High‐Oleic Ready‐to‐Use Therapeutic Food Maintains Docosahexaenoic Acid Status in Severe Malnutrition

Abstract

Objective Ready-to-use therapeutic food (RUTF) is the preferred treatment for uncomplicated severe acute malnutrition. RUTF contains large amounts of linoleic acid and very 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. Methods We conducted a prospective, randomized, double-blinded, clinical effectiveness trial treating rural Malawian children with severe acute malnutrition. Children were treated with either HO-RUTF or standard RUTF. Plasma phospholipid (PL) fatty acid status was measured upon enrollment and after 4 weeks and compared between the two intervention groups. Results Among the 141 children enrolled, 48/71 receiving HO-RUTF and 50/70 receiving RUTF recovered. Plasma PL 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 (P < 0.001). For arachidonic acid, the change in content was −3% and 13% in the HO-RUTF and RUTF groups (P < 0.009). Conclusions The changes in DHA and EPA seen in the children treated with HO-RUTF warrant further investigation as they suggest HO-RUTF support improved PUFA status, necessary for neural development and recovery.

Whole Blood Levels of the n-6 Essential Fatty Acid Linoleic Acid Are Inversely Associated with Stunting in 2-to-6 Year Old Tanzanian Children: A Cross-Sectional Study

“…Thus, rapid conversion of LA to ARA could limit the amount of LA available for incorporation into skin ceramides, but may increase endocannabinoid levels. Additionally, dietary intake of other FAs affects desaturase and elongase enzyme activities [ 89 – 92 ] so intake of other dietary FAs, such as high levels of oleic acid [ 29 , 90 ], could be responsible for the EFA levels observed in the current study. Unfortunately, it was outside the scope of the present study to assess FADS genotype or dietary intake.…”

Treatment of severe acute malnutrition with oat or standard ready-to-use therapeutic food: a triple-blind, randomised controlled clinical trial

“…The formulation was cost-optimised using a linear programming tool, which considered the current ingredient costs and nutrient compositions to craft a formulation that met UNICEF specifications while minimising ingredient costs. The oat formulation was also optimised for polyunsaturated fatty acid composition by reducing linoleic acid (omega-6) and increasing the α-linolenic acid (omega-3) 5–7…”

Stunting is a recognized problem: Evidence for the potential benefits of ω-3 long-chain polyunsaturated fatty acids

“…The effect of long chain PUFA substitution for malnutrition children have been reported in 2 studies by Jones et al (2015) 17 and Hsieh et al (2015) 18 . In study by Jones et al (2015) reported that malnourished children who had received high-oleic RUTF made with peanut oil from a high-oleic acid peanut cultivar, hence the ratio of linoleic acid (LA) to alpha-linolenic acid (ALA) achieving 1:1 had a significantly better weight-for height (WFH) at the time they recovered from malnutrition compared to children who were fed with standard RUFT that contained 53 times more LA than ALA, although still marginally below average weight-forheight 17 .…”