linoleic-acid and Protein-Energy-Malnutrition

This report summarizes data on the availability of essential fatty acids (EFAs) and their long-chain polyunsaturated fatty acid (LCPUFA) metabolites in protein-energy malnutrition (PEM), in human immunodeficiency virus-1 (HIV-1) infection for which less information is available, and the combination of both PEM and HIV-1. The contribution of different EFAs and LCPUFAs to the fatty-acid composition of plasma and erythrocyte membrane lipids was found to be reduced in children with PEM in comparison with well-nourished children. In addition to limited dietary EFA supply, reduced bioconversion of EFAs to their respective LCPUFA metabolites and/or peroxidative degradation of LCPUFAs may contribute to the reduction of LCPUFA status in malnourished children. Restoration of normal energy, protein, and EFA intakes does not appear to readily correct abnormalities of plasma and erythrocyte membrane LCPUFA values. Enhanced dietary supply of LCPUFAs and/or improved supply of antioxidant vitamins may represent novel therapeutic modalities in severe PEM. With and without PEM, HIV infection was related to altered availability of various EFAs and LCPUFAs in HIV-seropositive children. The plasma total lipid fatty-acid profiles seen in well-nourished children with HIV infection were compatible with an HIV infection-related enhancement of the metabolic activity of the conversion of EFAs to their respective LCPUFA metabolites. However, the plasma phospholipid EFA and LCPUFA profiles seen in severely malnourished children with HIV infection more closely resembled those seen in children with PEM but without HIV infection than in those in children with HIV infection but no PEM. Metabolic studies using stable isotope-labeled fatty acids may contribute to better understanding of the HIV-related changes in EFA metabolism and clearly are needed before therapeutic conclusions can be drawn.

Topics: Acquired Immunodeficiency Syndrome; alpha-Linolenic Acid; Arachidonic Acid; Child; Docosahexaenoic Acids; Fatty Acids, Essential; Humans; Linoleic Acid; Lipids; Protein-Energy Malnutrition

Since the discovery in 1929 that certain polyunsaturated fatty acids (PUFA) are essential for life and health, intense investigation has revealed the multiplicity of members in each of several families of PUFA, no two of which are equivalent. The quantified nutrient requirements for the essential dietary precursors of the two dominant families of PUFA have been estimated, and the general functions of these families are slowly becoming known. The PUFA are essential components of structural membrane lipids. The functions of the individual members are not yet differentiated, except as they act as precursors of synthesis of unique octadecanoid, eicosanoid, and docosanoid products of oxidation that have potent biological properties. The PUFA occur in animals and higher plants as ubiquitous and essential components of structural lipid that are in a dynamic equilibrium with the pool of dietary acyl groups. Many human diseases have been found to involve unique essential fatty acid (EFA) deficiencies or distortions of the normal equilibrium pattern. The equilibrium is influenced by the level of dietary intake or precursors, by the presence of competing essential and nonessential acyl groups, by nonoptimum intake of other essential nutrients, by hormonal effects, by drug therapy, and by other effects upon physiological condition. With the many variables already known to modulate or control the equilibrium, it should be possible with more precise understanding of each variable to shift abnormal equilibria in the direction of normalcy. This perhaps will be the next area of intensive investigation in this field of nutrition and metabolism.

Topics: Acrodermatitis; alpha-Linolenic Acid; Arachidonic Acid; Arachidonic Acids; Aspirin; Child; Crohn Disease; Cystic Fibrosis; DDT; Dicofol; Ethanol; Fatty Acids, Essential; Fatty Acids, Unsaturated; Female; Humans; Ichthyosis; Indomethacin; Isomerism; Linoleic Acid; Linoleic Acids; Linolenic Acids; Lipid Metabolism; Lipolysis; Liver Cirrhosis, Alcoholic; Models, Chemical; Myocardial Infarction; Protein-Energy Malnutrition; Reye Syndrome; Structure-Activity Relationship

Ready-to-use therapeutic food (RUTF) is the preferred treatment for uncomplicated severe acute malnutrition. It contains large amounts of linoleic acid and little α-linolenic acid, which may reduce the availability of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to the recovering child. A novel high-oleic RUTF (HO-RUTF) was developed with less linoleic acid to determine its effect on DHA and EPA status.. We conducted a prospective, randomized, double-blind clinical effectiveness trial treating rural Malawian children with severe acute malnutrition. Children were treated with either HO-RUTF or standard RUTF. Plasma phospholipid fatty acid status was measured on enrollment and after 4 weeks and compared between the 2 intervention groups.. Among the 141 children enrolled, 48 of 71 receiving HO-RUTF and 50 of 70 receiving RUTF recovered. Plasma phospholipid samples were analyzed from 43 children consuming HO-RUTF and 35 children consuming RUTF. The change in DHA content during the first 4 weeks was +4% and -25% in the HO-RUTF and RUTF groups, respectively (P = 0.04). For EPA, the change in content was 63% and -24% in the HO-RUTF and RUTF groups, respectively (P < 0.001). For arachidonic acid, the change in content was -3% and 13% in the HO-RUTF and RUTF groups, respectively (P < 0.009).. The changes in DHA and EPA seen in the children treated with HO-RUTF warrant further investigation because they suggest that HO-RUTF support improved polyunsaturated fatty acid status, necessary for neural development and recovery.

Topics: alpha-Linolenic Acid; Arachidonic Acid; Child, Preschool; Docosahexaenoic Acids; Double-Blind Method; Eicosapentaenoic Acid; Fast Foods; Female; Food, Formulated; Humans; Infant; Linoleic Acid; Male; Nutritional Status; Oleic Acid; Phospholipids; Prospective Studies; Protein-Energy Malnutrition; Weight Gain

Topics: Brain; Child; Cognition; Humans; Linoleic Acid; Nutritional Status; Protein-Energy Malnutrition; Severe Acute Malnutrition

The influence of vitamin B6 on linoleic (LA), alpha-linolenic (ALA), arachidonic (AA), eicosapentaenoic (EPA) and docosahexaenoic (DHA) acid content in serum and liver of rats fed with protein-energy deficient diets for 90 d, was studied. To estimate the effect of dietary supplementation with vitamin B6 on the composition and level of fatty acids in the serum and liver of rats, two experiments were performed. In these experiments control rats were fed ad libitum semisynthetic isocaloric diets of 1,466.5 kJ/100 g (350 kcal/100 g) throughout 90 d while the examined rats were offered 50% and 30% of the previously determined daily intake of the diet consumed in the control group. The experimental diet was supplemented with vitamin B6 to the level 4-times higher than in the control diet. A reduction to the half consumption of a standard diet supplemented with vitamin B6 caused a significant decrease of LA and ALA in blood serum at 30 and 60 d. At 90 d of the experiment the value of LA was lower and the content of AA was higher in comparison to the control group. After 30 d of consumption of vitamin B6 enriched diet in rats subjected to feed restriction to only 30% of the control intake, an increase of ALA and a decrease of AA, EPA and DHA were noticed in serum. At 60 d an increase of DHA was observed. Ninety days of feeding this diet caused a significant increase of AA level. Feeding animals for 90 d with a vitamin B6 enriched diet, with limited consumption to 50%, caused a significant increase of ALA content in liver. Further limitation of this diet consumption to 30%, caused a significant decrease of LA and ALA and an increase of EPA content.

Topics: alpha-Linolenic Acid; Animals; Arachidonic Acid; Dietary Fats; Dietary Supplements; Docosahexaenoic Acids; Eicosapentaenoic Acid; Energy Intake; Fatty Acids, Unsaturated; Food Deprivation; Linoleic Acid; Liver; Male; Protein-Energy Malnutrition; Rats; Rats, Wistar; Time Factors; Vitamin B 6

Polyunsaturated fatty acids (PUFAs) derived from essential fatty acids (EFAs) play an important role in prenatal visual and neural development. Protein-energy malnutrition affects PUFA supply, and hence the synthesis of structural lipids during growth. Recently, some physiological studies reported abnormalities in the visual function of formula-fed infants relative to breast-fed infants. The purpose of our study was to assess whether fatty acid composition of the malnourished infant diet modifies the visual function and erythrocyte phospholipid fatty acid composition. Three groups of full-term malnourished infants were selected. Two groups received commercial formulas. One of them supplied linoleic and alpha -linolenic acid: Formula I (FI), and the other supplied, in addition, long-chain PUFAs from n-3 and n-6 series: Formula II (FII). A reference group of breast-fed infants was also enrolled. Visual function was assessed using full-field flash electroretinography, and the erythrocyte phospholipid fatty acid composition was determined by gas-liquid chromatography. Those infants receiving the supplemented formula (FII) exhibited a similar retinal function to that of breast-fed infants. However, normal results were not achieved when infants were fed on the FI formula. In all groups, the results were correlated with the proportion of docosahexaenoic acid in erythrocyte phospholipid fatty acid composition. We conclude that in malnourished infants a nutrient formula enriched with long-chain fatty acids of n-6 and n-3 series could be helpful to achieve an erythrocyte fatty acid pattern and a visual function similar to that obtained in breast-fed infants.

Topics: alpha-Linolenic Acid; Breast Feeding; Cross-Sectional Studies; Dietary Fats; Dietary Supplements; Docosahexaenoic Acids; Electroretinography; Erythrocyte Membrane; Fatty Acids; Fatty Acids, Essential; Fatty Acids, Omega-3; Fatty Acids, Omega-6; Fatty Acids, Unsaturated; Female; Humans; Infant; Infant Food; Linoleic Acid; Male; Membrane Lipids; Milk, Human; Phospholipids; Protein-Energy Malnutrition; Retina; Vision, Ocular

Fatty acids in plasma phospholipids were studied in 35 severely malnourished young children with a median age of 29 mo (range: 9-43 mo), who were either seronegative for human immunodeficiency virus-1 (HIV) (n = 16) or suffered from asymptomatic (stage P-1; n = 12) or symptomatic (stage P-2; n = 7) HIV disease. The malnourished children had significantly lower percentages (% by wt) of phospholipid arachidonic (20:4n-6, AA) and docosahexaenoic (22:6n-3, DHA) acids than 25 age-matched healthy control subjects (AA: 7.05% and 8.70% by wt; DHA: 0.92 and 2.61% by wt, P < 0.001). Body weights of malnourished children did not correlate with linoleic (18:2n-6) and alpha-linolenic (18:3n-3) acid values but were significantly and positively correlated with AA and DHA values (r = 0.40, P = 0.02 and r = 0.63, P < 0.0001, respectively). Plasma concentrations (mg/L) of total phospholipid fatty acids did not differ among seronegative, stage P-1, or stage P-2 patients. Percentage contributions of AA and eicosapentaenoic acid (20:5n-3, EPA) did not differ among those seronegative or in stages P-1 and P-2. In contrast, values of dihomo-gamma-linolenic acid (20:3n-6) were significantly (P < 0.05) lower in stage P-2 (2.38 mg/L) than in either seronegative (3.47 mg/L) or stage P-1 (3.66 mg/L) patients. We conclude that the severely malnourished children developed a depletion of both AA and DHA proportional to the degree of malnutrition.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Arachidonic Acids; Body Weight; Child, Preschool; Docosahexaenoic Acids; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; HIV Infections; HIV-1; Humans; Infant; Linoleic Acid; Linoleic Acids; Phospholipids; Protein-Energy Malnutrition

The fatty acid composition of plasma cholesterol esters, plasma phospholipids, erythrocyte phosphatidylcholine and erythrocyte phosphatidylethanolamine was investigated in severely malnourished Nigerian children with kwashiorkor (n = 12) and marasmus (n = 32). Normally nourished children from the same area (n = 23) served as controls. The malnourished children showed a significant reduction of highly polyunsaturated fatty acids in cholesterol esters, phospholipids and phosphatidylcholine. No differences between the groups were found in erythrocyte phosphatidylethanolamine. Children with kwashiorkor had lower levels of linoleic acid metabolites and docosahexaenoic acid than marasmic children. The results suggest that the kwashiorkor syndrome is associated with impaired desaturation and elongation of PUFA and/or increased lipid peroxidation.

Topics: Arachidonic Acid; Case-Control Studies; Child, Preschool; Docosahexaenoic Acids; Erythrocytes; Fatty Acids, Unsaturated; Humans; Infant; Kwashiorkor; Linoleic Acid; Linoleic Acids; Lipid Peroxidation; Membrane Lipids; Protein-Energy Malnutrition

The fatty acid (FA) composition of the main plasma lipids was analysed in eight well-nourished, generally healthy Nigerian children aged 14.1 +/- 7.2 months and in 17 malnourished children (8 marasmus, 9 kwashiorkor) aged 14.6 +/- 3.8 months within the first 2 days of admission at the Dept. of Child Health, University of Benin. In comparison to the control group, the malnourished children showed a marked decrease of polyunsaturated FA with low linoleic acid, mainly in sterol esters (STE), and severely reduced linoleic acid metabolites, including arachidonic acid, in all lipid fractions. omega-3-FA were not altered except for a reduction of docosapentaenoic and docosahexaenoic acids in phospholipids. Clearly increased values were found for saturated FA in STE and for the non-essential monoenoic FA in all lipid classes. This pattern indicates the presence of essential fatty acid deficiency in the malnourished children. There was no significant difference between marasmus and kwashiorkor. Eight malnourished children were followed up in the early phase of recovery during hospital treatment 14.0 +/- 3.1 days after obtaining the first sample. Linoleic acid had increased again in STE, but its metabolites were as low or even lower than before. An impaired activity of delta-6-desaturase, the rate limiting enzyme of linoleic acid metabolism, in suggested by elevated substrate-product-ratios of this enzyme in untreated children with protein energy malnutrition and in the early phase of recovery, which may be due to low insulin levels, protein and zinc deficiency. The trientetraen ratio (20:3 omega 9/20:4 omega 6) thus is not a reliable indicator of essential FA status in protein-energy malnutrition.

Topics: Arachidonic Acid; Arachidonic Acids; Fatty Acid Desaturases; Fatty Acids; Fatty Acids, Essential; Fatty Acids, Unsaturated; Humans; Infant; Infant Nutrition Disorders; Kwashiorkor; Linoleic Acid; Linoleic Acids; Linoleoyl-CoA Desaturase; Nigeria; Oleic Acid; Oleic Acids; Phospholipids; Protein-Energy Malnutrition; Triglycerides

Topics: Animals; Carbon Radioisotopes; Female; Kinetics; Linoleic Acid; Linoleic Acids; Lipids; Pregnancy; Pregnancy Complications; Pregnancy, Animal; Protein-Energy Malnutrition; Rats; Rats, Inbred Strains