 18 mg/kg of body weight/day to about 24 mg/kg of body weight/day.


[0019] The growth enhancing amount of ARA is typically about 5 mg/kg of body weight/day to about 120 mg/kg of body weight/day, preferably about 12 mg/kg of body weight/day to about 80 mg/kg of body weight/day, more preferably about 24 mg/kg body weight/day to about 60 mg/kg body weight/day, and even more preferably about 36 mg/kg of body weight/day to about 48 mg/kg body weight/day.


[0020] The amount of DHA in infant formulas for use in the present invention typically varies from about 2 mg/100 kilocalories (kcal) to about 50 mg/100 kcal, preferably about 5 mg/100 kcal to about 33 mg/100 kcal, more preferably about 10 mg/100 kcal to about 25 mg/100 kcal, and even more preferably about 15 mg/100 kcal to about 20 mg/100 kcal.


[0021] The amount of ARA in infant formula for use in the present invention typically varies from about 4 mg/100 kcal to about 100 mg/100 kcal, preferably about 10 mg/100 kcal to about 67 mg/100 kcal, more preferably about 20 mg/100 kcal to about 50 mg/100 kcal, and even more preferably about 30 mg/100 kcal to about 40 mg/100 kcal.


[0022] The infant formula supplemented with oils containing DHA and ARA for use in the present invention can be made using standard techniques known in the art. For example, replacing an equivalent amount of an oil normally present, e. g., high oleic sunflower oil.


[0023] The source of the ARA and DHA can be any source known in the art such as fish oil, single cell oil, egg yolk lipid, brain lipid, and the like. The DHA and ARA can be in natural form, provided that the remainder of the LC PUFA source does not result in any substantial deleterious effect on the infant. Alternatively, the DHA and ARA can be used in refined form. It is preferred that the LC PUFA used in the invention contain little or no EPA. For example, it is preferred that the infant formulas used herein contain less than about 20 mg/100 kcal EPA; preferably less than about 10 mg/100 kcal EPA; more preferably less than about 5 mg/100 kcal EPA; and most preferably substantially no EPA.


[0024] Preferred sources of DHA and ARA are single cell oils as taught in U.S. Pat. Nos. 5,374,657, 5,550,156, and 5,397,591, the disclosures of which are incorporated herein by reference in their entirety.


[0025] The following examples are to illustrate the invention but should not be interpreted as a limitation thereon.







EXAMPLES


I


CLINICAL STUDY DESIGN

[0026] 1. Introduction


[0027] This study is a double-blind, randomized, controlled parallel design, prospective trial of premature infant formulas containing microalgae and fungi-derived oils which contain a part of their constituents arachidonic acid and docosahexaenoic acid. Formula feeding subjects will be randomized into one of 3 feeding groups:


[0028] premature formula plus DHA (about 0.13% of energy) and ARA (about 0.26% of energy)


[0029] premature formula plus DHA (about 0.13% of energy)


[0030] premature formula WITHOUT DHA and ARA


[0031] The products have the same nutrient composition (see Appendix A) and differ only in the level of DHA and ARA. The products will be blinded. The present order of formula has no relationship to randomization.


[0032] Normal, term, breast fed infants will be enrolled to provide a normal visual acuity reference.


[0033] Fifty evaluable subjects will be completed in each group. Premature infants will remain on study formulas after reaching 90 kcal/kg/d for a minimum of 28 days or until hospital discharge whichever is longer. After 28 days or discharge, whichever is longer, all premature infants will receive Enfamil or Enfalac with Iron. If medically indicated, ProSobee, Lactofree, Alactamil, Nutramigen, or Pregestimil may be used in place of Enfamil or Enfalac with Iron. Term infants will receive at least 85% of their nutrition from breast milk. Primary measures of effectiveness will include visual acuity and red blood cell membrane fatty acid profiles (i.e. DHA and ARA levels). The measure of safety will be growth and adverse experience reports.


[0034] 2. Subjects


[0035] 2.1 Source and Characterization of Study Group


[0036] Acceptable preterm subjects will be relatively healthy premature infants taking preterm formula. Anticipated hospitalization should be sufficient to allow for 28 days of enteral intake ≧90 kcal/kg/d and ≧85% study formula intake. All races and both sexes will be eligible for the study.


[0037] 2.2. Inclusion Criteria


[0038] Preterm infants:


[0039] Birth weight ≧900 g


[0040] Formula feeding at time of study enrollment


[0041] Anticipate enteral intake of ≧90 kcal/kg/day for ≧28 days before discharge home


[0042] Informed consent obtained


[0043] Term Infants:


[0044] 38 to 42 weeks gestation


[0045] Committed to breast feeding


[0046] Informed Consent obtained


[0047] 2.3 Exclusion Criteria


[0048] Preterm infants:


[0049] ≧1500 g at birth


[0050] Preterm and Term Infants:


[0051] History of underlying disease or congenital malformation which in the opinion of the investigator is likely to interfere with the evaluation of the subject


[0052] More than 24 days between birth and full oral feeds (≧90 kcal/kg/d)


[0053] Small (<10th percentile) for gestational age at birth (SGA)


[0054] Necrotizing enterocolitis as diagnosed by the physician


[0055] Other gastrointestinal disease


[0056] Impaired visual or ocular status at birth


[0057] 2.4 Concomitant Medications, Hospitalizations, Illnesses


[0058] No medication which may affect FPL response may be used within 3 days of measurement.


[0059] No evidence of viral of bacterial infection during FPL testing.


[0060] No medications known to affect lipid metabolism (e.g., heparin at therapeutic levels)


[0061] 3. Study Product Information


[0062] 3.1 Formulations


[0063] Nutrient composition is included as Appendix A.


[0064] 4. Study Procedures


[0065] 4.2.1 Enrollment


[0066] Enrollment will take place over a 6 month period. Ideally, sufficient subjects will be enrolled so that 10 subjects in each group complete the study at each site for the multi-center trial. A total of 50 infants per formula group will complete this trial.


[0067] 4.2.2 Schedule of Events (See Flow Chart, Section 8.4)


[0068] 4.2.2.1 Recruitment


[0069] Mothers of eligible, healthy, preterm formula fed infants and term, breastfed infants will be contacted, the study explained to them, and if they are agreeable, written informed consent obtained.


[0070] Term infants may be enrolled anytime from birth until or during the 48 week visit.


[0071] 4.2.2.2 Randomization


[0072] Recruited formula fed subjects will be randomized into study groups. Randomization can occur anytime after enteral feeds reach 50 kcal/kg/day until commencement of full enteral feeds (i.e., ≧90 kcal/kg/day).


[0073] 4.2.2.3 Feeding


[0074] All premature infants will receive their assigned study formula after informed consent has been granted and enteral feeds are at least 50 kcal/kg/day. The infant will remain on study formula 28 days after reaching 90 kcal/kg/d or until hospital discharge, whichever is longer. Oral feeding amount, strength and rate will advance as appropriate for the clinical management of the infant.


[0075] All parents will be instructed not to feed solid foods during the study. The parents will be instructed that the study formula or breast milk is to serve as the sole source of food from enrollment to study end.


[0076] 4.2.2.4 Baseline Data Collection


[0077] The following data will be collected by the Investigator at the time of enrollment and randomization on the case report forms:


[0078] Informed consent of parent obtained.


[0079] Post conceptual age.


[0080] That the subject is a premature infant, with Birth weight ≧900 gm and ≧1500 gm or a normal term infant between 38 and 42 weeks gestational age.


[0081] That the preterm subject is receiving infant formula or term infant is committed to breast feeding.


[0082] Anticipated preterm infant enteral intake of ≧90 kcal/kg/day for ≧28 days prior to discharge home.


[0083] That the subject has no history of underlying disease, inborn error of metabolism, or congenital malformation which in the opinion of the Investigator is likely to interfere with the evaluation of the study formulas.


[0084] That the subject is not small (<10th percentile) for gestational age at birth.


[0085] That the subject does not have necrotizing enterocolitis as diagnosed by a physician.


[0086] That the subject does not have a gastrointestinal disease.


[0087] No more than 24 days between birth and full enteral feeds (i.e., >90 kcal/kg/day).


[0088] That the subject did not have impaired visual or ocular status at birth.


[0089] Birth date, sex, race.


[0090] Birth weight, length and head circumference


[0091] 4.2.2.5 Investigator Periodic Data Collection


[0092] “During hospitalization, preterm subjects will have their weight recorded daily while they are receiving study formula. Length and head circumference will be recorded weekly, along with an additional weight measurement. For a given subject, the same scale should be used for the weekly weight measurement.”“Weight, length, and head circumference will also be recorded at the 40, 48, and 57 week post conceptual age visit (preterm) and 56 and 119 days of age visit (term).”


[0093] 4.2.2.6 Blood Draw


[0094] When preterm infant enrolls in the study and again at termination of study formula (i.e., hospital discharge or 28 days after reaching 90 kcal/kg/d of study product), the Investigator will ascertain that the infant is essentially solely formula fed. If this criteria is met, 1.2 ml/blood will be drawn for blood lipids. The sample will be processed as described in Appendix B.


[0095] An attempt will also be made to draw a similar blood sample at the 48 weeks PCA visit when visual acuity is measured in both term and preterm infants.


[0096] 4.2.2.7 Visual Acuity by Forced Choice Preferential Looking (FPL) at 48 and 57 Weeks±4 Days Post-Conceptual Age


[0097] When the infant is 48 and 57 weeks±4 days post-conceptual age, trained persons at each study site will follow the Teller Acuity Card Procedure for the measurement of visual acuity of all study subjects. It is essential that only persons who are trained in the FPL procedure for determining visual acuity do the testing. If necessary, training of responsible persons and documentation of completion of successful training will be done at Children's Hospital Medical Center Ophthalmology Department in Seattle, Wash., according to the procedure attached as Appendix C.


[0098] If the infant cannot complete the procedure at 48 or 57 weeks±4 days postconceptual age (i.e., too fussy, too sleepy, too inattentive) the test should be repeated within 7 days.


[0099] 4.2.2.8 Interim Evaluation


[0100] At preterm infant hospital discharge or 28 days after reaching 90 kcal/kg/d of study formula feeding, whichever is longer, the Investigator will fill out an “Interim Evaluation” form. After reviewing the subject's records and discussion with the parents and staff, the Investigator will indicate:


[0101] Whether or not the subject completed at least 28 days of study formula intake ≧90 kcal/kg/d and both blood samples obtained


[0102] If the study was not completed, and reason


[0103] Whether or not the subject received steroids (glucorticoids)


[0104] Investigator's evaluation of the study formula


[0105] The first and last dates study material was taken will be recorded.


[0106] 4.2.2.9 Final Evaluation


[0107] At the final study visit (57 weeks postconceptual age) or earlier if the subject drops out, the Investigator will fill out a “Final Evaluation” Case Report Form. After reviewing the subject's records and discussion with the parents, the Investigator will indicate whether the subject:


[0108] (1) Completed feeding regiment and all study parameters (i.e., anthropometrics and visual acuity measured).


[0109] (2) Did not complete feeding regimen.


[0110] (3) Not completed and reason.


[0111] 4.3 Clinical Observations


[0112] 4.3.1 Physical Examinations


[0113] Subjects will have weight, length and head circumferences recorded at birth, weekly while hospitalized, then at 40, 48, and 57 weeks±4 days postconceptual age.


[0114] Body weight will be measured using an electronic balance or a double beam balance accurate to 10 g or ½ oz with non-detachable weights. During hospitalization, if more than one such balance is employed in the practice, either one balance should be designated the study balance and all study weights will be carried out on that balance for a particular subject, or the balances will be checked and certified to register the same weight throughout the range of weights expected. Outpatient weights will be obtained on a calibrated office scale.


[0115] Documentation indicating balance calibration of the outpatient balance carried out within 12 months of study initiation will be supplied to the Sponsor.


[0116] Length will be measured with the infant in recumbent position with the help of two examiners and a suitable measuring apparatus. One person holds the subject's head in contact with a fixed vertical headboard and a second person holds the subject's feet, toes pointing directly upward and, also applying gentle traction. The baby is measured from the headboard to the soles of the feet with a non-stretching tape measure.


[0117] Head circumference will be measured, employing a flexible, non-stretchable cloth or vinyl tape.


[0118] 4.3.2 Visual Acuity by Forced Choice Preferential Looking (FPL)


[0119] Visual acuity will be determined at 48 and 57 weeks±4 days postconceptual age according to procedures outlined in Appendix C.


[0120] 4.3.3 Laboratory Tests


[0121] Blood will be drawn from preterm infants by heel prick or venipuncture when study formula is begun and terminated. An attempt will be made to draw blood at 48 weeks±4 days PCA from both term and preterm infants. Procedures for handling the blood are described in Appendix B.
14.4 FLOWCHARTPRETERMTERMEnteralTerminationVisit 1Visit 2Visit 3Visit 1Visit 2Visit 3Intake >50of Study40 wks ± 4d48 wks ± 4d57 wks ± 4d40 wks ± 4d48 wks ± 4d57 wks ± 4dEVENTBirthkcal/kg/dFormula †PCAPCAPCAPCAPCAPCARandomization✓ Study Formula✓ Enfamil w/ironHuman MilkPhysicalPhysicalWeight✓*Length✓*Head✓*CircumferenceBlood Draw✓ Visual AcuityTestIllnessInterimAssessmentFinal(when the subject discontinues or completes)(when the subiect discontinues or completes)AssessmentMedical problems related to or affecting formula consumption will be recorded when they occur. *recorded daily and weekly during hospitalization †At hospital discharge or 28 days of study formula intake (after reaching 90 kcal/kg/d), whichever is later


[0122] 5. Criteria for Response


[0123] Criteria for response will depend upon the following:


[0124] Visual Acuity better than the control formula.


[0125] Visual Acuity comparable to breastfed term infant.


[0126] Red Blood Cell phosphatidyl ethanolamine DHA and ARA weight % greater than formula control group.


[0127] Growth as measured by weight achieved at 48 and 57 weeks postconceptual age comparable to formula control group.


[0128] 6. Statistics


[0129] 6.1 Randomization


[0130] If the subject meets the inclusion and exclusion criteria, randomization to one of three formula groups will take place. The randomization schedule will be provided by Mead Johnson Research Center. A separate randomization schedule will be provided for males and females.


[0131] 6.2 Sample Size


[0132] The primary parameter of interest is visual acuity as measured by the Forced Choice Preferential Looking (FPL). The minimal clinically relevant difference was determined to be 0.5 octave. A consultant in the field of visual acuity estimated the standard deviation to be 0.5 octave. This value was increased to 0.7 octave in case more variability was experienced in this study. Thirty-two subjects per group are needed to attain 80% power when testing at an alpha level of 0.05.


[0133] A sample size estimate of 50 per group was determined to achieve α+0.05, β+0.20, for weight of infants receiving study oil being greater than 400 gm below control at 48 weeks postconceptual age or 500 g below control at 57 weeks postconceptual age with a standard deviation of 800 g. It was therefore determined that 50 subjects per group will be used in the study.


[0134] 6.3 Analytical Plan


[0135] Visual acuity data will be recorded in cycles per cm. These values will be converted to cycles per degree using the following formula:
1cycles/degree=38×cycles/cm55


[0136] A log transformation will be applied to the data prior to analysis. Analysis of variance techniques will be used to assess feeding regimen group differences in visual acuity. If the overall F test for feeding regimen is significant at an alpha level of 0.05, pairwise comparisons will be made at an alpha level of 0.05. If no significant differences are detected, then a post-study power analysis will be performed to demonstrate that the study had adequate power to detect the minimal clinically relevant difference.


[0137] Analysis of variance will be used to assess feeding regimen differences in phosphatidyl choline DHA and ARA levels and in phosphatidyl ethanolamine DHA and ARA levels at each time point. If the overall F test is significant at an alpha level of 0.05, then pairwise comparisons will be made at an alpha level of 0.05.


[0138] Analysis of variance will be used to assess feeding regiment differences in weight at 48 and 57 weeks postconceptual age. The statistical model will include terms for feeding regimen, study center, sex and all two-way interactions. Non-significant interactions will be removed from the final statistical model. Two one-sided tests will be performed comparing each experimental formula (EC) with the control formula (CF). The hypothesis to be tested is as follows:




H


0
=Weight (CF)≧Weight (EF).



[0139] The alternative hypothesis is as follows:




H


1
=Weight (CF)≧Weight (EF).



[0140] If H0 is rejected and the mean weight of the control formula exceeds that of the experimental formula by more than 400 mg at 48 weeks postconceptual age or by 500 g at 57 weeks postconceptual age then the conclusion is that the experimental formula does not exceed that of the experimental formula by more than 400 g at 48 weeks postconceptual age or by 500 mg at 57 weeks postconceptual age then the conclusion is that the experimental formula does provide adequate growth. If H0 is not rejected then a post-study power analysis will be performed to demonstrate that the study had adequate power to detect the above mentioned clinically relevant differences. If adequate power is achieved then the conclusion is that the experimental formula does provide adequate growth.


[0141] Fisher's exact test will be used to compare the proportion of subjects in each group with illness/symptoms of concern during the study. The analysis will be performed for each type of illness/symptom reported, with classification of investigator terms into similar terminology made as necessary.



APPENDIX A


Nutrient Composition of Formulas

[0142] All study formulas are 24 kcal/fl oz and are identical in composition to marketed Enfamil Premature Formula except for the study oils employed. These oils are described in the protocol.
2STUDY FORMULASNUTRIENTAMOUNT/100 kcalENFAMIL WITH FeProtein g32.2Fat, g5.15.6Carbohydrate, g11.110.3Vitamin A IU1250310Vitamin D IU27063Vitamin E IU6.3.2Vitamin K mcg88Thiamine, mcg20078Riboflavin, mcg300150Vitamin B6, mcg15063Vitamin B12, mcg0.250.23Niacin, mcg40001250Folic Acid, mcg3515.6Pantothenate, mcg1200470Biotin, mcg42.3Vitamin C, mg208.1Choline, mg1215.6Inositol, mg174.7Calcium, mg16578Phosphorus, mg8353Magnesium, mg6.37.8Iron, mg1.80.5Zinc, mg1.50.78Manganese, mcg6.315.6Copper, mcg12594Iodine, mcg256Sodium mg (mEq)39 (1.7)27 (1.17)Potassium mg(Meq)103 (2.6) 108 (2.8) Chloride mg (Meq)85 (2.4)63 (1.77)



II


FINAL STUDY REPORT

[0143] Study Design:


[0144] This double-blind, parallel-group study (project 3338) was carried out in 16 neonatal centers (study numbers 9698-9709, 9712, 9723, 9743, and 9746) in North America. Three premature infant feedings were compared. Each had the same composition except for the incorporation of fungal and/or micro algal oils up to about 3% of the fat blend to provide the experimental levels of docosahexaenoic acid (DHA) and arachidonic acid (ARA). The control formula (C, Enfamil® Premature Formula) contained no DHA or ARA, the DHA formula (D) contained about 0.15% of energy as DHA (0.34% of fat), and the DHA+ARA formula (DA) contained about 0.14% of energy as DHA (0.33% of fat) and 0.27% of energy as ARA (0.60% of fat). The formulas were fed to 284 randomized infants weighing 846 to 1560 grams at birth for at least 28 days. Upon completion of study formula intake, they were given routine infant formula and followed through 4 months gestationally corrected age. A group of 90 exclusively human milk fed term infants were enrolled and followed to 4 months of age as a reference group (H).


[0145] Study Objective and Statistical Analysis:


[0146] The primary objective of this study was to establish the safety of feeding D or DA to preterm infants during their initial hospitalization as measured 1) by growth, acceptance and tolerance while consuming the formula for at least 1 month and 2) by close monitoring and observation for a 4 to 5 month follow-up period (4-5 times the treatment period) while consuming unsupplemented routine term infant formula. The primary growth parameter selected was weight with evaluation of the proposition that weight on test formula was greater than or equal to weight on control formula. The one sided statistical test for an adverse effect on growth maximized the power to detect a difference should one be present. A two-sided test was used for all other parameters. A p-value of less than 0.05 was used to establish significance.


[0147] Secondary objectives of the study were 1) to evaluate the impact of fatty acid levels in erythrocyte phospholipids at the end of study feeding and 2) to determine if any effect on mean visual acuity greater than half an octave could be demonstrated at 2 and 4 months corrected age.


[0148] Results:


[0149] Six infants were just outside the weight parameters and five infants just older than the less than 24 days chronological age parameter for enrollment in the study. In each case, judgement by the clinical or medical monitor was made to include them in the study prior to enrollment based on their homogeneity with other study infants in all other particulars, e.g., state of health, type of medical complications, and weight for gestational age. All these infants were included in the analysis of the study results.


[0150] The formula groups were comparable at enrollment (See table 1). Post-conceptual age, weight, length, and head circumference at enrollment did not differ among the groups.


[0151] All groups experienced comparable final study status (See table 2). Drop outs did not differ among the formula fed groups during hospitalization. There also were no differences in drop outs among the four groups at study completion.


[0152] Both formulas D and DA provide adequate growth when compared to formula C (See table 3, FIG. 1, and Appendix 1). Weight gain during hospitalization was no less on D or DA than on C, 33.3, 34.7, and 30.7 g/day, respectively. Furthermore, no less weight was achieved on D or DA than on C at 40, 48, and 57 weeks post-conceptual age (See table 4, FIG. 2, and Appendix 1); statistical power was greater than 0.89 to detect a clinically relevant decrease.


[0153] Post-hoc analysis reveals that infants on DA grew faster than infants receiving C and D (See table 5 and FIG. 1). This enhanced growth provided faster “premature infant catch-up” compared to C and D. Weight achieved by the DA group (3198 g) was higher than C (3075 g) and D (3051 g) at 40 weeks post-conceptual age but had not fully caught up to the term birth weight (3438 g) of group H (See table 4 and FIG. 2). This catch up trend continued through 48 to 57 weeks by which time the mean weight of group DA did not differ from group H while groups C and D remained significantly lower.


[0154] Length was not different among the formula groups either during hospitalization or the follow-up period, although the ordered sequence of mean lengths was the same as for the weights (See table 7 and FIG. 3). This is likely at least partially due to length being a less sensitive parameter of growth than weight. For the same reason, the mean lengths of group H infants were higher than that of all the premature infant groups at 40, 48 and 57 weeks post-conceptual age indicating slower catch up in this parameter.


[0155] Head circumference is the least sensitive parameter of growth and was not different among any of the four groups at any time measured except at 40 weeks postconceptual age (See table 8 and FIG. 4). At this time, as expected, the birth head circumference of group H was smaller than the formula fed premature infants possibly due to molding of labor and to insufficient time for adjustment to the extrauterine environment.


[0156] Visual acuity has reportedly been enhanced in studies where DHA supplemented formulas were fed to premature infants both in the hospital and continuing after discharge. In this study, visual acuity was measured about 3 months and then about 5 months after stopping study formula to determine whether a residual beneficial effect of at least half an octave might be observed. Although no difference in visual acuity was found among the formula groups at these times (See table 8 and FIG. 5), the acuity card method used, the length of study formula feeding, and/or the length of time not on study formula at the time of measurement may have precluded its detection. However, at 57 weeks post-conceptual age, the breast fed term infant group did have statistically higher visual acuity scores than the test formula groups. But even these differences were at most only 0.33 octave and were clinically insignificant (See FIG. 6). It is important to note that the breast fed infants continued to receive DHA and ARA during the 3-5 month follow-up period while the formula fed groups did not. Thus, this minor difference in performance was not unexpected based on previous study findings and on developmental differences between term and preterm infants even at the same gestational age.


[0157] Individual fatty acid levels were determined in the phosphatidylcholine and phosphatidylethanolamine fractions of red blood cells before formula feeding, at the conclusion of test formula feeding, and at 48 weeks post-conceptual age (See tables 9 and 10). The premature infant groups were comparable at the beginning of test formula feeding. At the conclusion of test formula feeding, individual fatty acid levels varied among the groups. DHA and ARA were statistically significantly higher in the respectively supplemented groups. Other fatty acid levels reflected the impact of the supplementation. No clinically significant alterations in fatty acid levels or metabolism were identified. After discontinuing study formula and consuming a diet without DHA or ARA for about 3 months, no differences in fatty acid levels among formula fed groups were detectable, except for phosphatidylethanolamine levels of 18:2 (range 8.9-9.3%) and DHA (range 3.2-4.1%) which differences were not identified as being clinically significant. However, the breast fed group shows statistically significant differences in 13 fatty acid levels compared to the formula fed infants. These differences are undoubtedly due to the differences in fatty acid composition of human milk and the term formulas including the lack of DHA and ARA in the latter.


[0158] Preterm infant complications were similar in all groups (See table 11). Over 80% of all infants were opthamologically examined and over 90% had ultrasound evaluation of their heads. Specifically, the incidence and severity of retinopathy of prematurity (ROP or retrolental fibroplasia/RLF) and the incidence of intraventricular hemorrhage or its complications did not differ among formula groups. No feeding group related complications were identified.


[0159] Serious adverse experiences did not differ (p=0.93) among the formula groups and were in the range of those expected in a premature infant population while on study formula: 6% in group C, 5% in group D, and 6% in group DA (See table 12). After the experimental formula phase, serious adverse experiences still did not differ among the preterm groups (See table 13): 13% in group C, 15% in group D, and 15% in group DA. However, the term infant breast fed group had significantly fewer serious adverse experiences (1%, p=0.002) as expected. Two infants reportedly suffered sudden infant death syndrome (SIDS), one in group C and one in group D; there was no significant difference in this complication among all four groups.


[0160] Conclusions:


[0161] We conclude that feeding 0.13% of calories as DHA from micro algal oil and feeding 0.13% of calories as DHA from micro algal oil plus 0.26% of calories as ARA from fungal oil in the matrix of premature infant formula to premature infants during the period of their initial hospitalization prior to 40 weeks post conceptual age is safe. These micro algal and fungal oil supplements do not result in any adverse effect on growth, clinical complications, or untoward events. Furthermore, this study reveals that growth benefits accrue to premature infants fed Enfamil Premature Formula supplemented with DHA and ARA from these sources compared to unsupplemented formula or formula supplemented with only DHA. No measurable benefit on visual acuity was identified when infants were tested at about 3 and 5 months after the supplemented formula was discontinued (2 and 4 months corrected age). However, providing human milk levels of intake of long chain polyunsaturated acids are warranted because they are critical to brain development and foster enhanced catch-up growth during this early development period.
3TABLE 1Birth Statistics of Premature SubjectsnMean (std)Rangep-valuePost-ConceptualAge (Weeks)Control6229.5 (1.7)25-330.076DHA6630.0 (1.4)26-32DHA + ARA6629.7 (1.7)26-34Birth Weight (g)Control621233.1 (176.6) 846-15600.25DHA661272.8 (168.1) 900-1545DHA + ARA661278.9 (177.6) 910-1535Birth Length (cm)Control6038.4 (2.3)  34-43.750.62DHA6638.6 (2.2)  33-43.5DHA + ARA6638.7 (2.3)33-44Birth HeadCircumference (cm)Control6126.9 (1.5)23.5-30.50.53DHA6427.3 (2.1)22-37DHA + ARA6527.2 (1.6)23.5-30  


[0162]

4





TABLE 2










Summary of Final Study Status










Regimen














Control
DHA
DHA + ARA
HM
p-value




















Immediate dropout, study formula


2

2






never consumed


Study Formula Phase*


Completed
52
(84%)
59
(89%)
62
(94%)

0.20


Discontinued
10
(16%)
7
(11%)
4
(6%)



Reason discontinued


>96 cumulative hours NPO
3

1


<28 days of intake >= 90 kcal/kg/day
3

3


Complications unrelated to study
1


formula


NEC or other GI disease


1

1


Formula intolerance




1


Parents request
2

2

1


Not off oxygen prior to discharge




1


Protocol violation
1


Term Formula Phase**


Completed
45
(87%)
47
(80%)
53
(85%)
77
(86%)
0.74


Discontinued
7
(13%)
12
(20%)
9
(15%)
13
(14%)






*The CRFs for 9709-003 (DHA) and 9743-304 (DHA) were marked discontinued because the subjects met the study formula intake criteria for only 27 days. These subjects are counted completed here because subjects at other sites with similar intakes were marked completed.




**Based on subjects who completed the Study Formula phase. During the Term Formula phase, subjects were fed marketed formula. Switching to a different marketed formula did not result in termination from the Term Formula phase.








[0163]

5





TABLE 3










Weight Growth Rate During Study Formula Phase

















Least Square
Standard

Comparison
Study
Gender
Gender-by-Regimen


Regimen
n
Mean
Error
Comparison
p-value*
p-value
p-value
p-value


















Control
60
30.7
1.1
Control vs DHA
0.967
0.00
0.17
0.87


DHA
65
33.3
1.1
Control vs
0.998






DHA + ARA


DHA +
66
34.7
1.1


ARA






*One-sided test of the null hypothesis: Test Mean >= Control MeaN








[0164]

6





TABLE 4










Weight at 40, 48, and 57 Weeks Post-Conceptual Age
















Weeks











Post-Conceptual


Least Square
Standard

Comparison
Study
Gender
Gender-by-Regimen


Age
Regimen
n
Mean
Error
Comparison
p-value*
p-value
p-value
p-value



















40
Control
52
3075.3
67.9
Control vs DHA
0.388
0.59
0.45
1.00



DMA
54
3051.4
66.8
ControL vs DHA + ARA
0.931



DHA + ARA
59
3198.2
62.9
HM vs DHA
0.000



HM
90
3437.7
60.6
HM vs DHA + ARA
0.001







HM vs Control
0.000


48
Control
53
4711.0
94.6
Control vs DHA
0.360
0.58
0.13
0.29



DMA
51
4663.8
97.3
Control vs DHA + ARA
0.995



DHA + ARA
57
5039.1
93.0
HM vs DHA
0.000



HM
81
5181.5
85.9
HM vs DHA + ARA
0.114







HM vs Control
0.000


57
Control
47
6045.4
139.5
Control vs DHA
0.371
0.58
0.29
0.33



DHA
49
5987.2
137.6
Control vs DHA + ARA
0.940



DHA + ARA
55
6312.9
127.9
HM vs DHA
0.005



HM
76
6405.0
126.7
HM vs DHA + ARA
0.278







HM vs Control
0.014






*One-sided test of the null hypothesis: Test Mean >= Control Mean








[0165]

7





TABLE 5










Post-hoc Analysis of Weight











Two-sided


Time
Comparison
p-value












Weight Gain During Study
C vs. DHA
0.067


Formula Phase
C vs. DHA + ARA
0.004



DHA vs. DHA + ARA
0.30


Weight at 40 Weeks pca
C vs. DHA
0.78



C vs. DHA + ARA
0.14



DHA vs. DHA + ARA
0.074



HM vs. DHA
<0.001



HM vs. DHA + ARA
0.002



HM vs. C
<0.001


Weight at 48 Weeks pca
C vs. DHA
0.72



C vs. DHA + ARA
0.011



DHA vs. DHA + ARA
0.004



HM vs. DHA
<0.001



HM vs. DHA + ARA
0.23



HM vs. C
<0.001


Weight at 57 Weeks pca
C vs. DHA
0.74



C vs. DHA + ARA
0.12



DHA vs. DHA + ARA
0.057



HM vs. DNA
0.010



HM vs. DHA + ARA
0.56



HM vs. C
0.028










[0166]

8





TABLE 6










Length at 40, 48, and 57 Weeks Post-Conceptual Age

















Weeks









Gender-by-


Post-Conceptual


Least Square
Standard
Regimen
Pairwise
Pairwise
Study
Gender
Regimen


Age
Regimen
n
Mean
Error
p-value
Comparison
p-value
p-value
p-value
p-value




















40
Control
52
48.4
0.4
0.000
Control vs DHA
0.242
0.03
0.88
0.63



DHA
54
47.8
0.4

Control vs DHA + ARA
0.233



DHA + ARA
58
49.0
0.4

HM vs DHA
0.000



HM
89
50.6
0.4

HM vs DSA + ARA
0.000








Control vs HM
0.000








DHA vs DHA + ARA
0.017


48
Control
53
54.7
0.3
0.000
Control vs DHA
0.824
0.00
0.14
0.52



DHA
52
54.6
0.3

Control vs DSA + ARA
0.079



DHA + ARA
57
55.5
0.3

HM vs DHA
0.000



HM
81
57.4
0.3

HM vs DHA + ARA
0.000








Control vs HM
0.000








DHA vs DHA + ARA
0.050


57
Control
47
60.7
0.4
0.000
Control vs DHA
0.615
0.00
0.02
0.84



DHA
49
60.5
0.4

Control vs DHA + ARA
0.236



DHA + ARA
54
61.3
0.3

HM vs DHA
0.000



HM
76
62.4
0.3

HM vs DHA + ARA
0.006








Control vs HM
0.000








DHA vs GHA + ARA
0.087










[0167]

9





TABLE 7










Head Circumference at 40, 48, and 57 Weeks Post-Conceptual Age

















Weeks









Gender-by-


Post-Conceptual


Least Square
Standard
Regimen
Pairwise
Pairwise
Study
Gender
Regimen


Age
Regimen
n
Mean
Error
p-value
Comparison
p-value
p-value
p-value
p-value




















40
Control
51
35.4
0.2
0.000
Control vs DHA
0.931
0.91
0.00
0.38



DHA
53
35.4
0.2

Control vs DHA + ARA
0.900



DHA + ARA
58
35.5
0.2

HM vs DHA
0.000



HM
85
34.5
0.2

HM vs DHA + ARA
0.000








Control vs HM
0.000








DHA vs DHA + ARA
0.829


48
Control
52
39.1
0.2
0.983


0.81
0.00
1.00



DHA
51
39.0
0.2



DHA + ARA
56
39.0
0.2



HM
81
39.0
0.1


57
Control
47
41.9
0.2
0.689


0.64
0.00
0.85



DHA
49
41.6
0.2



DHA + ARA
53
41.7
0.2



HM
76
41.7
0.2










[0168]

10





TABLE 8










Visual Acuity at 48 and 57 Weeks Post-Conceptual Age
















Weeks


Geometric
Least Square
Standard






Post-Conceptual


mean
Mean
Error
Regimen
Pairwise
Pairwise
Study


Age
Regimen
n
(cycles/deg)
(log base2 cycles/deg)
(octaves)
p-value
Comparison
p-value
p-value



















48
ControL
51
1.72
0.78
0.10
0.950


0.000



DHA
50
1.80
0.85
0.10



DHA + ARA
57
1.72
0.78
0.09



HM
81
1.75
0.81
0.09


57
Control
46
3.47
1.79
0.08
0.004
Control vs DHA
0.697
0.000



DHA
47
3.37
1.75
0.08

Control vs DHA + ARA
0.071



DHA + ARA
55
3.06
1.61
0.07

HM vs DHA
0.042



HM
77
3.85
1.94
0.07

HM vs DHA + ARA
0.000









Control vs HM
0.113









DMA vs DHA + ARA
0.158










[0169]

11





TABLE 9










Red Blood Cell Phosphatidylcholine Fatty Acids

















Fatty


Arithmetic
Standard

Regimen
Pairwise
Pairwise


Time
Acid
Regimen
n
Mean
Error
Median
p-value
Comparison
p-value



















Study Form Initiation
12:0
Control
52
0.081
0.019
0.036
0.762






DHA
58
0.066
0.013
0.030




DHA + ARA
61
0.057
0.009
0.031


Study Form Initiation
14:0
Control
52
0.623
0.036
0.599
0.559




DHA
58
0.663
0.031
0.686




DHA + ARA
61
0.661
0.031
0.656


Study Form Initiation
14:1
Control
52
0.045
0.009
0.021
0.165




DHA
58
0.026
0.005
0.016




DHA + ARA
61
0.035
0.006
0.018


Study Form Initiation
16:0
Control
52
36.706
0.540
36.594
0.884




DHA
58
36.363
0.462
35.578




DHA + ARA
61
36.877
0.445
35.987


Study Form Initiation
16:1
Control
52
0.940
0.049
0.845
0.441




DHA
58
0.981
0.050
0.976




DHA + ARA
61
1.094
0.064
0.931


Study Form Initiation
18:0
Control
52
11.660
0.243
11.468
0.243




DHA
58
11.402
0.238
11.201




DHA + ARA
61
11.016
0.192
11.174


Study Form Initiation
18:1
Control
52
17.053
0.298
17.308
0.679




DHA
58
17.219
0.391
16.935




DHA + ARA
61
17.256
0.271
16.988


Study Form Initiation
18:2
Control
52
18.614
0.525
18.952
0.830




DHA
58
18.631
0.505
19.603




DHA + ARA
61
18.573
0.466
18.824


Study Form Initiation
18:3n6
Control
52
0.120
0.008
0.116
0.034
Control vs DHA
0.196




DHA
58
0.136
0.008
0.130

Control vs DHA + ARA
0.010




DHA + ARA
61
0.150
0.009
0.134

DHA vs DHA + ARA
0.176


Study Form Initiation
20:0
Control
52
0.399
0.050
0.224
0.647




DHA
58
0.337
0.035
0.236




DHA + ARA
61
0.310
0.037
0.188


Study Form Initiation
18:3n3
Control
52
0.315
0.033
0.246
0.234




DHA
58
0.257
0.014
0.246




DHA + ARA
61
0.233
0.010
0.216


Study Form Initiation
20:1
Control
52
0.287
0.020
0.262
0.723




DHA
58
0.287
0.015
0.281




DHA + ARA
61
0.268
0.011
0.269


Study Form Initiation
18:4
Control
52
0.017
0.003
0.000
0.290




DHA
58
0.025
0.004
0.017




DHA + ARA
61
0.017
0.003
0.008


Study Form Initiation
20:2n6
Control
52
0.632
0.025
0.632
0.673




DHA
58
0.628
0.025
0.640




DHA + ARA
61
0.602
0.021
0.614


Study Form Initiation
20:3n6
Control
52
2.144
0.098
2.096
0.507




DHA
58
2.208
0.080
2.296




DHA + ARA
61
2.218
0.074
2.135


Study Form Initiation
20:4n6
Control
52
7.657
0.262
8.124
0.819




DHA
58
8.164
0.347
7.876




DHA + ARA
61
8.090
0.310
8.207


Study Form Initiation
22:1
Control
52
0.106
0.010
0.105
0.155




DHA
58
0.127
0.010
0.130




DHA + ARA
61
0.126
0.010
0.139


Study Form Initiation
20:5n3
Control
52
0.351
0.057
0.298
0.911




DHA
58
0.322
0.015
0.302




DHA + ARA
61
0.321
0.015
0.329


Study Form Initiation
22:4n6
Control
52
0.578
0.144
0.423
0.331




DHA
58
0.493
0.030
0.481




DHA + ARA
61
0.443
0.021
0.425


Study Form Initiation
24:1
Control
52
0.205
0.054
0.075
0.665




DHA
58
0.115
0.019
0.084




DHA + ARA
61
0.180
0.056
0.096


Study Form Initiation
22:5n6
Control
52
0.266
0.020
0.232
0.923




DHA
58
0.259
0.017
0.239




DHA + ARA
61
0.265
0.018
0.256


Study Form Initiation
22:4n3
Control
52
0.000
0.000
0.000
0.199




DHA
58
0.001
0.001
0.000




DHA + ARA
61
0.002
0.001
0.000


Study Form Initiation
22:5n3
Control
52
0.213
0.019
0.203
0.885




DHA
58
0.215
0.013
0.195




DHA + ARA
61
0.203
0.010
0.193


Study Form Initiation
22:6n3
Control
52
0.984
0.051
1.000
0.858




DHA
58
1.075
0.053
1.034




DHA + ARA
61
1.006
0.050
0.970


Study Form Termination
12:0
Control
53
0.100
0.026
0.035
0.843




DHA
56
0.111
0.042
0.031




DHA + ARA
59
0.064
0.012
0.032


Study Form Termination
14:0
Control
53
0.808
0.039
0.806
0.834




DHA
56
0.781
0.035
0.783




DHA + ARA
59
0.755
0.036
0.758


Study Form Termination
14:1
Control
53
0.047
0.008
0.033
0.155




DHA
56
0.036
0.009
0.015




DHA + ARA
59
0.036
0.007
0.018


Study Form Termination
16:0
Control
53
35.837
0.512
34.798
0.767




DHA
56
35.560
0.595
34.841




DHA + ARA
59
35.069
0.584
33.890


Study Form Termination
16:1
Control
53
0.566
0.026
0.526
0.013
Control vs DHA
0.118




DHA
56
0.594
0.042
0.475

Control vs DHA + ARA
0.003




DHA + ARA
59
0.526
0.029
0.472

DHA vs DHA + ARA
0.152


Study Form Termination
18:0
Control
53
13.972
0.261
14.197
0.886




DHA
56
14.065
0.237
13.867




DHA + ARA
59
14.341
0.253
14.108


Study Form Termination
18:1
Control
53
14.456
0.277
14.291
0.686




DHA
56
14.116
0.272
13.998




DHA + ARA
59
14.344
0.380
14.218


Study Form Termination
18:2
Control
53
21.673
0.340
21.506
0.001
Control vs DHA
0.600




DHA
56
22.045
0.457
22.517

Control vs DHA + ARA
0.005




DHA + ARA
59
19.899
0.337
20.662

DHA vs DHA + ARA
0.001


Study Form Termination
18:3n6
Control
53
0.080
0.006
0.074
0.527




DHA
56
0.088
0.009
0.076




DHA + ARA
59
0.087
0.013
0.066


Study Form Termination
20:0
Control
53
0.504
0.050
0.392
0.424




DHA
56
0.472
0.053
0.281




DHA + ARA
59
0.430
0.049
0.251


Study Form Termination
18:3n3
Control
53
0.321
0.020
0.283
0.031
Control vs DHA
0.503




DHA
56
0.335
0.030
0.285

Control vs DHA + ARA
0.068




DHA + ARA
59
0.273
0.009
0.256

DHA vs DHA + ARA
0.011


Study Form Termination
20:1
Control
53
0.318
0.014
0.302
0.149




DHA
56
0.300
0.013
0.283




DHA + ARA
59
0.307
0.013
0.283


Study Form Termination
18:4
Control
53
0.022
0.004
0.015
0.672




DHA
56
0.022
0.003
0.018




DHA + ARA
59
0.014
0.002
0.008


Study Form Termination
20:2n6
Control
53
0.893
0.026
0.910
0.051




DHA
56
0.880
0.023
0.873




DHA + ARA
59
0.824
0.022
0.821


Study Form Termination
20:3n6
Control
53
2.032
0.073
2.091
0.208




DHA
56
2.017
0.070
2.043




DHA + ARA
59
1.908
0.064
1.904


Study Form Termination
20:4n6
Control
53
6.046
0.240
6.029
0.000
Control vs DHA
0.097




DHA
56
5.774
0.220
5.892

Control vs DHA + ARA
0.000




DHA + ARA
59
8.465
0.255
8.891

DHA vs DHA + ARA
0.000


Study Form Termination
22:1
Control
53
0.117
0.010
0.125
0.946




DHA
56
0.110
0.009
0.114




DHA + ARA
59
0.115
0.011
0.104


Study Form Termination
20:5n3
Control
53
0.214
0.022
0.189
0.000
Control vs DHA
0.004




DHA
56
0.246
0.012
0.233

Control vs DHA + ARA
0.108




DHA + ARA
59
0.186
0.014
0.169

DHA vs DHA + ARA
0.000


Study Form Termination
22:4n6
Control
53
0.484
0.048
0.390
0.093




DHA
56
0.489
0.061
0.426




DHA + ARA
59
0.496
0.027
0.487


Study Form Termination
24:1
Control
53
0.127
0.039
0.062
0.303




DHA
56
0.143
0.036
0.086




DHA + ARA
59
0.177
0.040
0.089


Study Form Termination
22:5n6
Control
53
0.181
0.013
0.163
0.006
Control vs DHA
0.005




DHA
56
0.145
0.011
0.133

Control vs DHA + ARA
0.895




DHA + ARA
59
0.172
0.009
0.165

DHA vs DHA + ARA
0.006


Study Form Termination
22:4n3
Control
53
0.001
0.001
0.000
0.359




DHA
56
0.001
0.001
0.000




DHA + ARA
59
0.003
0.002
0.000


Study Form Termination
22:5n3
Control
53
0.306
0.019
0.289
0.221




DHA
56
0.293
0.026
0.260




DHA + ARA
59
0.265
0.013
0.255


Study Form Termination
22:6n3
Control
53
0.895
0.072
0.812
0.000
Control vs DHA
0.000




DHA
56
1.380
0.063
1.352

Control vs DHA + ARA
0.000




DHA + ARA
59
1.244
0.049
1.259

DHA vs DHA + ARA
0.141


48 Weeks PCA
12:0
Control
37
0.032
0.005
0.026
0.729




DHA
32
0.028
0.006
0.016




DHA + ARA
38
0.026
0.004
0.021




HM
56
0.059
0.016
0.020


48 Weeks PCA
14:0
Control
37
0.402
0.039
0.331
0.943




DHA
32
0.353
0.032
0.324




DHA + ARA
38
0.353
0.024
0.328




HM
56
0.381
0.026
0.335


48 Weeks PCA
14:1
Control
37
0.025
0.006
0.013
0.448




DHA
32
0.026
0.007
0.011




DHA + ARA
38
0.026
0.006
0.015




HM
56
0.024
0.003
0.020


48 Weeks PCA
16:0
Control
37
34.627
0.577
34.319
0.000
Control vs DHA
0.527




DHA
32
35.272
0.689
34.473

Control vs DHA + ARA
0.593




DHA + ARA
38
34.802
0.506
34.165

HM vs DHA
0.000




HM
56
33.037
0.506
32.228

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.906


48 Weeks PCA
16:1
Control
37
0.435
0.043
0.338
0.000
Control vs DHA
0.524




DHA
32
0.380
0.023
0.352

Control vs DHA + ARA
0.467




DHA + ARA
38
0.395
0.024
0.368

HM vs DHA
0.000




HM
56
0.507
0.020
0.473

HM vs DHA + ARA
0.006










Control vs HM
0.000










DHA vs DHA + ARA
0.183


48 Weeks PCA
18:0
Control
37
13.016
0.313
12.759
0.000
Control vs DHA
0.760




DHA
32
12.944
0.249
12.786

Control vs DHA + ARA
0.589




DHA + ARA
38
12.804
0.235
12.793

HM vs DHA
0.000




HM
56
14.583
0.287
14.729

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.661


48 Weeks PCA
18:1
Control
37
17.894
0.453
18.636
0.256




DHA
32
17.766
0.429
18.492




DHA + ARA
38
17.850
0.289
18.227




HM
56
18.662
0.305
18.727


48 Weeks PCA
18:2
Control
37
23.469
0.518
23.552
0.000
Control vs DHA
0.840




DHA
32
23.538
0.516
23.717

Control vs DHA + ARA
0.527




DHA + ARA
38
23.738
0.422
23.839

HM vs DHA
0.000




HM
56
18.650
0.344
18.482

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.685


48 Weeks PCA
18:3n6
Control
37
0.071
0.008
0.061
0.002
Control vs DHA
0.950




DHA
32
0.069
0.005
0.067

Control vs DHA + ARA
0.774




DHA + ARA
38
0.069
0.006
0.062

HM vs DHA
0.004




HM
56
0.042
0.004
0.039

HM vs DHA + ARA
0.001










Control vs HM
0.003










DHA vs DHA + ARA
0.831


48 Weeks PCA
20:0
Control
37
0.348
0.075
0.197
0.785




DHA
32
0.339
0.061
0.206




DHA + ARA
38
0.304
0.061
0.172




HM
56
0.409
0.044
0.215


48 Weeks PCA
18:3n3
Control
37
0.222
0.019
0.182
0.001
Control vs DHA
0.812




DHA
32
0.211
0.015
0.182

Control vs DHA + ARA
0.918




DHA + ARA
38
0.203
0.010
0.190

HM vs DHA
0.001




HM
56
0.182
0.022
0.120

HM vs DHA + ARA
0.002










Control vs HM
0.001










DHA vs DHA + ARA
0.737


48 Weeks PCA
20:1
Control
37
0.418
0.019
0.420
0.000
Control vs DHA
0.579




DHA
32
0.406
0.025
0.435

Control vs DHA + ARA
0.588




DHA + ARA
38
0.382
0.016
0.375

HM vs DHA
0.001




HM
56
0.311
0.014
0.309

HM vs DHA + ARA
0.001










Control vs HM
0.000










DHA vs DHA + ARA
0.974


48 Weeks PCA
18:4
Control
37
0.018
0.005
0.000
0.010
Control vs DHA
0.822




DHA
32
0.016
0.004
0.000

Control vs DHA + ARA
0.161




DHA + ARA
38
0.007
0.002
0.000

HM vs DHA
0.039




HM
56
0.024
0.004
0.015

HM vs DHA + ARA
0.001










Control vs HM
0.054










DHA vs DHA + ARA
0.262


48 Weeks PCA
20:2n6
Control
37
0.543
0.023
0.537
0.629




DHA
32
0.557
0.032
0.543




DHA + ARA
38
0.636
0.053
0.550




HM
56
0.560
0.014
0.531


48 Weeks PCA
20:3n6
Control
37
1.709
0.086
1.741
0.000
Control vs DHA
0.610




DHA
32
1.702
0.073
1.684

Control vs DHA + ARA
0.735




DHA + ARA
38
1.844
0.090
1.717

HM vs DHA
0.000




HM
56
2.265
0.086
2.166

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.405


48 Weeks PCA
20:4n6
Control
37
4.738
0.255
4.736
0.000
Control vs DHA
0.508




DHA
32
4.475
0.196
4.499

Control vs DHA + ARA
0.505




DHA + ARA
38
4.550
0.185
4.746

HM vs DHA
0.000




HM
56
7.408
0.250
7.666

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.672


48 Weeks PCA
22:1
Control
37
0.166
0.036
0.131
0.664




DHA
32
0.116
0.014
0.118




DHA + ARA
38
0.131
0.024
0.105




HM
56
0.160
0.030
0.104


48 Weeks PCA
20:5n3
Control
37
0.102
0.015
0.077
0.000
Control vs DHA
0.633




DHA
32
0.084
0.006
0.083

Control vs DHA + ARA
0.086




DHA + ARA
38
0.099
0.009
0.078

HM vs DHA
0.000




HM
56
0.138
0.009
0.123

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.239


48 Weeks PCA
22:4n6
Control
37
0.426
0.059
0.373
0.244




DHA
32
0.382
0.029
0.417




DHA + ARA
38
0.440
0.054
0.384




HM
56
0.406
0.022
0.377


48 Weeks PCA
24:1
Control
37
0.247
0.070
0.112
0.000
Control vs DHA
0.337




DHA
32
0.210
0.062
0.116

Control vs DHA + ARA
0.247




DHA + ARA
38
0.179
0.055
0.108

HM vs DHA
0.000




HM
56
0.115
0.020
0.079

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.578


48 Weeks PCA
22:5n6
Control
37
0.210
0.016
0.212
0.000
Control vs DHA
0.505




DHA
32
0.189
0.012
0.186

Control vs DHA + ARA
0.647




DHA + ARA
38
0.231
0.022
0.198

HM vs DHA
0.000




HM
56
0.264
0.016
0.265

HM vs DHA + ARA
0.001










Control vs HM
0.000










DHA vs DHA + ARA
0.270


48 Weeks PCA
22:4n3
Control
37
0.000
0.000
0.000
1.000




DHA
32
0.000
0.000
0.000




DHA + ARA
38
0.000
0.000
0.000




HM
56
0.000
0.000
0.000


48 Weeks PCA
22:5n3
Control
37
0.286
0.029
0.260
0.000
Control vs DHA
0.598




DHA
32
0.253
0.017
0.251

Control vs DHA + ARA
0.759




DHA + ARA
38
0.268
0.026
0.256

HM vs DHA
0.000




HM
56
0.339
0.018
0.314

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.817


48 Weeks PCA
22:6n3
Control
37
0.595
0.047
0.569
0.000
Control vs DHA
0.111




DHA
32
0.685
0.048
0.676

Control vs DHA + ARA
0.052




DHA + ARA
38
0.662
0.043
0.663

HM vs DHA
0.000




HM
56
1.475
0.081
1.333

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.776










[0170]

12





TABLE 10










Red Blood Cell Phosphatidylethanolamine Fatty Acids

















Fatty


Arithmetic
Standard

Regimen
Pairwise
Pairwise


Time
Acid
Regimen
n
Mean
Error
Median
p-value
Comparison
p-value



















Study Form Initiation
12:0
Control
52
0.069
0.015
0.022
0.546


5




DHA
57
0.075
0.013
0.033




DHA + ARA
61
0.063
0.010
0.039


Study Form Initiation
14:0
Control
52
0.307
0.038
0.220
0.792




DHA
57
0.278
0.025
0.206




DHA + ARA
61
0.277
0.021
0.246


Study Form Initiation
14:1
Control
52
0.080
0.015
0.032
0.181




DHA
57
0.061
0.012
0.028




DHA + ARA
61
0.062
0.009
0.050


Study Form Initiation
16:0
Control
52
20.021
0.736
17.945
0.967




DHA
57
19.847
0.622
19.295




DHA + ARA
61
19.796
0.451
19.035


Study Form Initiation
16:1
Control
52
0.731
0.035
0.698
0.337




DHA
57
0.769
0.034
0.746




DHA + ARA
61
0.836
0.035
0.837


Study Form Initiation
18:0
Control
52
8.857
0.329
8.469
0.142




DHA
57
8.434
0.227
8.308




DHA + ARA
61
8.201
0.215
7.904


Study Form Initiation
18:1
Control
52
16.450
0.301
16.698
0.412




DHA
57
16.208
0.326
16.308




DHA + ARA
61
16.415
0.375
16.001


Study Form Initiation
18:2
Control
52
6.615
0.253
6.682
0.773




DHA
57
6.336
0.280
6.346




DHA + ARA
61
6.175
0.294
5.682


Study Form Initiation
18:3n6
Control
52
0.165
0.018
0.145
0.040
Control vs DHA
0.373




DHA
57
0.190
0.019
0.152

Control vs DHA + ARA
0.013




DHA + ARA
61
0.192
0.016
0.169

DHA vs DHA + ARA
0.101


Study Form Initiation
20:0
Control
52
0.372
0.043
0.291
0.151




DHA
57
0.314
0.030
0.244




DHA + ARA
61
0.259
0.024
0.186


Study Form Initiation
18:3n3
Control
52
0.305
0.023
0.261
0.641




DHA
57
0.269
0.018
0.249




DHA + ARA
61
0.257
0.016
0.225


Study Form Initiation
20:1
Control
52
0.573
0.036
0.517
0.395




DHA
57
0.615
0.034
0.555




DHA + ARA
61
0.571
0.027
0.544


Study Form Initiation
18:4
Control
52
0.025
0.005
0.000
0.371




DHA
57
0.031
0.004
0.025




DHA + ARA
61
0.030
0.007
0.021


Study Form Initiation
20:2n6
Control
52
0.479
0.023
0.460
0.706




DHA
57
0.463
0.024
0.437




DHA + ARA
61
0.443
0.028
0.427


Study Form Initiation
20:3n6
Control
52
1.843
0.072
1.829
0.099




DHA
57
1.965
0.077
1.820




DHA + ARA
61
1.973
0.064
1.911


Study Form Initiation
20:4n6
Control
52
25.817
0.618
26.820
0.353




DHA
57
26.475
0.611
27.376




DHA + ARA
61
26.747
0.645
27.708


Study Form Initiation
22:1
Control
52
0.150
0.017
0.138
0.572




DHA
57
0.167
0.015
0.151




DHA + ARA
61
0.168
0.017
0.141


Study Form Initiation
20:5n3
Control
52
0.378
0.024
0.357
0.997




DHA
57
0.384
0.024
0.370




DHA + ARA
61
0.366
0.022
0.335


Study Form Initiation
22:4n6
Control
52
7.290
0.182
7.402
0.875




DHA
57
7.431
0.186
7.638




DHA + ARA
61
7.456
0.167
7.270


Study Form Initiation
24:1
Control
52
0.100
0.028
0.041
0.068




DHA
57
0.059
0.009
0.031




DHA + ARA
61
0.072
0.010
0.047


Study Form Initiation
22:5n6
Control
52
1.757
0.083
1.782
0.555




DHA
57
1.809
0.070
1.857




DHA + ARA
61
1.851
0.075
1.775


Study Form Initiation
22:4n3
Control
52
0.001
0.001
0.000
0.257




DHA
57
0.001
0.001
0.000




DHA + ARA
61
0.005
0.002
0.000


Study Form Initiation
22:5n3
Control
52
1.496
0.109
1.308
0.195




DHA
57
1.375
0.109
0.988




DHA + ARA
61
1.380
0.097
1.041


Study Form Initiation
22:6n3
Control
52
6.119
0.200
6.381
0.375




DHA
57
6.444
0.185
6.468




DHA + ARA
61
6.407
0.220
6.579


Study Form Termination
12:0
Control
53
0.093
0.015
0.033
0.630




DHA
55
0.093
0.019
0.036




DHA + ARA
58
0.067
0.012
0.035


Study Form Termination
14:0
Control
53
0.360
0.031
0.279
0.782




DHA
55
0.380
0.039
0.265




DHA + ARA
58
0.348
0.030
0.256


Study Form Termination
14:1
Control
53
0.086
0.020
0.041
0.592




DHA
55
0.066
0.013
0.000




DHA + ARA
58
0.066
0.011
0.043


Study Form Termination
16:0
Control
53
19.326
0.673
17.617
0.560




DHA
55
19.062
0.614
17.556




DHA + ARA
58
18.357
0.467
17.568


Study Form Termination
16:1
Control
53
0.511
0.034
0.476
0.604




DHA
55
0.579
0.045
0.509




DHA + ARA
58
0.618
0.049
0.555


Study Form Termination
18:0
Control
53
9.614
0.266
9.406
0.024
Control vs DHA
0.130




DHA
55
9.173
0.208
8.818

Control vs DHA + ARA
0.006




DHA + ARA
58
8.961
0.242
8.697

DHA vs DHA + ARA
0.219


Study Form Termination
18:1
Control
53
14.763
0.437
14.695
0.333




DHA
55
15.177
0.299
14.927




DHA + ARA
58
14.814
0.330
14.499


Study Form Termination
18:2
Control
53
9.405
0.192
9.359
0.000
Control vs DHA
0.908




DHA
55
9.180
0.207
9.188

Control vs DHA + ARA
0.000




DHA + ARA
58
7.756
0.141
7.586

DHA vs DHA + ARA
0.000


Study Form Termination
18:3n6
Control
53
0.169
0.012
0.163
0.160




DHA
55
0.187
0.017
0.157




DHA + ARA
58
0.198
0.018
0.161


Study Form Termination
20:0
Control
53
0.404
0.044
0.278
0.146




DHA
55
0.336
0.037
0.208




DHA + ARA
58
0.288
0.029
0.208


Study Form Termination
18:3n3
Control
53
0.382
0.017
0.364
0.134




DHA
55
0.368
0.016
0.354




DHA + ARA
58
0.329
0.015
0.305


Study Form Termination
20:1
Control
53
0.553
0.029
0.526
0.164




DHA
55
0.579
0.028
0.537




DHA + ARA
58
0.507
0.025
0.483


Study Form Termination
18:4
Control
53
0.042
0.010
0.018
0.108




DHA
55
0.026
0.005
0.019




DHA + ARA
58
0.022
0.004
0.000


Study Form Termination
20:2n6
Control
53
0.754
0.029
0.765
0.065




DHA
55
0.774
0.030
0.750




DHA + ARA
58
0.654
0.026
0.663


Study Form Termination
20:3n6
Control
53
2.253
0.111
2.073
0.203




DHA
55
2.295
0.094
2.206




DHA + ARA
58
2.066
0.073
1.992


Study Form Termination
20:4n6
Control
53
24.279
0.527
25.132
0.000
Control vs DHA
0.119




DHA
55
23.464
0.520
24.038

Control vs DHA + ARA
0.000




DHA + ARA
58
26.760
0.437
27.372

DHA vs DHA + ARA
0.000


Study Form Termination
22:1
Control
53
0.149
0.019
0.122
0.229




DHA
55
0.176
0.016
0.169




DHA + ARA
58
0.146
0.012
0.130


Study Form Termination
20:5n3
Control
53
0.519
0.020
0.493
0.000
Control vs DHA
0.286




DHA
55
0.563
0.025
0.575

Control vs DHA + ARA
0.000




DHA + ARA
58
0.411
0.015
0.415

DHA vs DHA + ARA
0.000


Study Form Termination
22:4n6
Control
53
7.309
0.208
7.656
0.007
Control vs DHA
0.025




DHA
55
7.135
0.154
6.885

Control vs DHA + ARA
0.461




DHA + ARA
58
7.592
0.155
7.635

DHA vs DHA + ARA
0.002


Study Form Termination
24:1
Control
53
0.092
0.023
0.038
0.294




DHA
55
0.056
0.009
0.042




DHA + ARA
58
0.062
0.008
0.041


Study Form Termination
22:5n6
Control
53
1.444
0.064
1.423
0.010
Control vs DHA
0.003




DHA
55
1.231
0.034
1.213

Control vs DHA + ARA
0.255




DHA + ARA
58
1.347
0.040
1.330

DHA vs DHA + ARA
0.050


Study Form Termination
22:4n3
Control
53
0.000
0.000
0.000
0.137




DHA
55
0.004
0.002
0.000




DHA + ARA
58
0.004
0.002
0.000


Study Form Termination
22:5n3
Control
53
2.694
0.110
2.839
0.003
Control vs DHA
0.004




DHA
55
2.334
0.091
2.400

Control vs DHA + ARA
0.002




DHA + ARA
58
2.237
0.069
2.269

DHA vs DHA + ARA
0.943


Study Form Termination
22:6n3
Control
53
4.798
0.151
4.815
0.000
Control vs DHA
0.000




DHA
55
6.762
0.183
7.043

Control vs DHA + ARA
0.000




DHA + ARA
58
6.389
0.150
6.498

DHA vs DHA + ARA
0.027


48 Weeks PCA
12:0
Control
37
0.053
0.019
0.024
0.587




DHA
32
0.054
0.016
0.019




DHA + ARA
38
0.047
0.014
0.018




HM
56
0.045
0.011
0.023


48 Weeks PCA
14:0
Control
37
0.243
0.030
0.169
0.598




DHA
32
0.251
0.041
0.162




DHA + ARA
38
0.235
0.025
0.188




HM
56
0.230
0.016
0.210


48 Weeks PCA
14:1
Control
37
0.080
0.017
0.037
0.092




DHA
32
0.055
0.017
0.000




DHA + ARA
38
0.078
0.019
0.044




HM
56
0.053
0.011
0.021


48 Weeks PCA
16:0
Control
37
17.319
0.595
16.314
0.177




DHA
32
17.101
0.729
15.692




DHA + ARA
38
17.225
0.538
16.997




HM
56
18.138
0.395
17.607


48 Weeks PCA
16:1
Control
37
0.440
0.050
0.349
0.000
Control vs DHA
0.601




DHA
32
0.390
0.035
0.336

Control vs DHA + ARA
0.524




DHA + ARA
38
0.390
0.022
0.376

HM vs DHA
0.000




HM
56
0.596
0.027
0.562

HM vs DHA + ARA
0.000










Control vs HM
0.001










DHA vs DHA + ARA
0.928


48 Weeks PCA
18:0
Control
37
7.935
0.327
7.174
0.000
Control vs DHA
0.347




DHA
32
7.962
0.293
7.552

Control vs DHA + ARA
0.483




DHA + ARA
38
7.443
0.270
7.173

HM vs DHA
0.020




HM
56
8.754
0.230
8.409

HM vs DHA + ARA
0.000










Control vs HM
0.001










DHA vs DHA + ARA
0.108


48 Weeks PCA
18:1
Control
37
19.438
0.368
19.410
0.038
Control vs DHA
0.401




DHA
32
19.066
0.421
19.534

Control vs DHA + ARA
0.234




DHA + ARA
38
19.302
0.332
19.433

HM vs DHA
0.067




HM
56
18.469
0.278
18.141

HM vs DHA + ARA
0.118










Control vs HM
0.005










DHA vs DHA + ARA
0.758


48 Weeks PCA
18:2
Control
37
9.328
0.261
9.267
0.000
Control vs DHA
0.024




DHA
32
8.867
0.210
8.696

Control vs DHA + ARA
0.187




DHA + ARA
38
9.257
0.216
8.840

HM vs DHA
0.000




HM
56
6.291
0.193
6.027

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.318


48 Weeks PCA
18:3n6
Control
37
0.198
0.020
0.182
0.050
Control vs DHA
0.879




DHA
32
0.219
0.031
0.171

Control vs DHA + ARA
0.590




DHA + ARA
38
0.158
0.021
0.158

HM vs DHA
0.029




HM
56
0.129
0.012
0.112

HM vs DHA + ARA
0.061










Control vs HM
0.014










DHA vs DHA + ARA
0.714


48 Weeks PCA
20:0
Control
37
0.263
0.058
0.146
0.728




DHA
32
0.262
0.042
0.145




DHA + ARA
38
0.212
0.037
0.125




HM
56
0.295
0.031
0.240


48 Weeks PCA
18:3n3
Control
37
0.291
0.025
0.225
0.001
Control vs DHA
0.559




DHA
32
0.270
0.017
0.262

Control vs DHA + ARA
0.848




DHA + ARA
38
0.265
0.015
0.245

HM vs DHA
0.008




HM
56
0.226
0.020
0.169

HM vs DHA + ARA
0.002










Control vs HM
0.001










DHA vs DHA + ARA
0.689


48 Weeks PCA
20:1
Control
37
0.715
0.031
0.648
0.000
Control vs DHA
0.339




DHA
32
0.772
0.032
0.782

Control vs DHA + ARA
0.512




DHA + ARA
38
0.936
0.188
0.738

HM vs DHA
0.000




HM
56
0.533
0.024
0.492

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.115


48 Weeks PCA
18:4
Control
37
0.017
0.005
0.003
0.057




DHA
32
0.017
0.005
0.000




DHA + ARA
38
0.023
0.006
0.000




HM
56
0.027
0.004
0.019


48 Weeks PCA
20:2n6
Control
37
0.672
0.035
0.698
0.000
Control vs DHA
0.543




DHA
32
0.668
0.026
0.684

Control vs DHA + ARA
0.532




DHA + ARA
38
0.715
0.032
0.689

HM vs DHA
0.000




HM
56
0.444
0.016
0.412

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.995


48 Weeks PCA
20:3n6
Control
37
2.138
0.099
1.999
0.012
Control vs DHA
0.896




DHA
32
2.165
0.100
2.045

Control vs DHA + ARA
0.935




DHA + ARA
38
2.172
0.114
2.132

HM vs DHA
0.015




HM
56
1.715
0.053
1.637

HM vs DHA + ARA
0.006










Control vs HM
0.007










DHA vs DHA + ARA
0.835


48 Weeks PCA
20:4n6
Control
37
24.508
0.536
24.774
0.950




DHA
32
24.428
0.491
25.206




DHA + ARA
38
24.788
0.429
25.122




HM
56
24.625
0.384
25.189


48 Weeks PCA
22:1
Control
37
0.168
0.016
0.172
0.121




DHA
32
0.189
0.022
0.188




DHA + ARA
38
0.154
0.022
0.133




HM
56
0.148
0.013
0.134


48 Weeks PCA
20:5n3
Control
37
0.382
0.026
0.368
0.497




DHA
32
0.369
0.015
0.377




DHA + ARA
38
0.347
0.011
0.347




HM
56
0.384
0.016
0.360


48 Weeks PCA
22:4n6
Control
37
8.580
0.267
8.761
0.001
Control vs DHA
0.612




DHA
32
8.791
0.250
9.132

Control vs DHA + ARA
0.416




DHA + ARA
38
8.576
0.188
8.472

HM vs DHA
0.000




HM
56
7.727
0.203
7.618

HM vs DHA + ARA
0.013










Control vs HM
0.001










DHA vs DHA + ARA
0.199


48 Weeks PCA
24:1
Control
37
0.067
0.016
0.035
0.943




DHA
32
0.049
0.009
0.034




DHA + ARA
38
0.046
0.008
0.036




HM
56
0.062
0.016
0.027


48 Weeks PCA
22:5n6
Control
37
1.401
0.066
1.411
0.000
Control vs DHA
0.977




DHA
32
1.353
0.057
1.414

Control vs DHA + ARA
0.997




DHA + ARA
38
1.364
0.054
1.359

HM vs DHA
0.000




HM
56
1.883
0.056
1.889

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.975


48 Weeks PCA
22:4n3
Control
37
0.000
0.000
0.000
1.000




DHA
32
0.000
0.000
0.000




DHA + ARA
38
0.000
0.000
0.000




HM
56
0.001
0.001
0.000


48 Weeks PCA
22:5n3
Control
37
2.567
0.092
2.681
0.000
Control vs DHA
0.884




DHA
32
2.561
0.086
2.630

Control vs DHA + ARA
0.148




DHA + ARA
38
2.436
0.066
2.443

HM vs DHA
0.000




HM
56
1.942
0.065
1.978

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.213


48 Weeks PCA
22:6n3
Control
37
3.196
0.159
3.013
0.000
Control vs DHA
0.000




DHA
32
4.143
0.177
4.079

Control vs DHA + ARA
0.000




DHA + ARA
38
3.801
0.134
3.721

HM vs DHA
0.000




HM
56
7.283
0.201
7.341

HM vs DHA + ARA
0.000










Control vs HM
0.000










DHA vs DHA + ARA
0.281










[0171]

13





TABLE 11










Preterm Infant Complications










Regimen















DHA +




Control
DHA
ARA
p-value*





Retinopathy of






Prematurity Test Results


Absent
34 (76%)
44 (76%)
41 (79%)
0.91


I
 8 (18%)
11 (19%)
 6 (12%)


II
2 (4%)
2 (3%)
4 (8%)


III
1 (2%)
1 (2%)


Present, but not


1 (2%)


graded


Ultrasound Examination


for Intraventricular


Hemorrhage


None
47 (81%)
52 (84%)
49 (80%)
0.78


Stage 1
 6 (10%)
 9 (15%)
 7 (11%)


Stage 2
3 (5%)

2 (3%)


Stage 3
1 (2%)

1 (2%)


Stage 4
1 (2%)

2 (3%)


Questionable

1 (2%)


Posthemorrhagic


Hydrocephalus


developed?


No
61 (98%)
65 (98%)
64 (97%)
1.00


Yes
1 (2%)
1 (2%)
2 (3%)






*The statistical test was based on a dichotomous response: present or absent.








[0172]

14





TABLE 12










Serious Adverse Events Reported During Study Formula Phase










Regimen















DHA +



Event
Control
DHA
ARA
p-value





Any Event
4 (6%)
3 (5%)
4 (6%)
0.93


Other Respiratory Conditions
2 (3%)
0
0
0.10


of Fetus and Newborn


Other Infection Specific to
1 (2%)
0
0
0.32


the Perinatal Period


Intraventricular Hemorrhage
0
0
1 (2%)
1.00


Other Specified Perinatal
0
1 (2%)
0
1.00


Disorders of Digestive System


Convulsions in Newborn
1 (2%)
0
0
0.32


Feeding Problems in Newborn
0
1 (2%)
1 (2%)
1.00


Hernia
0
0
1 (2%)
1.00


Other
0
1 (2%)
1 (2%)
1.00










[0173]

15





TABLE 13










Serious Adverse Events Reported During the Term Formula Phase










Regimen













Event
Control
DHA
DHA + ARA
HM
p-value















Any Event
7 (13%)
9 (15%)
9 (15%)
1 (1%)
0.002


















C vs D
0.79







C vs D + A
0.79







D vs D + A
1.00







C vs HM
0.006







D vs HM
0.001







D + A vs HM
0.001












Infectious Colitis,
0
0
1 (2%)
0
0.67


Enteritis, and


Gastroenteritis


Croup
0
0
1 (2%)
0
0.67


Bronchopneumonia,
2 (4%)
3 (5%)
6 (10%)
0
0.013













Organism Unspecified




C vs D
1.00







C vs D + A
0.27







D vs D + A
0.49







C vs HM
0.15







D vs HM
0.064







D + A vs HM
0.004












Asthma, Unspecified
1 (2%)
0
0
0
0.21


Esophageal Reflux
0
1 (2%)
2 (3%)
0
0.23


Dyspepsia and Other
0
0
0
1 (1%)
1.0


Stomach Function


Disorder


Other Respiratory
1 (2%)
1 (2%)
3 (5%)
0
0.11


Conditions of Fetus


and Newborn


Convulsions
1 (2%)
0
0
0
0.21


Sudden Infant Death
1 (2%)
1 (2%)
0
0
0.34


Syndrome


Hernia
2 (4%)
2 (3%)
0
0
0.11


Other
0
3 (5%)
2 (3%)
0
0.063










[0174]

16





APPENDIX 1








Listing of Weights Included in the Statistical Analyses



























Gender
Regimen
Subject
Variable
Wgt1
Wgt2
Wgt3
Wgt4
Wgt5
Wgt6
Wgt7
Wgt8
Wgt9






















Male
Control
9698-0301
Weight (g)
1120
1240
1360
1590
1870









Age (weeks pca)
30.3
31.3
32.1
33.1
34.1


Male
Control
9698-0304
Weight (g)
1450
1630
1940
2180





Age (weeks pca)
32.6
33.4
34.7
35.4


Male
Control
9699-0302
Weight (g)
958.0
1108
1251
1378
1659





Age (weeks pca)
30.7
31.7
32.7
33.7
34.7


Male
Control
9699-0306
Weight (g)
1185
1261
1437
1647
1933





Age (weeks pca)
31.0
32.0
33.0
34.0
35.0


Male
Control
9699-0308
Weight (g)
1600
1840
2752





Age (weeks pca)
34.4
35.4
38.3


Male
Control
9700-0301
Weight (g)
1810
1855
2075
2330
2595
3120





Age (weeks pca)
32.1
32.6
33.4
34.4
35.4
37.4


Male
Control
9701-0303
Weight (g)
1181
1298
1494
1785
2012





Age (weeks pca)
32.4
33.4
34.4
35.4
36.3


Male
Control
9701-0304
Weight (g)
1412
1566
1851
2117
2318





Age (weeks pca)
31.9
32.9
33.7
34.7
35.9


Male
Control
9702-0302
Weight (g)
1480
1775
2045
2240
2340
2570





Age (weeks pca)
31.0
32.1
33.0
34.0
34.6
35.6


Male
Control
9703-0302
Weight (g)
1785
2040
2375
2685
2955





Age (weeks pca)
33.3
34.6
35.6
36.4
37.4


Male
Control
9703-0304
Weight (g)
1475
1705
1920
2190
2425





Age (weeks pca)
31.7
33.0
34.0
34.9
35.7


Male
Control
9703-0308
Weight (g)
1140
1230
1445
1665
1945





Age (weeks pca)
31.7
32.6
33.7
34.7
35.7


Male
Control
9704-0303
Weight (g)
975.0
1205
1270
1450
1665
1760
2045





Age (weeks pca)
32.3
33.4
34.4
35.4
36.3
37.3
38.3


Male
Control
9704-0305
Weight (g)
1315
1475
1640
1860





Age (weeks pca)
30.9
32.0
33.0
34.1


Male
Control
9705-0302
Weight (9)
1280
1389
1588
1786
2240





Age (weeks pca)
33.0
34.0
35.0
36.0
37.4


Male
Control
9705-0304
Weight (g)
1270
1280
1570
1810





Age (weeks pca)
31.3
32.3
33.3
34.6


Male
Control
9706-0302
Weight (g)
1645
1865
2130
2435





Age (weeks pca)
35.7
36.6
37.7
38.7


Male
Control
9706-0303
Weight (g)
1875
1984
2135
2185
2465





Age (weeks pca)
33.7
34.7
35.6
36.4
37.3


Male
Control
9706-0308
Weight (9)
1655
1734
2005
2495





Age (weeks pca)
32.9
33.1
34.0
35.4


Male
Control
9707-0302
Weight (g)
1544
1820
2215
2450
2460





Age (weeks pca)
31.6
32.9
34.4
35.4
35.7


Male
Control
9707-0303
Weight (g)
1415
1600
1850
2195
2310





Age (weeks pca)
33.1
34.1
35.1
36.6
37.1


Male
Control
9707-0309
Weight (g)
1046
1442
1644
1910





Age (weeks pca)
30.9
32.7
33.7
34.9


Male
Control
9708-0303
Weight (g)
1730
1960
2205
2520





Age (weeks pca)
32.7
33.7
34.7
35.7


Male
Control
9709-0302
Weight (g)
1090
1440
1660
1910
2040





Age (weeks pca)
29.9
31.7
32.7
33.7
34.3


Male
Control
9712-0301*
Weight (g)
1245
1221
1245
1291
1294
1330
1369
1402
1433





Age (weeks pca)
31.6
31.7
31.9
32.0
32.1
32.3
32.4
32.6
32.7


Male
Control
9712-0302
Weight (g)
1292
1345
1456
1670
1835
1985





Age (weeks pca)
33.1
34.1
35.1
36.1
37.1
38.1


Male
Control
9743-0301
Weight (g)
1520
1570
1670
1720





Age (weeks pca)
34.1
35.0
36.0
37.1


Male
Control
9746-0301
Weight (g)
2065
2465
2760
3085
3085





Age (weeks pca)
37.6
38.9
39.7
40.6
40.6


Male
DHA
9698-0302
Weight (g)
1640
1860
3170





Age (weeks pca)
35.1
36.1
39.9


Male
DHA
9698-0306
Weight (g)
1620
1830
2090
2575





Age (weeks pca)
35.1
36.3
37.3
40.0


Male
DHA
9699-0301
Weight (g)
1018
1207
1360
1617





Age (weeks pca)
31.3
32.3
33.3
34.3


Male
DHA
9699-0303
Weight (g)
1258
1435
1631
1882
2724





Age (weeks pca)
32.4
33.4
34.4
35.4
36.4


Male
DHA
9699-0307
Weight (g)
1182
1358
1484
1666





Age (weeks pca)
34.7
35.7
36.7
37.7


Male
DHA
9700-0303
Weight (g)
1830
1980
2450
3045





Age (weeks pca)
33.9
34.4
35.9
37.7


Male
DHA
9701-0301
Weight (g)
1098
1234
1365
1689
1902
2019
2104
2276
2288





Age (weeks pca)
29.6
30.6
31.6
33.4
34.6
35.6
36.4
37.4
38.6


Male
DHA
9701-0305
Weight (g)
1621
1829
1880
2253
2582





Age (weeks pca)
31.7
33.1
33.7
34.7
35.7


Male
DHA
9703-0303
Weight (g)
1775
2030
2285
2595
2780





Age (weeks pca)
33.3
34.1
35.1
36.0
37.1


Male
DHA
9703-0306
Weight (g)
1725
1870
2180





Age (weeks pca)
33.4
34.0
35.0


Male
DHA
9703-0307
Weight (g)
1525
1725
2020
2390





Age (weeks pca)
32.7
33.7
34.9
36.0


Male
DHA
9704-0304
Weight (g)
1380
1570
1730
1960
2140





Age (weeks pca)
32.1
33.1
34.1
35.0
35.9


Male
DHA
9704-0306
Weight (g)
1320
1370
1550
1760
2020
2170





Age (weeks pca)
30.7
31.7
32.7
33.7
34.7
35.9


Male
DHA
9705-0303
Weight (g)
1380
1446
1616
1843
2330





Age (weeks pca)
33.0
34.0
35.0
36.0
37.4


Male
DHA
9705-0305
Weight (g)
1490
1770
1980
2240





Age (weeks pca)
31.1
32.1
33.1
34.0


Male
DHA
9706-0304
Weight (g)
1490
1655
1915
2260





Age (weeks pca)
33.0
33.7
34.7
36.0


Male
DHA
9706-0306
Weight (g)
1604
1908
2160





Age (weeks pca)
34.4
35.4
36.3


Male
DHA
9707-0001
Weight (g)
1305
1429





Age (weeks pca)
31.0
32.0


Male
DHA
9707-0304
Weight (g)
1555
1740
1990
2400
2570





Age (weeks pca)
32.0
33.0
34.0
35.4
36.0


Male
DHA
9707-0306
Weight (g)
1728
2040
2260
3050
3050





Age (weeks pca)
36.1
37.3
38.1
40.6
40.6


Male
DHA
9707.0307*
Weight (g)
1649
1675
1699
1732
1778
1811
1858
1882
1938





Age (weeks pca)
32.4
32.6
32.7
32.9
33.0
33.1
33.3
33.4
33.6


Male
DHA
9707-1308
Weight (g)
1780
2045
3004
3004





Age (weeks pca)
34.4
35.7
39.3
39.3


Male
DHA
9707-2308
Weight (g)
1651
1923
2850
2850





Age (weeks pca)
34.4
35.7
39.3
39.3


Male
DHA
9708-0302
Weight (g)
1485
1740
2500





Age (weeks pca)
33.3
34.3
37.0


Male
DHA
9709-0301
Weight (g)
1490
1740
2000
2400
2800





Age (weeks pca)
32.4
33.4
34.4
35.4
36.7


Male
DHA
9709-0304
Weight (g)
1470
1520





Age (weeks pca)
34.4
35.4


Male
DHA
9712-0304
Weight (g)
1545
1800
1985
2160
2550





Age (weeks pca)
33.0
34.0
35.0
36.0
37.6


Male
DHA
9712-0306
Weight (g)
1240
1435
1695
1945





Age (weeks pca)
31.5
32.5
33.5
34.5


Male
DHA
9743-0303
Weight (g)
1700
1810
2100
2300





Age (weeks pca)
32.9
33.9
34.9
35.7


Male
DHA
9743-0304
Weight (g)
1530
1880
2160
2375
2440





Age (weeks pca)
32.3
34.0
35.0
36.0
36.4


Male
DHA + ARA
9698-0305
Weight (g)
1120
1340
1550





Age (weeks pca)
30.7
32.6
33.6


Male
DHA + ARA
9698-0308
Weight (g)
1410
1690
1870
2120





Age (weeks pca)
31.1
32.4
33.3
34.3


Male
DHA + ARA
9699-0304
Weight (g)
1499
1689
1950
2355





Age (weeks pca)
36.1
37.1
38.1
40.3


Male
DHA + ARA
9699-0305
Weight (g)
1056
1134
1290
1490





Age (weeks pca)
32.0
33.0
34.0
35.7


Male
DHA + ARA
9700-0302
Weight (g)
1635
1880
2235
2570
2735





Age (weeks pca)
33.9
34.7
35.9
36.9
37.9


Male
DHA + ARA
9701-0302
Weight (g)
1442
1686
2045
2835





Age (weeks pca)
33.6
34.6
35.6
37.7


Male
DHA + ARA
9701-0306
Weight (g)
1587
2037
2245
2460
2756
3072
3228





Age (weeks pca)
32.3
33.4
34.4
35.3
36.3
37.3
37.7


Male
DHA + ARA
9701-0307
Weight (g)
1397
1710
1919
2932





Age (weeks pca)
33.3
34.3
35.1
38.4


Male
DHA + ARA
9702-0301
Weight (g)
1670
1865
2160
2660





Age (weeks pca)
32.0
33.0
34.0
36.0


Male
DHA + ARA
9702-0303
Weight (g)
1650
1905
2660





Age (weeks pca)
32.9
33.9
36.4


Male
DHA + ARA
9703-0301
Weight (g)
1255
1460
1745
2055
2415





Age (weeks pca)
29.4
30.4
31.3
32.3
33.4


Male
DHA + ARA
9703-0305
Weight (g)
1440
1635
1830
2115
2390
2590





Age (weeks pca)
32.0
33.0
34.0
35.0
36.1
36.9


Male
DHA + ARA
9704-0301
Weight (g)
1110
1270
1490
1740
2050





Age (weeks pca)
30.6
31.6
32.4
33.4
34.4


Male
DHA + ARA
9704-0302
Weight (g)
1080
1230
1370
1520
1680
1840





Age (weeks pca)
32.0
33.0
34.0
34.9
36.0
36.9


Male
DHA + ARA
9705-0301
Weight (g)
1300
1440
1620
1870





Age (weeks pca)
32.7
33.7
34.7
35.7


Male
DHA + ARA
9705-0306
Weight (g)
1320
1490
1700
2020
2300





Age (weeks pca)
31.4
32.4
33.4
34.4
35.9


Male
DHA + ARA
9705-0307
Weight (g)
1480
1650
1810
2240





Age (weeks pca)
34.4
35.4
36.1
37.4


Male
DHA + ARA
9706-0305
Weight (g)
1330
1455
1660
1930





Age (weeks pca)
33.9
34.4
35.4
36.6


Male
DHA + ARA
9706-0307
Weight (g)
1355
1585
1825
2270





Age (weeks pca)
31.9
33.0
33.9
35.1


Male
DHA + ARA
9706-0309
Weight (g)
1620
1910
2150





Age (weeks pca)
34.1
35.3
36.0


Male
DHA + ARA
9707-0301
Weight (g)
1553
1980
2280
2720





Age (weeks pca)
32.6
34.3
35.3
36.6


Male
DHA + ARA
9707-0305
Weight (g)
1755
1990
2245
2505
2770





Age (weeks pca)
33.9
34.7
35.7
36.7
37.7


Male
DHA + ARA
9707-0310
Weight (g)
1620
1828
2140
3195





Age (weeks pca)
32.7
33.7
34.7
37.9


Male
DHA + ARA
9708-0301
Weight (g)
1640
1880
2200
2420





Age (weeks pca)
32.7
33.7
34.7
35.7


Male
DHA + ARA
9708-0304
Weight (g)
1680
2180





Age (weeks pca)
34.6
35.9


Male
DHA + ARA
9709-0303
Weight (g)
1470
1810





Age (weeks pca)
32.6
33.6


Male
DHA + ARA
9709-0305
Weight (g)
1410
1655
1900
2160





Age (weeks pca)
34.4
35.4
36.4
37.4


Male
DHA + ARA
9712-0303
Weight (g)
1180
1210
1450
1590





Age (weeks pca)
31.4
32.3
33.4
34.4


Male
DHA + ARA
9712-0305
Weight (g)
1325
1505
1785
2010
2300





Age (weeks pca)
31.5
32.5
33.5
34.5
35.6


Male
DHA + ARA
9723-0301
Weight (g)
1630
1728
1961
2214





Age (weeks pca)
33.9
34.9
35.9
36.9


Male
HM
9698-0601







Male
HM
9698-0602







Male
HM
9698-0603







Male
HM
9698-0604







Male
HM
9698-0605







Male
HM
9699-0501







Male
HM
9699-0502







Male
HM
9701-0601







Male
HM
9701-0602







Male
HM
9701-0603







Male
HM
9701-0604







Male
HM
9701-0605







Male
HM
9701-0606







Male
HM
9702-0601







Male
HM
9702-0602







Male
HM
9703-0502







Male
HM
9703-0503







Male
HM
9703-0504







Male
HM
9704-0502







Male
HM
9704-0503







Male
HM
9705-0601







Male
HM
9705-0602







Male
HM
9706-0601







Male
HM
9706-0602







Male
HM
9706-0603







Male
HM
9706-0604







Male
HM
9706-0605







Male
HM
9706-0606







Male
HM
9707-0601







Male
HM
9707-0602







Male
HM
9707-0603







Male
HM
9707-0604







Male
HM
9707-0605







Male
HM
9707-0606







Male
HM
9707-0607







Male
HM
9707-0608







Male
HM
9707-0609







Male
HM
9708-0601







Male
HM
9708-0602







Male
HM
9708-0603







Male
HM
9708-0604







Male
HM
9708-0605







Male
HM
9708-0606







Male
HM
9708-0607







Male
HM
9709-0505







Female
Control
9698-0003*
Weight (g)
1020
1050
1070
1080
1080
1060
1080
1070





Age (weeks pca)
31.1
31.3
31.4
31.6
31.7
31.9
32.0
32.1


Female
Control
9699-0001
Weight (g)
1464
1672
1862
2000
2145





Age (weeks pca)
32.7
33.7
34.7
35.7
36.7


Female
Control
9699-0003
Weight (g)
1473
1629
1860
2497





Age (weeks pca)
34.0
35.0
36.0
38.0


Female
Control
9701-0003
Weight (g)
1480
1633
1903
1975
2292





Age (weeks pca)
34.6
35.6
36.6
37.3
38.6


Female
Control
9701-0005
Weight (g)
1174
1366
1555
1745
1976





Age (weeks pca)
30.7
31.7
32.7
33.7
34.7


Female
Control
9701-0008
Weight (g)
1391
1569
1898
2198
2406





Age (weeks pca)
34.3
35.3
36.4
37.3
37.9


Female
Control
9701-0011
Weight (g)
1050
1254
1492
1756
2044





Age (weeks pca)
30.6
31.4
32.4
33.4
34.4


Female
Control
9702-0002
Weight (g)
1222
1371
1570
1750
1995
2390





Age (weeks pca)
31.7
32.7
34.1
35.1
36.0
37.1


Female
Control
9702-0004
Weight (g)
1454
1555
1840
2530





Age (weeks pca)
31.0
31.9
33.1
36.0


Female
Control
9702-0010
Weight (g)
1775
2065
2410
2645





Age (weeks pca)
34.0
35.0
36.0
37.0


Female
Control
9703-0002
Weight (g)
1170
1250
1390
1570
1825
2130





Age (weeks pca)
29.1
30.4
31.3
32.4
33.4
34.3


Female
Control
9703-0005
Weight (g)
1420
1590
1765
1900
2220





Age (weeks pca)
31.4
32.3
33.3
33.9
35.3


Female
Control
9703-0008
Weight (g)
1495
1715
2095
2445
2685





Age (weeks pca)
33.0
34.0
35.0
36.0
36.6


Female
Control
9705-0004
Weight (g)
1120
1290
1490
1660





Age (weeks pca)
31.3
32.3
33.3
34.0


Female
Control
9706-0003
Weight (g)
1515
1673
1965
2330





Age (weeks pca)
35.1
36.3
37.1
38.3


Female
Control
9706-0005
Weight (g)
1485
1610
1805
2150





Age (weeks pca)
33.0
33.7
34.7
36.0


Female
Control
9706-0009
Weight (g)
1525
1620
1960





Age (weeks pca)
32.3
32.9
34.3


Female
Control
9706-0010
Weight (g)
1905
2185





Age (weeks pca)
34.3
35.0


Female
Control
9706-0013
Weight (g)
1185
1270
1585
1810





Age (weeks pca)
31.6
32.4
33.6
34.6


Female
Control
9706-0016
Weight (g)
1510
1765
1935





Age (weeks pca)
32.0
33.1
33.9


Female
Control
9707-0003
Weight (g)
1465
1505
1655
2010
2325
2765





Age (weeks pca)
32.0
32.6
33.6
35.3
36.4
38.3


Female
Control
9707-0006
Weight (g)
1866
3430
3430





Age (weeks pca)
34.6
40.0
40.0


Female
Control
9707-1006
Weight (g)
1815
3330
3330





Age (weeks pca)
34.6
40.0
40.0


Female
Control
9708-0001
Weight (g)
1410
1600
1850
2050





Age (weeks pca)
33.4
34.4
35.4
36.9


Female
Control
9708-0003
Weight (g)
940.0
970.0





Age (weeks pca)
30.0
31.0


Female
Control
9708-0008
Weight (g)
1380
1605
1860
2180





Age (weeks pca)
32.9
33.7
34.9
36.3


Female
Control
9709-0002
Weight (g)
1980
2225
2400





Age (weeks pca)
32.7
33.7
34.7


Female
Control
9709-0005
Weight (g)
1175
1425
1665
1945
2200





Age (weeks pca)
31.9
33.3
34.6
35.6
36.3


Female
Control
9712-0005
Weight (g)
972.0
1145
1290
1490
1695





Age (weeks pca)
29.1
30.1
31.1
32.1
33.1


Female
Control
9712-0006
Weight (g)
1203
1358
1585
1790





Age (weeks pca)
31.9
32.9
33.9
34.9


Female
Control
9743-0003
Weight (g)
1300
1520
1740
1890





Age (weeks pca)
31.6
33.4
34.1
35.1


Female
Control
9746-0001
Weight (g)
1420
1740
2075
2320
2625





Age (weeks pca)
32.6
33.6
34.6
35.6
36.6


Female
DHA
9698-0004
Weight (g)
1410
1650
1890
2140





Age (weeks pca)
30.1
31.1
32.1
33.1


Female
DHA
9698-0006
Weight (g)
1110
1240
1420
1720





Age (weeks pca)
30.7
31.7
32.7
33.7


Female
DHA
9698-0009
Weight (g)
1205
1310
1520
1630
2020





Age (weeks pca)
30.3
31.4
32.4
33.1
34.9


Female
DHA
9698-0307
Weight (g)
1790
2110
2450





Age (weeks pca)
34.4
35.7
37.6


Female
DHA
9699-0002
Weight (g)
1313
1477
1669
1929
2380





Age (weeks pca)
32.9
33.9
34.9
35.9
36.9


Female
DHA
9700-0001
Weight (g)
1580
1820
2050
2295
2500





Age (weeks pca)
32.4
33.4
34.3
35.3
36.3


Female
DHA
9701-0001
Weight (g)
1300
1356
1586
1924
2125





Age (weeks pca)
33.0
34.0
35.0
36.0
36.6


Female
DHA
9701-0004
Weight (g)
1108
1261
1441
1671
1897





Age (weeks pca)
30.7
31.7
32.7
33.7
34.7


Female
DHA
9701-0012
Weight (g)
1674
1928
2151
2311
2685
2685





Age (weeks pca)
34.9
35.9
36.9
37.6
39.6
39.6


Female
DHA
9701-0014
Weight (g)
1422
1631
1858
2455





Age (weeks pca)
33.9
34.9
35.9
37.9


Female
DHA
9702-0001
Weight (g)
1780
2115
2390
3000





Age (weeks pca)
31.6
32.9
33.9
36.4


Female
DHA
9702-0006
Weight (g)
1850
2005
2650
2650





Age (weeks pca)
35.4
36.1
39.6
39.6


Female
DHA
9702-0007
Weight (g)
1285
1459
1780
1965
2035





Age (weeks pca)
31.1
32.1
33.6
34.4
34.9


Female
DHA
9702-0008
Weight (g)
1605
1930
3540
3540





Age (weeks pca)
34.1
35.1
39.6
39.6


Female
DHA
9703-0003
Weight (g)
1255
1355
1535
1845
2150





Age (weeks pca)
34.4
35.1
36.1
37.1
38.1


Female
DHA
9703-0004
Weight (g)
1170
1340
1550
1795
2225





Age (weeks pca)
32.6
33.3
34.3
35.3
37.0


Female
DHA
9703-0009
Weight (g)
1570
1830
2095
2395
2655





Age (weeks pca)
33.3
34.3
35.1
36.3
37.9


Female
DHA
9704-0004
Weight (g)
1440
1670
1740





Age (weeks pca)
33.6
34.6
35.0


Female
DHA
9704-0005
Weight (g)
1050
1310
1490
1700
1890





Age (weeks pca)
29.7
30.9
31.7
32.7
33.7


Female
DHA
9705-0001
Weight (g)
1220
1370
1590
1880
2098





Age (weeks pca)
32.7
33.6
34.7
35.7
36.7


Female
DHA
9706-0006
Weight (g)
1270
1405
1630
1930





Age (weeks pca)
33.0
33.7
34.7
36.0


Female
DHA
9706-0008
Weight (g)
990.0
1188
1345
1485





Age (weeks pca)
33.4
34.6
35.7
36.4


Female
DHA
9706-0012
Weight (g)
1610
1830
2130
2280





Age (weeks pca)
31.6
32.4
33.6
34.6


Female
DHA
9706-0014
Weight (g)
1080
1170
1395
1560
1804





Age (weeks pca)
31.3
32.6
33.4
34.4
35.3


Female
DHA
9707-0004
Weight (g)
1635
1771
2850





Age (weeks pca)
34.0
35.0
38.7


Female
DHA
9707-0308
Weight (g)
2005
3440
3440





Age (weeks pca)
34.4
39.3
39.3


Female
DHA
9708-0004
Weight (g)
1460
1665
1955
2280
2485





Age (weeks pca)
32.6
33.6
34.6
35.6
36.6


Female
DHA
9708-0006
Weight (g)
1485
1775
2110
2380





Age (weeks pca)
33.7
34.7
35.7
37.0


Female
DHA
9709-0001
Weight (g)
1250
1490
1755
1970
2250
2520





Age (weeks pca)
29.6
31.0
32.0
33.0
34.0
35.0


Female
DHA
9709-0003
Weight (g)
1540
1725
2015
2155





Age (weeks pca)
34.4
35.4
36.4
37.4


Female
DHA
9712-0001
Weight (g)
987.0
1120
1270
1470
1685





Age (weeks pca)
30.0
31.0
32.0
33.0
34.0


Female
DHA
9712-0002
Weight (g)
1060
1230
1430





Age (weeks pca)
32.7
33.7
34.7


Female
DHA
9712-0007
Weight (g)
1082
1230
1440
1650





Age (weeks pca)
32.7
33.7
34.7
35.7


Female
DHA
9743-0001
Weight (g)
1000
1170
1470
1800
1930





Age (weeks pca)
32.1
33.1
34.4
35.7
36.1


Female
DHA
9743-0002
Weight (g)
1380
1570
1845
1975





Age (weeks pca)
32.1
33.3
34.1
35.1


Female
DHA + ARA
9698-0001
Weight (g)
1550
1690
2000
2380





Age (weeks pca)
31.6
32.6
33.6
34.9


Female
DHA + ARA
9698-0002
Weight (g)
1580
1870
2130
2260





Age (weeks pca)
32.6
33.7
34.6
35.7


Female
DHA + ARA
9699-0004
Weight (g)
985.0
1122
1283
1536
1788





Age (weeks pca)
31.0
32.0
33.0
34.0
35.0


Female
DHA + ARA
9699-0005
Weight (g)
1330
1542
1688
2000
2330





Age (weeks pca)
31.9
32.9
33.9
34.9
35.9


Female
DHA + ARA
9700-0002
Weight (g)
1315
1525
1885
2035
2220
2480





Age (weeks pca)
30.3
31.3
32.3
33.3
34.1
35.6


Female
DHA + ARA
9701-0002
Weight (g)
1398
1609
1887
2210
2420





Age (weeks pca)
33.4
34.4
35.4
36.4
37.4


Female
DHA + ARA
9701-0006
Weight (g)
1720
1859
2113
2456
2728





Age (weeks pca)
32.3
33.3
34.3
35.3
36.1


Female
DHA + ARA
9701-0007
Weight (g)
1469
1427
1590
1982
2227





Age (weeks pca)
33.7
34.9
35.7
36.7
37.7


Female
DHA + ARA
9701-0010
Weight (g)
1488
1703
1978
2234
2433
2759





Age (weeks pca)
32.3
33.4
34.4
35.3
36.1
37.7


Female
DHA + ARA
9701-0013
Weight (g)
1841
2019





Age (weeks pca)
33.0
33.7


Female
DHA + ARA
9702-0003
Weight (g)
1293
1488
1820
2155
2400





Age (weeks pca)
30.1
31.1
32.1
33.4
34.1


Female
DHA + ARA
9702-0005
Weight (g)
1895
2060
2300
2525
2710





Age (weeks pca)
34.0
35.0
36.0
37.0
38.0


Female
DHA + ARA
9702-0009
Weight (g)
1725
2000
2230
2595
2655





Age (weeks pca)
34.0
35.0
36.0
37.0
37.3


Female
DHA + ARA
9703-0001
Weight (g)
1145
1255
1450
1680
1955





Age (weeks pca)
31.3
32.1
33.1
34.3
35.3


Female
DHA + ARA
9703-0006
Weight (g)
1865
2200
2560
2880





Age (weeks pca)
34.0
35.0
35.9
37.0


Female
DHA + ARA
9703-0007
Weight (g)
1390
1495
1620
1880
2030
2240





Age (weeks pca)
32.0
33.1
34.0
35.0
35.7
36.6


Female
DHA + ARA
9704-0002
Weight (g)
960.0
1090
1200
1370
1570
1780
2070





Age (weeks pca)
29.0
30.0
30.9
31.9
32.9
33.9
34.9


Female
DHA + ARA
9704-0003
Weight (g)
1690
1840





Age (weeks pca)
32.7
33.4


Female
DHA + ARA
9705-0003
Weight (g)
1760
2260
2500
2920





Age (weeks pca)
34.4
35.7
36.6
37.7


Female
DHA + ARA
9705.0005*
Weight (g)
1075
1120
1185
1280
1310
1310
1265
1350
1380





Age (weeks pca)
31.1
31.4
31.7
32.1
32.4
32.7
33.0
33.3
33.4


Female
DHA + ARA
9706-0001
Weight (g)
1290
1515
1685
2060





Age (weeks pca)
31.7
32.9
33.7
34.9


Female
DHA + ARA
9706-0002
Weight (g)
1395
1710
1884
2275





Age (weeks pca)
31.9
33.0
33.9
35.4


Female
DHA + ARA
9706-0004
Weight (g)
1550
1705
2050





Age (weeks pca)
36.7
37.6
38.7


Female
DHA + ARA
9706-0007
Weight (g)
1235
1490
1820
1930





Age (weeks pca)
33.4
34.6
35.7
36.4


Female
DHA + ARA
9706-0011
Weight (g)
1900
2105





Age (weeks pca)
34.3
35.0


Female
DHA + ARA
9706-0015
Weight (g)
1670
1975
2210





Age (weeks pca)
34.6
35.6
36.4


Female
DHA + ARA
9706-0017
Weight (g)
1465
1700
1895
2170





Age (weeks pca)
32.3
33.4
34.3
35.3


Female
DHA + ARA
9707-0002
Weight (g)
1775
2240
2385
2610





Age (weeks pca)
34.3
36.0
36.9
37.9


Female
DHA + ARA
9708-0002
Weight (g)
1535
1700
1980
2200





Age (weeks pca)
33.0
34.0
35.0
36.0


Female
DHA + ARA
9708-0005
Weight (g)
1125
1345
1610
1980





Age (weeks pca)
32.4
33.4
34.4
35.4


Female
DHA + ARA
9708-0007
Weight (g)
1200
1440
1680
1975





Age (weeks pca)
31.3
32.3
33.3
34.3


Female
DHA + ARA
9709-0004
Weight (g)
1350
1560
1885
2250
2475





Age (weeks pca)
31.9
33.3
34.6
35.6
36.3


Female
DHA + ARA
9712-0003
Weight (g)
1283
1410
1590
1850
2010





Age (weeks pca)
32.0
33.0
34.0
35.0
36.0


Female
DHA + ARA
9712-0004
Weight (g)
1575
1780
1890
2080
2530





Age (weeks pca)
33.0
34.0
34.6
35.6
37.6


Female
DHA + ARA
9712-0008
Weight (g)
1590
1780
1990
2475





Age (weeks pca)
34.0
35.0
35.8
37.4


Female
DHA + ARA
9746-0002
Weight (g)
1249
1429
1597
1814
2110





Age (weeks pca)
32.7
33.7
34.7
35.7
36.7


Female
HM
9698-0501


Female
HM
9698-0502


Female
HM
9698-0503


Female
HM
9698-0504


Female
HM
9698-0505


Female
HM
9699-0601


Female
HM
9699-0602


Female
HM
9699-0603


Female
HM
9699-0604


Female
HM
9699-0605


Female
HM
9701-0501


Female
HM
9701-0502


Female
HM
9701-0503


Female
HM
9701-0504


Female
HM
9702-0501


Female
HM
9702-0502


Female
HM
9702-0503


Female
HM
9702-0504


Female
HM
9702-0505


Female
HM
9702-0506


Female
HM
9702-0507


Female
HM
9702-0508


Female
HM
9703-0501


Female
HM
9703-0505


Female
HM
9703-0506


Female
HM
9703-0507


Female
HM
9704-0501


Female
HM
9705-0501


Female
HM
9705-0502


Female
HM
9706-0501


Female
HM
9706-0502


Female
HM
9707-0501


Female
HM
9707-0502


Female
HM
9707-0503


Female
HM
9708-0501


Female
HM
9708-0502


Female
HM
9708-0503


Female
HM
9705-0504


Female
HM
9708-0505


Female
HM
9709-0501


Female
HM
9709-0502


Female
HM
9709-0503


Female
HM
9709-0504


Female
HM
9709-0506















Growth






Rate



g/day
Wgt_40
Wgt_48
Wgt_57
















27.7






36.1
3731
5752
6816




40.3
48.3
56.6



23.9
3064
4993
6553




39.9
48.0
57.9



26.9
3575
4936
6014




40.3
48.3
57.1



43.3
3688
5504
6922




40.3
48.3
57.3



36.2
3745
5080
6610




40.1
47.6
56.7



31.5
3070
3895
4965




41.6
48.6
57.6



34.1
3070
5445
7135




39.9
48.3
56.9



33.8
3590
4840
6110




40.1
48.6
58.4



41.7
3620
5850
7470




39.7
48.6
57.3



34.2
3170
5240
6970




40.1
47.7
57.1



28.9
2520
4010
5030




39.7
48.4
56.9



24.4
2150
3700
4950




39.3
48.3
57.4



23.7



30.9
2540
4936
5646




39.6
47.4
56.4



25.3
3291
5816
7490




39.7
47.7
56.7



37.1
2800
4660
6170




40.1
48.7
56.7



22.2
3050
4550
6675




41.0
48.6
56.9



46.9
3835
5155
6090




40.6
48.0
56.3



32.8
2930
3795
5185




40.1
47.7
56.6



32.7
2530
4235
6530




39.7
47.7
57.1



30.7
2965
4465




39.9
48.0



37.4
3680
5470
7330




40.1
48.1
57.0



30.8
3845
5700
6775




39.9
48.0
56.7



26.1



21.0
2160
3300
3980




40.1
47.7
57.3



10.0
2260
4535




41.0
50.0



48.9
3085
4795
6695




40.6
47.6
57.6



47.5
3170
5206
7036




39.9
47.9
57.1



28.3
2575
4334
6022




40.0
48.0
57.0



27.9
3121
5192
6752




39.9
48.0
57.9



48.3
2724
4341
5674




40.1
48.1
57.0



22.5
1986
3206
4511




40.0
48.0
57.0



45.4
3585
5420
7035




39.6
47.4
56.7



20.4
2805
3405
4660




40.4
47.6
57.0



34.7
3660




39.7



38.2
3080
3940
5260




39.9
48.0
56.9



41.7



37.6
3120
4410
5600




40.7
47.9
56.9



29.3
2880
3900
4300




40.3
48.3
57.3



25.6

3750
4800





48.0
57.0



30.8
2370
4170
5787




39.6
47.4
56.4



36.7
3291




39.6



36.8
3335
5265
6900




40.0
48.1
57.3



42.8
3310
4205
5600




41.4
47.6
56.9



17.7



36.9
3280
5115
6755




39.9
48.0
57.6



43.2
3050
5100
7150




40.6
48.6
57.6



39.6



36.7
3004
4420
6090



39.3
47.3
57.7



35.8
2850
4375
5930




39.3
47.3
57.7



39.2
3873
6256




42.9
57.3



44.4
3150
5080
6750




39.4
47.4
56.4



7.1



30.5
3160
5200
7300




40.3
48.1
57.1



33.9
3040
4680
5860




39.6
48.6
57.6



31.1
3100
5500




40.6
48.6



32.2
3628
5840




38.1
50.6



20.9
2440
5525
6646




37.4
47.6
56.6



32.0
3553
6007
7937




40.3
47.6
57.3



29.8
2355
3404
4993




40.3
48.0
57.1



17.2
2610
4256
5050




40.6
48.7
57.6



40.7
3255
5540
7380




39.7
47.7
56.7



48.9
3240
5055
6600




39.7
46.7
56.7



41.4
3960
5200




42.3
48.4



42.5
3445
5930
7475




40.6
48.6
57.4



36.0
3780
5250




40.6
47.6



40.7
3500
5160
6520




40.0
48.0
56.4



42.3
4350
6020
6720




40.4
47.4
56.6



34.1
3170
4330
5630




40.0
47.9
56.7



35.1
3220
5460
7050




39.9
47.7
56.7



22.2
2570
6540
8050




40.0
48.1
57.4



27.0
2979
4400
5873




40.1
48.1
58.0



32.7
3631
5447
6809




39.9
47.9
56.9



36.4
3007
5589
6596




39.9
48.4
56.7



31.4
2695
4820
6225




39.9
48.1
58.1



40.0
3585
5955
6925




40.4
49.1
57.6



40.3
3460
5255
5775




40.9
48.7
57.4



41.5
3395
4950
6285




40.1
47.9
56.9



37.4



44.8
3585
5170
6725




39.7
47.9
56.3



38.0
3730
4835
6185




40.1
47.9
57.0



55.6



48.6



35.6
2630
4570
5520




39.7
47.7
57.1



20.9
2520
3500
5010




40.4
47.4
56.4



34.1
3030
4350
5510




39.6
48.6
57.6



28.4
3104

5986




40.3

58.9




3518
5497
6582




40.0
48.3
56.9




3177
5220
6355




40.0
48.1
57.0




3858
5447
6454




40.0
48.0
57.0




4355
5092
6383




40.0
48.0
57.0




3433
4979
6426




40.0
48.1
57.1




3915
6639
7773




40.0
48.3
57.4




3802
5787
7178




40.0
48.4
57.4




3317
5555
7070




40.0
47.9
56.4




3487
5833
8070




40.0
47.3
58.3




3232
4940
5855




40.0
47.4
56.4




3600
5215
6285




40.0
47.9
56.9




3402
5575
7210




40.0
47.6
57.6




3090
4485
5445




40.0
47.7
56.7




3480
5780
6530




40.0
48.6
56.6




3165
5060
6660




40.0
48.3
57.1




2670
5420
7220




40.0
48.3
57.1




4100
6740
8330




40.0
47.4
56.4




3435
6000
7930




40.0
48.1
57.1




3285
5220
6560




40.0
48.1
56.6




3400
5200
6725




40.0
48.7
56.9




3200
5617
6752




40.0
48.3
57.3




3860
6227




40.0
48.0




3152
5105
6545




40.0
49.0
57.0




3557
5175
7315




40.0
47.4
57.7




3192
5070
6970




40.0
47.9
56.7




3461
4225
5525




40.0
48.0
57.1




3870
6220
7660




40.0
48.1
56.4




4315
5975
6720




40.0
48.3
56.6




3263
4730
5825




40.0
48.1
57.0




3206
4515
6220




40.0
48.1
57.7




4256
6930
8810




40.0
48.0
57.0




3419
5460
6130




40.0
48.0
56.7




3433




40.0




3603
5825




40.0
48.4




3569
5410
6870




40.0
47.9
56.9




3348
5135
6370




40.0
48.0
57.0




3348




40.0




3064
5220
6595




40.0
47.6
56.4




4085




40.0




3319
5135
6327




40.0
48.4
57.1




3291




40.0




3796




40.0




4020
4645
5405




40.0
48.4
57.1




3333
4043
5180




40.0
47.9
56.7




3400




40.0



5.6



24.1
2610
4369
5220




39.7
47.9
56.9



37.3
2780
4596
5816




40.0
48.0
57.0



29.1
2675
4165
5200




40.6
48.6
55.6



28.3
3175
5140
6280




39.7
48.4
56.4



41.1
2980
4425
5815




40.4
47.4
56.4



36.6
2870
4420
5505




39.7
48.6
57.4



29.4
3380
4900




40.4
47.6



31.6
3600
5160
6900




39.9
47.7
56.7



42.2
3060
4820
6690




39.9
48.3
57.6



26.4
3210
4750




39.6
47.4



29.5
2610
4330
5640




37.3
46.0
55.0



48.3
3360
4780
6410




40.1
47.7
56.1



28.3
2722
4085
5646




39.7
46.6
55.0



37.9



31.7
2740
4165
5305




40.0
48.1
57.3



31.6
3640
5495
7225




40.3
47.6
53.4



56.0
3655
5390
6535




40.0
48.4
56.7



31.1
2680
3800




40.1
48.4



32.6
3320
4535
5297




40.7
48.7
56.6



30.2
3110
4125
4995




40.1
48.1
57.1



41.2
3430
5385
7250




40.0
48.9
57.3



39.9
3330
5490
6920




40.0
48.9
57.3



27.2
2910
4734




40.6
48.4



4.3



33.1
2582
4110
5361




39.3
47.4
57.1



30.0



32.3
2975
4700
5900




39.6
48.4
56.7



25.6
2930
4450
5880




40.3
47.6
57.1



28.4
3030
4560
6230




39.7
48.0
57.0



24.0

4000
5160





48.4
57.4



42.7
3170
4145
5192




39.7
47.6
56.6



34.7
3787
4795
6291




40.0
48.0
57.0



28.7



25.9
2891
3979
5121




40.0
48.0
57.0



29.7
3135
5185
6695




39.4
47.4
56.4



36.9
3177
5787
7093




39.7
47.7
56.7



34.5
3210
5110
6300




40.1
48.1
57.1



34.2
2910
4325
5625




39.6
48.0
57.0



28.4
3020
4855
6040




39.7
48.4
56.4



30.1
2685




39.6



37.2
2970
4605
5140




39.9
47.7
56.9



35.8
3850
5610
6600




40.0
49.6
57.0



27.3
2650
4450
6020




39.6
48.4
56.4



29.6



51.3
3540
5920
7820




39.6
47.6
57.1



34.8
2430
4130
5010




39.4
48.0
56.1



33.9
2870
4610
6490




39.4
48.1
57.1



34.6
3160
4480
5570




40.4
48.4
58.0



30.5
3100
5830
8630




40.0
48.0
57.0



30.0
3360
4860
6100




39.6
48.0
57.0



31.9
3092
4795
5986




40.1
48.1
57.1



31.7
2705
4145
5320




40.0
48.1
57.3



23.0
2120




39.9



32.5
3530
4790




40.1
48.4



26.2
3295
5600
7675




40.6
49.4
58.0



38.1
3045
4595
5765




40.0
48.0
57.0



42.2
3440
4800
6360




39.3
47.3
57.7



38.1



39.5
3010
4620
6530




40.1
48.1
57.0



33.8
3500




40.1



30.5
2580
4080
5420




40.3
47.7
57.1



24.9
2940
3980
5250




40.1
48.1
57.1



26.4



27.3
2425
4250
5340




39.7
47.9
56.9



33.5

4140
5400





48.3
57.3



29.7

4540
5160





48.4
57.4



37.1
3530
5348
6582




40.0
47.7
56.7



31.8
3241




40.7



28.9
3177
5107
6979




41.3
48.3
57.3



35.1
4029
6752
8341




40.0
48.0
57.0



31.9
3340
4930
6420




40.3
48.1
57.1



37.8
2930
5115
6525




39.4
48.4
56.4



38.3
3600
5045
6270




40.3
48.0
57.3



29.8
2680
4935
6955




39.9
47.9
56.9



34.6
3500
5545




41.1
48.4



35.6

4545
5550





48.7
57.4



39.9
4190
6220
7500




40.0
48.4
56.9



29.9
3025
4300
5340




40.0
47.4
56.4



40.9
2905
4680
6410




39.9
48.3
57.6



28.9
3030
4250
5420




41.0
48.1
57.3



49.1
3600
5400
6650




40.0
48.1
56.7



27.4
2850
4190
5850




40.0
47.9
56.7



26.7
3110
5150
6800




40.0
48.0
57.3



30.0
4000
5400
6640




40.0
48.0
57.0



49.8
3376
5107
6894




39.9
48.4
56.9



22.1
2600
4000
5050




40.4
48.0
57.0



34.5
4100
6550
7655




40.1
48.6
56.7



34.8
2845
4645
5550




40.3
48.9
57.3



36.1
2645
4225
4935




41.7
49.7
58.0



34.3
2505




40.3



41.0
3430
5175
6140




40.0
48.4
56.7



41.6
3005
4465
5810




40.9
48.4
57.6



33.4



33.2



32.5
2724
4645
6315




38.1
47.6
55.4



40.4
3121
5855
7875




39.4
47.4
57.4



36.6



37.0
3295
5250
6685




39.7
48.4
56.7



27.1
2580
4130
5640




40.0
48.2
57.5



29.7
3220
4920
6600




40.3
48.1
57.1



37.2
2960
4470
5760




40.1
48.1
57.1



30.1
2680
4010
5362




39.9
46.9
56.9




3546
4880




40.0
48.3




3518
5972




40.0
47.9




3390
4213
5319




40.0
48.3
57.1




3383
5234
6667




40.0
48.7
57.9




3646
4638
5653




40.0
48.3
57.0




2582
4766
5731




40.0
49.0
57.0




4284
4823
5986




40.0
48.0
57.0




3716
4482
5674




40.0
47.7
56.7




3660
4738
6355




40.0
48.0
57.0




3433
5617
7603




40.0
48.4
57.6




3884
5630
6450




40.0
47.7
57.7




3858
5420
6700




40.0
48.6
57.6




3430
4265
5085




40.0
47.4
57.4




3317
5020
6230




40.0
48.1
57.1




3302
5540
6630




40.0
47.7
56.7




2658
5310
6800




40.0
47.4
57.1




2895
3430
4530




40.0
47.7
57.4




3401
5390
6270




40.0
48.0
57.4




3141
4210
5320




40.0
47.9
57.0




3762
6040
7600




40.0
48.9
57.7




2718
4050
4940




40.0. 48.9
57.4




2927
4240
5860




40.0
47.4
57.0




4085
5260
6360




40.0
48.1
57.1




3390
5760
7670




40.0
48.3
57.3




3405
6170
7490




40.0
47.9
56.9




3085
5090
6550




40.0
48.0
56.3




3194
4700
5880




40.0
48.1
57.4




3120
4500
5702




40.0
48.1
57.1




4080
6327
7348




40.0
48.3
57.3




3396
5000
6645




40.0
48.3
58.1




3041
4315
5525




40.0
47.7
57.6




4653
5515
6770




40.0
47.9
56.6




3419
5500
7080




40.0
48.0
57.1




3773
5785
7675




40.0
47.9
56.9




3716




40.0




3688
5440
6890




40.0
48.1
57.6




3454
5192
5950




40.0
48.1
57.4




2977
5165
7040




40.0
48.1
57.4




3864
5660
6705




40.0
48.4
57.4




3831
5800
7435




40.0
47.7
57.6




3550




40.0




3715
5205
6100




40.0
48.0
56.9




3195




40.0




3190
4590




40.0
48.3




3505
4500
5910




40.0
48.0
57.1























Gender
Regimen
SUBJECT
Variable
Wgt1
Wgt2
Wgt3
Wgt4
Wgt5
Wgt6
Wgt7
Wgt8
Wgt9






















Male
Control
9712-0301
Weight (g)
1245
1221
1245
1291
1294
1330
1369
1402
1433





Age (weeks pca)
31.6
31.7
31.9
32.0
32.1
32.3
32.4
32.6
32.7


Male
DHA
9707-0307
Weight (g)
1649
1675
1699
1732
1778
1811
1858
1882
1938





Age (weeks pca)
32.4
32.6
32.7
32.9
33.0
33.1
33.3
33.4
33.6


Female
Control
9698-0003
Weight (g)
1020
1050
1070
1080
1080
1060
1080
1070





Age (weeks pca)
31.1
31.3
31.4
31.6
31.7
31.9
32.0
32.1


Female
DHA + ARA
9705-0005
Weight (g)
1075
1120
1185
1280
1310
1310
1265
1350
1380





Age (weeks pca)
31.1
31.4
31.7
32.1
32.4
32.7
33.0
33.3
33.4






























Growth












Rate



Wgt10
Wgt11
Wgt12
Wgt13
Wgt14
Wgt15
Wgt16
Wgt17
Wgt18
g/day






















1448
1465







26.1



32.9
33.0



1994
2030
2075






39.6



33.7
33.9
34.0












5.6



1440
1450
1510
1515
1565
1585
1640
1680
1670
22.1



33.7
33.9
34.0
34.1
34.3
34.4
34.6
34.7
34.9








Four subjects had more the 9 weights used in growth rate calculation. A complete listing appears on the last page.








Claims
  • 1. A method for enhancing the growth of preterm infants comprising administering to the preterm infants a preterm nutritional product or nutritional supplement having a growth-enhancing amount of DHA and ARA.
  • 2. The method according to claim 1, wherein the nutritional product or supplement is a preterm infant formula.
  • 3. The method according to claim 1, wherein the ratio of ARA:DHA is about 1:2 to about 5:1.
  • 4. The method according to claim 1, wherein the ratio of ARA:DHA is about 1:1 to about 3:1.
  • 5. The method according to claim 1, wherein the ratio of ARA:DHA is about 2:1.
  • 6. The method according to claim 1, wherein the DHA and ARA are derived from a source comprising fish oils.
  • 7. The method according to claim 1, wherein the DHA and ARA are derived from a source comprising single cell oils.
  • 8. The method according to claim 1, wherein the DHA and ARA are derived from a source comprising egg or yolk lipids.
  • 9. The method according to claim 1, wherein the DHA and ARA are derived from a source comprising brain lipids.
  • 10. The method according to claim 2, wherein the infant formula is nutritionally complete and comprises lipid in an amount of from about 3 g/100 kcal to about 7 g/100 kcal, protein in an amount of from about 1 g/100 kcal to about 5 g/100 kcal, and carbohydrate in an amount of from about 8 g/100 kcal to about 12 g/100 kcal.
  • 11. The method according to claim 1, wherein the nutritional supplement is selected from the group consisting of oil drops, sachets, and vitamins.
  • 12. A preterm infant formula for enhancing the growth of preterm infants, the preterm infant formula comprising a growth-enhancing amount of DHA and ARA.
  • 13. The preterm infant formula according to claim 12, wherein the ratio of ARA:DHA is about 1:2 to about 5:1.
  • 14. The preterm infant formula according to claim 12, wherein the ratio of ARA:DHA is about 1:1 to about 3:1.
  • 15. The preterm infant formula according to claim 12, wherein the ratio of ARA:DHA is about 2:1.
  • 16. The preterm infant formula according to claim 12, wherein the infant formula is nutritionally complete and comprises lipid in an amount of from about 3 g/100 kcal to about 7 g/100 kcal, protein in an amount of from about 1 g/100 kcal to about 5 g/100 kcal, and carbohydrate in an amount of from about 8 g/100 kcal to about 12 g/100 kcal.
  • 17. A method for enhancing the growth of a preterm infant comprising feeding said infant a nutrient-enriched formula containing DHA and ARA in quantities that, if said infant formula were the sole source of caloric intake, would deliver an average daily intake per kg body weight of about 2.5 to 60 mg DHA and about 5 to 120 mg ARA, said feeding continuing until said preterm infant reaches a corrected age of about six months.
  • 18. A method for enhancing the neurological development of a preterm infant comprising feeding said infant a nutrient-enriched formula containing DHA and ARA in quantities that, if said infant formula were the sole source of caloric intake, would deliver an average daily intake per kg body weight of about 2.5 to 60 mg DHA and about 5 to 120 mg ARA, said feeding continuing until said preterm infant reaches a corrected age of about six months.
CROSS REFERENCE TO RELATED APPLICATIONS

[0001] The present application is a Divisional of U.S. patent application Ser. No. 09/381,484, filed Feb. 19, 2002, which is a Continued Prosecution Application of U.S. Non-provisional patent application Ser. No. 09/381,484, filed Sep. 21, 1999 under 35 U.S.C. § 371, which is a National Phase Application of International Application No. PCT/US98/10566, filed Mar. 20, 1998, which designated the United States and claims the benefit of U.S. Provisional Application Serial No. 60/042,366, filed Mar. 27, 1997, and claims the priority benefit of each of these applications, each of which is incorporated herein by reference in its entirety, and is related to a commonly assigned and copending application having the title “Use of Docosahexaenoic Acid and Arachidonic Acid Enhancing The Growth of Preterm Infants”, which was filed on the same date as the present application.

Divisions (1)
Number Date Country
Parent 09381484 Feb 2000 US
Child 10714268 Nov 2003 US