title: Changes in whole-blood PUFA and their predictors during recovery from severe acute malnutrition.
abstract: Children with severe acute malnutrition (SAM) with complications require in-patient management including therapeutic feeding. Little attention has been given to the effects of these feeds on the essential fatty acid status of children with SAM. The objective of this study was to describe changes in the PUFA composition in whole blood in children with SAM during treatment and to determine predictors of change. This prospective study took place in a paediatric nutrition rehabilitation unit in Kampala, Uganda, and assessed whole-blood fatty acid composition of children with SAM at admission, transition, discharge and follow-up (8 and 16 weeks). ANCOVA was used to identify predictors of change in whole-blood PUFA. The study included 120 children with SAM and twenty-nine healthy control children of similar age and sex. Among the SAM children, 38 % were female and 64 % had oedema. Whole-blood n-6 PUFA proportions increased from admission to follow-up, except for arachidonic acid, which decreased by 0·79 (95 % CI 0·46, 1·12) fatty acid percentage (FA%) from admission to transition and 0·10 (95 % CI 0·23, 0·44) FA% at discharge. n-3 Long-chain (LC) PUFA decreased by 0·21 (95 % CI 0·03, 0·40) FA% at discharge and 0·22 (95 % CI 0·01, 0·42) FA% at 8 weeks of follow-up. This decrease was greater in children from families with recent fish intake and those with nasogastric tube feeding. Current therapeutic feeds do not correct whole-blood levels of LCPUFA, particularly n-3 LCPUFA, in children with SAM. Increased attention is needed to the contents of n-3 LCPUFA in therapeutic feeds.
authors.affiliation: 1Mwanamugimu Nutrition Unit,Department of Paediatrics,Mulago Hospital,PO Box 7051, Kampala,Uganda.
authors.forename: Esther
authors.initials: E
authors.lastname: Babirekere-Iriso
authors.affiliation: 2Department of Nutrition, Exercise and Sports,Faculty of Science,University of Copenhagen,1958 Frederiksberg C,Denmark.
authors.forename: Charlotte G
authors.initials: CG
authors.lastname: Mortensen
authors.affiliation: 3Department of Paediatrics,Makerere College of Health Sciences,PO Box 7072, Kampala,Uganda.
authors.forename: Ezekiel
authors.initials: E
authors.lastname: Mupere
authors.affiliation: 2Department of Nutrition, Exercise and Sports,Faculty of Science,University of Copenhagen,1958 Frederiksberg C,Denmark.
authors.forename: Maren J H
authors.initials: MJ
authors.lastname: Rytter
authors.affiliation: 1Mwanamugimu Nutrition Unit,Department of Paediatrics,Mulago Hospital,PO Box 7051, Kampala,Uganda.
authors.forename: Hanifa
authors.initials: H
authors.lastname: Namusoke
authors.affiliation: 2Department of Nutrition, Exercise and Sports,Faculty of Science,University of Copenhagen,1958 Frederiksberg C,Denmark.
authors.forename: Kim F
authors.initials: KF
authors.lastname: Michaelsen
authors.affiliation: 2Department of Nutrition, Exercise and Sports,Faculty of Science,University of Copenhagen,1958 Frederiksberg C,Denmark.
authors.forename: André
authors.initials: A
authors.lastname: Briend
authors.affiliation: 4Department of Kinesiology,University of Waterloo,200 University Avenue,Waterloo, ON,Canada N2L 3G1.
authors.forename: Ken D
authors.initials: KD
authors.lastname: Stark
authors.affiliation: 2Department of Nutrition, Exercise and Sports,Faculty of Science,University of Copenhagen,1958 Frederiksberg C,Denmark.
authors.forename: Henrik
authors.identifier: http://orcid.org/0000-0002-2848-2940
authors.initials: H
authors.lastname: Friis
authors.affiliation: 2Department of Nutrition, Exercise and Sports,Faculty of Science,University of Copenhagen,1958 Frederiksberg C,Denmark.
authors.forename: Lotte
authors.initials: L
authors.lastname: Lauritzen
mesh_terms: D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D005228:Fatty Acids, Essential / Q000008:administration & dosage / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000097:blood*; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D000067011:Severe Acute Malnutrition / Q000178:diet therapy* / Q000188:drug therapy; D011795:Surveys and Questionnaires; D014454:Uganda
chemical_list: D005228:Fatty Acids, Essential; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: %E percentage of energy intake; AA arachidonic acid; ALA 
                    α-linolenic acid; Children; DPA docosapentanoic acid; FA% fatty acid percentage; LA linoleic acid; LCPUFA long-chain PUFA; NG nasogastric; PUFA; RUTF ready-to-use therapeutic feed; Recovery; SAM severe acute malnutrition; Severe acute malnutrition