Assessment of essential fatty acid and omega3-fatty acid status by measurement of erythrocyte 20:3omega9 (Mead acid), 22:5omega6/20:4omega6 and 22:5omega6/22:6omega3.

BACKGROUND: Early suspicion of essential fatty acid deficiency (EFAD) or omega3-deficiency may rather focus on polyunsaturated fatty acid (PUFA) or long-chain PUFA (LCP) analyses than clinical symptoms. We determined cut-off values for biochemical EFAD, omega3-and omega3/22:6omega3 [docosahexaenoic acid (DHA)]-deficiency by measurement of erythrocyte 20:3omega9 (Mead acid), 22:5omega6/20:4omega6 and 22:5omega6/22:6omega3, respectively. METHODS: Cut-off values, based on 97.5 percentiles, derived from an apparently healthy omnivorous group (six Dominica breast-fed newborns, 32 breast-fed and 27 formula+LCP-fed Dutch low-birth-weight infants, 31 Jerusalem infants, 33 Dutch 3.5-year-old infants, 69 omnivorous Dutch adults and seven Dominica mothers) and an apparently healthy group with low dietary LCP intake (81 formula-fed Dutch low-birth-weight infants, 12 Dutch vegans). Cut-off values were evaluated by their application in an EFAD suspected group of 108, mostly malnourished, Pakistani children, three pediatric patients with chronic fat-malabsorption (abetal-ipoproteinemia, congenital jejunal and biliary atresia) and one patient with a peroxisomal beta-oxidation disorder. RESULTS: Erythrocyte 20:3omega9, 22:5omega6/20:4omega6 and 22:5omega6/22:6omega3 proved age-dependent up to 0.2 years. Cut-off values for ages above 0.2 years were: 0.46mol% 20:3omega9 for EFAD, 0.068mol/mol 22:5omega6/20:4omega6 for omega3-deficiency, 0.22mol/mol 22:5omega6/22:6omega3 for omega3/DHA-marginality and 0.48mol/mol 22:5omega6/22:6omega3 for omega3/DHA-deficiency. Use of RBC 20:3omega9 and 22:5omega6/20:4omega6 cut-off values identified 20.4% of the Pakistani subjects as EFAD+omega3-deficient, 12.9% as EFAD+omega3-sufficient, 38.9% as EFA-sufficient+omega3-deficient and 27.8% as EFA-sufficient+omega3-sufficient. The patient with the peroxisomal disorder was classified as EFA-sufficient, omega3-sufficient (based on RBC 22:5omega6/20:4omega6) and omega3/DHA-deficient (based on RBC 22:5omega6/22:6omega3). The three other pediatric patients were classified as EFAD, omega3-deficient and omega3/DHA-deficient. CONCLUSION: Use of the combination of the present cut-off values for EFA, omega3 and omega3/DHA status assessment, as based on 97.5 percentiles, may serve for PUFA supplement intervention until better concepts have emerged.

Development of low-birthweight infants at 19 months of age correlates with early intake and status of long-chain polyunsaturated fatty acids.

We investigated the influence of early nutrition with and without long-chain polyunsaturated fatty acids (LCP) on later development of < or = 2500 g newborns receiving preterm formula without LCP (n=75), preterm formula with 18:3omega6 and LCPomega3 (at two doses; n=26) or their mother's own milk (n=27). All diets were given from birth to day 42. Erythrocytes (RBC) fatty-acid compositions were determined on day 42. Bayley's mental development (MDI) and psychomotor development (PDI) indices were assessed at 19 months. Multivariate regression analysis revealed that PDI was most strongly related to RBC 22:6omega3 in the cohort of 101 infants who received formula. The most consistent correlations were between development and early LCPomega3 intake, and between development and parameters of RBC LCPomega3 status day 42, in infants who received formula with 18:3omega6 and LCPomega3. Development of formula-fed low-birthweight infants seems positively influenced by early dietary LCPomega3.

Does supplementation of formula with evening primrose and fish oils augment long chain polyunsaturated fatty acid status of low birthweight infants to that of breast-fed counterparts?

We investigated whether formulae with evening primrose and fish oils raise long chain polyunsaturated fatty acids (LCPUFA) in plasma cholesterol esters (CE), erythrocytes (RBC) and platelets (PLT) to levels encountered in breast-fed infants. Low birthweight infants (< or =2500 g) received LCP1 formula (n = 16; 0.31% 18:3 omega6, 0.17% 20:5 omega3 and 0.20% 22:6 omega3) or LCP2 formula (n = 13; 0.32% 18:3 omega6, 0.34% 20:5 omega3 and 0.43% 22:6 omega3). Fatty acids were measured days 10+/-2, 20+/-3 and 42+/-3. The formulae raised CE, RBC and PLT 20:5 omega3 and 22:6 omega3 dose-dependently (P<0.01), to exceed levels of breast-fed babies (n = 18) day 42 (P<0.05). CE, RBC and PLT 20:3 omega6 was comparable with, and CE, RBC, PLT 20:4 omega6 were below, that of breast-fed infants (P<0.05). Dietary 20:5 omega3 and 22:6 omega3 related with CE, RBC and PLT 20:5 omega3 and 22:6 omega3 (n = 47; P< or =0.01). Dietary 20:5 omega3 and LCPUFA omega3 related inversely with CE, RBC and PLT 20:4 omega6 and LCPUFA omega6 (P< or =0.002). LCP1 and LCP2 fed infants had similar LCPUFA omega6 status day 42. Added 18:3 omega6 does not correct 20:4 omega6 to that of breast-fed infants, but improves 20:3 omega6 status. Fish oil dose-dependently raises 20:5 omega3 and 22:6 omega3, but decreases 20:4 omega6 and other LCPUFA omega6.

Erythrocyte and plasma cholesterol ester long-chain polyunsaturated fatty acids of low-birth-weight babies fed preterm formula with and without ribonucleotides: comparison with human milk.

We investigated whether a regular formula for premature infants (pre) supplemented with ribonucleotides (pre+RN) raises erythrocyte and plasma cholesterol ester (CE) long-chain polyunsaturated fatty acids (LCPUFAs) of low-birth-weight babies (< or = 2.50 kg) compared with their breast-fed counterparts. From days 11 to 42, 31 babies received the pre formula and 37 received pre+RN. Eleven breast-fed babies served as a reference group. Erythrocytes and CE fatty acids were determined on days 11, 21, and 42. There were no differences in the courses of erythrocytes and CE fatty acids between pre formula-fed and pre+RN-fed babies. On day 42, formula-fed babies had lower erythrocytes and CE n-3 and n-6 LCPUFAs compared with breast-fed babies. Subdivision into gestational age- and body weight-matched subgroups gave similar results. RN supplementation does not augment the erythrocyte and CE LCPUFA status of formula-fed babies.