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

Abstract

BackgroundIn Tanzania, 35% of all children below five years of age are stunted. Dietary fatty acids (FA) are critical for growth and development. However, whole blood FA levels in Tanzanian children are poorly described.ObjectiveThe objectives of this cross-sectional study were to assess 1) whole blood levels of essential fatty acids and 2) the association between whole blood FA levels and growth parameters in Tanzanian children 2–6 years of age.MethodsA drop of blood was collected on an antioxidant treated card and analyzed for FA composition. Weight and height were measured and z-scores calculated. Relationships between FAs and growth parameters were analyzed by linear regression.ResultsOf the 334 children that participated, 30.3% were stunted. The average whole blood level of Mead acid was 0.15%. The anthropometric z-score height-for-age (HAZ) was inversely associated with Mead acid, the Mead acid to arachidonic acid (T/T) ratio, and total n-9 FA. Additionally, HAZ was positively associated with linoleic acid and total n-6 FA. BMI-for-age was positively associated with oleic acid, total n-9 FA and T/T ratio but inversely associated with arachidonic acid and total n-6 FA. Weight-for-height was inversely associated with arachidonic acid and total n-6 FAs and positively associated with oleic acid and total n-9 FA. Weight-for-age was not associated with any FA tested. Total n-3 FAs were not associated with any growth parameters measured.ConclusionsThe EFA linoleic acid and the markers of FA deficiency were associated with HAZ, an indicator for stunting in 2–6 year old Tanzanian children. Total n-6, total n-9, and a number of individual FAs were associated with growth. Increasing dietary intake of EFA and n-6 FAs may be a strategy to combat stunting in this population.

Children With Intestinal Failure Undergoing Intestinal Rehabilitation Are at Risk for Essential Fatty Acid Deficiency

“…PN lipid composition plays a dominant role in the FA status regardless of simultaneous enteral feeding, and here an increased TTR was observed only in patients receiving a combination of OO and SO (80:20) or no lipids at all as part of their home PN. [23][24][25][26][27][28] Traditionally, the cutoff for EFAD is defined as TTR above 0.2, while clinical symptoms are generally present when this ratio exceeds 0.4. 19 However, studies investigating healthy cohorts have shown TTR values between 0.01 and 0.04 (Table 1), and these are used as reference values here as well.…”

“…Table 2 contains detailed information about PN and growth in the subgroups. Duration of PN before the S-FA-Fr% measurements was 18 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) months in the supplemental PN group and 5.5 (3.8-21) months in the predominantly PN group. In the predominantly PN group (n = 20), both Clinoleic R and Omegaven R were given to 8 patients, Clinoleic R alone to 6, SMOFlipid R together with Omegaven R to 3, and SMOFlipid R or Omegaven R only to 1 each.…”

Upper arm fat and muscle in stunted and non-stunted children aged 0-24 months

“…Fatty acid n-9 is a nonessential fatty acid, which can be synthetized from fatty acid n-3 and n-6 using D-5 and D-6 desaturases, as well as elongases. 18 Our study shows that smaller fat and muscle area in stunted children is clinically important. Decreased muscle mass is related to high mortality among children.…”

“…Children with insufficient intake of fatty acids have higher risk of stunting with poor fat and muscle growth. 18 Tanzanian children aged 2-6 years with low intake of fatty acid n-6 had a high prevalence of stunting, however, increased intake of fatty acid n-9 correlated with stunting. Fatty acid n-9 is a nonessential fatty acid, which can be synthetized from fatty acid n-3 and n-6 using D-5 and D-6 desaturases, as well as elongases.…”

Association of Higher Omega-6/Omega-3 Fatty Acids in the Diet with Higher Prevalence of Metabolic Syndrome in North India

“…There is evidence that omega-6 and omega-3 fatty acids elicit divergent effects on body fat gain through mechanisms of adipogenesis, browning of adipose tissue, lipid homeostasis, brain-gut-adipose tissue axis, and most importantly systemic inflammation [53][54][55][56]. Prospective studies clearly show an increase in the risk of obesity as the level of omega-6 fatty acids and the omega-6/omega-3 ratio increase in red blood cell (RBC) membrane phospholipids, whereas high omega-3 RBC membrane phospholipids decrease the risk of obesity.…”