Fatty acid status in children with undernutrition, Phnom Penh, Cambodia

Abstract:

BACKGROUND: Cambodia has a high prevalence of undernutrition especially among children. The main animal source of protein in Cambodia is fish or fish products, which are usually rich in n-3 fatty acids. The fatty acids composition and possible implications for rehabilitation among undernourished children are unknown. 

OBJECTIVE: The objective of this study was to examine the whole blood fatty acid composition in undernourished Cambodian children (> 6 months of age) with WHZ or BAZ < -1 z-score, and to evaluate fatty acid status in relation to wasting status, anemia status and HIV status. Correlations between fatty acid status and nutritional status indicators (anthropometric measures and hemoglobin level) are investigated along with the implication of blood cell counts for interpretation of whole blood fatty acid composition.

METHODS: The study was a cross-sectional study using baseline measurement from an ongoing study, known as the SAM study: Effectiveness of a locally produced RUTF in comparison with the current imported RUTF (BP-100TM) for the management of severe acute malnutrition in Cambodian children: a Randomized Controlled Trial. The children were assessed for anthropometric measures using standard methods. Socio-economic background was assessed by questionnaire administered to caretakers. Venous blood (40 µl whole blood) was collected in an EDTA coated tubes. A dried blood spot (DBS) was preserved on chromatography paper for analysis of fatty acid composition at Waterloo University, Canada, using gas chromatography with iron flame ionization detection. Hemoglobin and complete blood count were analysed using hematology analyser.

RESULTS: No indication were found of n-6 or n-3 PUFA deficiency. Whole fatty acids composition were not found to be impacted by wasting status or anemia status (p >0.05). On the other hand HIV infection seems to influence five fatty acids classes (palmitic acid, steric acid, docosadienoic acid, gondoic acid and erucic acid (p <0.05). Fatty acids classes (PUFAs and LCPUFAs) were found to be correlated with nutritional status (body weight, BMI, biceps and triceps skinfold). No associations were found between fatty acid classes and hemoglobin levels, anemia status or HIV infection. Monocytes were associated with specific fatty acids.

CONCLUSION: No signs of n-6 PUFA or n-3 PUFA deficiency were present in this study. The study showed an indication of specific fatty acids associated with nutritional status. Further studies interpreting whole blood fatty acid composition should consider including complete blood counts in a clinical setting to avoid confounding.