linoleic-acid and Short-Bowel-Syndrome

Topics: Child; Fat Emulsions, Intravenous; Fatty Acids, Omega-3; Humans; Linoleic Acid; Liver Diseases; Parenteral Nutrition; Short Bowel Syndrome

A nursing woman afflicted with short bowel syndrome received parenteral infusions of Intralipid. In the morning following 2 nights of infusion, samples of milk and blood were taken; additional samples were taken the morning after 1 and 2 nights of no infusion. The fatty acid composition of these samples was determined by gas chromatography. The Intralipid infusion contained 51.5% linoleic acid (C18:2). The C18:2 content of the milk was highest (14%) after each infusion and dropped to about 10% on days 1 and 2. Inverse changes were seen in stearic acid (C18:0). The C18:2 content of the plasma showed little change, remaining at about 23%. These results provide further direct evidence that the composition of milk fatty acids can be influenced by changes in the composition of external sources of fatty acids to the lactating mother.

Topics: Chromatography, Gas; Fat Emulsions, Intravenous; Fatty Acids; Female; Humans; Infusions, Parenteral; Kinetics; Lactation; Linoleic Acid; Milk, Human; Short Bowel Syndrome; Stearic Acids

Essential fatty acid (EFA) requirements of patients receiving home parenteral nutrition (HPN) are uncertain.. The objective was to evaluate the influence of the route of administration (enteral compared with parenteral) on plasma phospholipid EFA concentrations.. Intestinal absorption, parenteral supplement of EFAs, and plasma phospholipid EFA concentrations were investigated in balance studies in 4 groups (A, B, C, and D) of 10 patients with short-bowel syndrome and a fecal loss of >2000 kJ/d. Groups A (fat malabsorption <50%) and B (fat malabsorption >50%) did not receive HPN, whereas group C received HPN containing lipids (7.5 and 1.2 g/d linoleic and linolenic acids, respectively) and group D received fat-free HPN.. Intestinal absorption of linoleic and linolenic acids was 8.9 and 1.3 g/d and 2. 6 and 0.4 g/d in groups A and B, respectively, whereas EFA absorption was negligible in groups C and D. Thus, intestinal absorption of EFAs in group A corresponded to parenteral EFA supplements in group C, whereas group D was almost totally deprived of EFAs. The median plasma phospholipid concentration of linoleic acid decreased by 21.9%, >16.3%, >13.8%, 11.0%, and >7.7% and linolenic acid by 0.3%, 0.2%, 0.2%, >0.2%, and 0.1%, respectively, in 10 healthy control subjects and groups A, B, C, and D (P < 0.001).. Intestinally absorbed EFAs maintained plasma EFA status better than did an equal quantity of parenterally supplied EFAs. Intravenous requirements of EFAs in patients with negligible absorption of EFAs are probably higher than the amounts recommended to patients with preserved intestinal absorption of EFAs.

Topics: Adult; alpha-Linolenic Acid; Dietary Fats; Enteral Nutrition; Fatty Acids; Fatty Acids, Essential; Humans; Intestinal Absorption; Linoleic Acid; Middle Aged; Nutritional Requirements; Parenteral Nutrition, Home; Phospholipids; Short Bowel Syndrome