A cross-sectional study of the growth characteristics of Nigerian infants from birth to 2 years of age.

Malnutrition compromises the growth of children in sub-Saharan Africa. In Nigeria, the prevalence of childhood malnutrition approaches 40%. There are few reports relating the growth characteristics of breast-fed Nigerian infants to the anthropometric properties of their mothers. A total of 100 urban and rural mother/baby pairs were recruited. The mean BMI values of the urban and rural mothers were 24.2 and 21.3 kg m(-2), respectively. The mean length, weight and head circumference of the rural infants were significantly lower than those of the urban infants. Z-scores based on World Health Organization standards showed: (i) length-for-age z-score <-2 in urban (27%) and rural (33%) children; (ii) a higher incidence of underweight and small HC in rural (33%; and 13%) versus urban children (12% and 0%); and (iii) positive correlations between all three z-scores and maternal BMI. Negative correlations were observed between infant age and z-scores for length-for-age, weight-for-age and HC-for-age.

Subclinical vitamin B12 deficiency in pregnant women attending an antenatal clinic in Nigeria.

SUMMARY: Inadequate vitamin B12 status in a pregnant woman increases the risk for adverse maternal and fetal outcomes. The use of serum vitamin B12 concentration alone to assess vitamin B12 status in pregnant women is unreliable because of the decrease in serum vitamin B12 levels in normal pregnancy. The combination of serum vitamin B12 and methylmalonic acid (MMA) concentrations may provide a better estimate of vitamin B12 status. We obtained blood samples from 98 pregnant women in the third trimester at an antenatal clinic in Jos, Nigeria. All subjects were taking iron and folate supplements. Twelve of the subjects had a serum vitamin B12 concentration <148 pmol/l and 18 subjects had a serum MMA level >271 nmol/l. Using a combination of low serum vitamin B12 and elevated MMA concentrations, eight subjects were classified as having subclinical vitamin B12 deficiency. Because of the potential harmful consequences of vitamin B12 deficiency in pregnant women, it would be advisable to add vitamin B12 supplements to the existing regimen of folate and iron supplements currently provided to pregnant women in Nigeria.

Assessment of the bone quality of black female athletes using quantitative ultrasound.

AIM: The mean daily calcium intake of adult Nigerians is reportedly low, and animal studies have shown that exercise-induced changes in the bones of growing mice are gender specific. We therefore sought to describe calcaneal broadband ultrasound attenuation (BUA), speed of sound (SOS), stiffness index (SI) and SI-based T-scores in a cohort of Nigerian female athletes; to assess the correlation of SI with energy expenditure; and to compare mean SI values between sports. METHODS: We recruited 52 female athletes in 10 sporting categories, and recorded their anthropometric data. Activity levels were estimated using a questionnaire. Bone density was assessed using calcaneal ultrasound. RESULTS: The mean age of athletes was 21+/-4 years (range 15-39 years). The mean body mass index (BMI) was 22.0+/-3.5 kg/m2, and was not different between the sub-group of footballers/runners (21.3+/-1.7 kg/m2) and other athletes (23.1+/-4.8 kg/m2, P=0.06). The mean energy expenditure was 32.2+/-9.5 kcal/kg/ day, and was not different between the sub-group of footballers/runners (30.8+/-9.2 kcal/kg/day) and other athletes (34.3+/-9.7 kcal/kg/day, P=0.19). The mean BUA of the athletes was 135+/-14 dB/MHz, the mean SOS was 1597+/-13 m/s, the mean SI was 118+/-15, and the median SI-based T-score was +1.1 (-1.6 to +3.53). The means of all ultrasound parameters were not significantly different between footballers/runners and other sportswomen. CONCLUSION: Consistent physical training may improve calcaneal SI of black females by one, and potentially by as much as three T-score units. Training intensity, rather than the qualitative aspects of a sport, appears to be a major determinant of SI in female Nigerian athletes.

Comparison of the clock test and a questionnaire-based test for screening for cognitive impairment in Nigerians.

BACKGROUND: Since it is projected that by 2020 seventy percent of the elderly will reside in developing countries, a reliable screening method for dementia and cognitive impairment in general in populations with diverse languages, culture, education and literacy will be needed. We sought to determine if the Clock Test, a screening test for dementia, was suitable for use in a Nigerian population. STUDY DESIGN: Cross-sectional survey of 54 men and 12 women from Northern Nigeria. Researchers administered two dementia screening tools: a questionnaire-based test adapted for use in a Nigerian population and the Clock Test. RESULTS: Overall, 53.0% of the subjects had an abnormal Clock Test whereas 10.6% of the subjects had an abnormal questionnaire score. Only 9.1% of the subjects had abnormal scores on both tests. Subjects with more schooling had a greater probability of having a positive clock concept (understanding that a circle represented a clock). Of those with more than 6 years of schooling, 91.0% had a positive clock concept. Subjects with a negative clock concept were more likely to have an abnormal Clock Test (93.3%) than a questionnaire (26.6%). CONCLUSIONS: The main finding of our study was the discrepancy between the results of the Clock Test and the questionnaire. Performance on the Clock Test appeared to have been heavily influenced by education level, indicating the test is not universally applicable across cultures. The questionnaire-based test appears to reduce the effects of illiteracy on assessing dementia in a Nigerian population. Larger studies should be done to control for how education affects the assessment of dementia.

Lysosomal enzymes in preeclamptic women in northern Nigeria.

BACKGROUND: The incidence of preeclampsia is high in northern Nigeria, as it is in many other developing countries, and preeclampsia is associated with significant maternal and fetal morbidity and mortality. We inquired if proteinuria or hypertension alone could account for the altered concentrations of urinary lysosomal hydrolases that have been reported in preeclamptic women and pregnant women without preeclampsia. METHODS: The activities of urinary beta-hexosaminidase and beta-galactosidase were determined fluorometrically in pregnant women assigned to one of four groups: Group I: 41 preeclamptic women; Group II: 31 hypertensive aproteinuric women; Group III: 44 normotensive proteinuric women; and Group IV: 52 healthy pregnant women (controls). RESULTS: The urinary beta-hexosaminidase concentrations were decreased in the preeclamptic women (P<0.005) and proteinuric women (P<0.001) when compared to the healthy pregnant controls. There was no significant difference in beta-hexosaminidase concentrations between the hypertensive women and the healthy pregnant controls. The urinary beta-galactosidase concentrations for preeclamptic, hypertensive, and proteinuric women did not differ significantly versus healthy pregnant controls. CONCLUSIONS: The reduced urinary excretion of beta-hexosaminidase in preeclamptic women is associated with proteinuria, but not hypertension. Measuring urinary concentrations of lysosomal hydrolases alone or in conjunction with urinary protein concentrations is not likely to be useful in predicting or monitoring the clinical course of preeclampsia; however, it might prove important in gaining a more complete understanding of the pathogenesis of renal tubular epithelial cell injury and proteinuria that occurs in preeclampsia.

Serum potassium and acid-base parameters in severe dialysis-associated hyperglycemia treated with insulin therapy.

We analyzed the changes in serum potassium concentration ([K]) and acid-base parameters in 43 episodes of dialysis-associated hyperglycemia (serum glucose level > 33.3 mmol/L), 22 of which were characterized as diabetic ketoacidosis (DKA) and the remaining 21 as nonketotic hyperglycemia (NKH). All episodes were treated with insulin therapy only. Age, gender, initial and final serum values of glucose, sodium, chloride, tonicity and osmolality did not differ between DKA and NKH. At presentation, serum values of [K] (DKA 6.2 +/- 1.3 mmol/L; NKH 5.2 +/- 1.5 mmol/L) and anion gap [AG] (DKA 27.2 +/- 6.4 mEq/L; NKH 15.4 +/- 3.5 mEq/L) were higher in DKA, whereas serum total carbon dioxide content [TCO2 ] (DKA 12.0 +/- 4.6 mmol/L; NKH 22.5 +/- 3.1 mmol/L), arterial blood pH (DKA 7.15 +/- 0.09; NKH 7.43 +/- 0.07) and arterial blood PaCO2 (DKA 26.2 +/- 12.3 mm Hg; NKH 34.5 +/- 6.7 mm Hg) were higher in NKH. At the end of insulin treatment, serum values of [K] (DKA 4.0 +/- 0.7 mmol/L, NKH 4.0 +/- 0.5 mmol/L), [AG] (DKA 16.3 +/- 5.4 mEq/L, NKH 14.9 +/- 3.0 mEq/L), [TCO2 ] (DKA 23.5 +/- 5.0 mmol/L, NKH 24.1 +/- 4.2 mmol/L), arterial blood pH (DKA 7.42 +/- 0.09, NKH 7.51 +/- 0.14) and arterial blood PaCO2 (DKA 31.8 +/- 6.7 mm Hg, NKH 34.2 +/- 8.3 mm Hg) did not differ between the two groups. Linear regression of the decrease in serum [K] value during treatment, (Delta[K]), on the presenting serum [K] concentration,([K]2 ), was: DKA, Delta[K] = 2.78 - 0.81 x [K]2 , r = -0.85, p < 0.001; NKH, Delta[K] = 2.44 - 0.71 x [K]2 , r = -0.90, p < 0.001. The slopes of the regressions were not significantly different. Stepwise logistic regression including both DKA and NKH cases identified the presenting serum [K] level and the change in serum [TCO2 ] value during treatment as the predictors of Delta[K] (R2 = 0.81). Hyperkalemia is a feature of severe hyperglycemia (DKA or NKH) occurring in patients on dialysis. Insulin administration brings about correction of DKA and return of serum [K] concentration to the normal range in the majority of the hyperglycemic episodes without the need for other measures. The initial serum [K] value and the change in serum [TCO2 ] level during treatment influence the decrease in serum [K] value during treatment of dialysis-associated hyperglycemia with insulin.

Factors contributing to maternal mortality in north-central Nigeria: a seventeen-year review.

Maternal mortality ratio in Nigeria is one of the highest in the world. This paper reports a facility based study in north-central Nigeria to determine the magnitude, trends, causes and characteristics of maternal deaths before and after the launch of the Safe Motherhood Initiative in Nigeria, with a view to suggesting strategic interventions to reduce these deaths. The records of all deliveries and case files of all women who died during pregnancy and childbirth between January 1, 1985 and December 31, 2001, in the maternity unit of Jos University Teaching Hospital, Jos, Nigeria, were reviewed. Data collected were analysed for socio-biological variables including age, booking status, educational level, parity, ethnic group, marital status, mode of delivery, duration of hospital stay before death occurred, cause (s) of maternal deaths. There were 38,768 deliveries and 267 maternal deaths during the period under review, giving a maternal mortality ratio (MMR) of 740/ 100,000 total deliveries. The trend fluctuated between 450 in 1990 and 1,010/100.000 deliveries in 1994. The mean age of maternal death was 26.4 (SD 8.1) years. The greatest risk of MMR was among young teenagers (> 15 years) and older women (< 40 years). Parity-specific maternal mortality ratio was highest in the grand multiparous women. Unbooked as well as illiterate women were associated with very high maternal mortality ratio. The Hausa - Fulani ethnic group contributed the largest number (44%) by tribe to maternal mortality in our study. The major direct causes of deaths were haemorrhage (34.6%), sepsis (28.3%), eclampsia (23.6%) and unsafe abortion (9.6%). The most common indirect causes of death were hepatitis (18.6%), anaesthetic death (14.6%), anaemia in pregnancy (14.6%), meningitis (12.0%), HIV/AIDS (10.6%) and acute renal failure (8.0%). Seventy-nine percent of the maternal deaths occurred within 24 hours of admission. Most of the deaths were preventable. A regional-specific programme should be planned to reduce the deplorably high maternal mortality in north-central Nigeria.

Ascorbic acid intake and plasma levels in healthy elderly people.

Plasma ascorbic acid concentrations were determined in eight men and nine women over age 65 on controlled intakes of vitamin C. Plasma ascorbic acid levels were significantly lower in elderly men compared with women for vitamin C intakes ranging from 30 to 280 mg/d. A maximum steady-state level of 1.0 mg/dL (56.78 mumol/L) ascorbic acid was observed in male subjects at an intake of approximately 150 mg/d; female subjects approached a plasma ascorbate level of 1.0 mg/dL (56.78 mumol/L) with an intake of approximately 80 mg/d. At a total vitamin C intake of 60 mg/d, plasma ascorbate levels in men were estimated to be 0.4 mg/dL (22.71 mumol/L) or less. The amount of dehydroascorbic acid in plasma did not vary with intake of vitamin C.

Ascorbate and dehydroascorbate: distribution in mononuclear cells of healthy elderly people.

Concentrations of ascorbic acid and total ascorbate (ascorbic acid + dehydroascorbic acid) were determined in mononuclear cells from eight elderly men and nine elderly women (aged greater than 65 y) on controlled intakes of vitamin C. No increase in mononuclear cell ascorbic acid concentration was observed for intakes between 30 and 280 mg/d. A significant increase in total ascorbate concentrations was observed for the same range of intakes (p less than 0.01), primarily because of an increase in dehydroascorbic acid. Women were found to have significantly higher ascorbic acid concentrations in mononuclear cells than men (p less than 0.02) for similar intakes of vitamin C. No difference was observed for total ascorbate concentrations. The ratio of dehydroascorbate to ascorbate increased with increasing intake of vitamin C for both men and women.

Longitudinal study of dietary intakes and plasma lipids in healthy elderly men and women.

Dietary intakes and blood lipid concentrations were assessed in elderly men (n = 65) and women (n = 92) from 1980 through 1989. Mean age in 1980 was 70 y (range 60-84 y). Health and socioeconomic status was above that found in the general US elderly population. Cross-sectional and longitudinal changes in variables were determined by using least-squares linear regression. No significant cross-sectional differences in energy (kJ/kg), protein (g/kg), total fat, and carbohydrate intake with age was noted. Significant longitudinal decreases in total fat, saturated and polyunsaturated fatty acids, and cholesterol intakes were noted in both men and women. Significant decreases in total, HDL, and LDL plasma cholesterol concentrations were noted over time in both men and women. Ratios of both total and LDL cholesterol to HDL cholesterol increased over time. The decrease in total fat and cholesterol intakes were significantly correlated with the decrease in total plasma cholesterol.

Clinical chemistry reference intervals for healthy elderly subjects.

In 1979, 304 healthy elderly individuals in New Mexico were recruited for a longitudinal study of nutrition and aging. Repeat measurements on a yearly basis of commonly requested clinical chemistry analytes allowed the calculation of reference intervals, between and within-subject variance components, and percentiles for change in concentration between two yearly measurements. The latter was further divided into analytical and biological variance components. The upper 95th percentile for the difference between two yearly measurements, expressed as a percent of the population mean, ranged from 4% for Na+ to approximately 20% for total cholesterol and to greater than 90% for ferritin. Year-to-year differences attributable to the biological component ranged from a low of 2% of the population mean for Na+ to 70% for gamma-glutamyltransferase.

A longitudinal study of the relationship between vitamin A supplementation and plasma retinol, retinyl esters, and liver enzyme activities in a healthy elderly population.

This study examined the association between dietary supplementation with vitamin A and biochemical symptoms of toxicity in 116 healthy elderly volunteers (47 male, 69 female), aged 64-88 y. Plasma retinol and retinyl ester concentrations, seven liver-function tests, and dietary and supplemental vitamin A intakes were measured annually for 5 y. Supplemental intake range was 0-47,000 IU/d; dietary intake range was 2528-23,032 IU/d. Fasting retinol and retinyl ester concentrations were determined by HPLC and dietary intake was assessed by a 3-d food record. Supplemental vitamin A intake was highly correlated with retinyl ester concentrations (r = 0.74, P = 0.0001). Retinyl esters ranges from 3.4% to 10.2% of retinol concentrations. Retinyl ester concentrations did not increase over time, regardless of supplement amount. The association of retinyl esters and liver-function tests was significant only for aspartate aminotransferase activity in females (r = 0.47, P = 0.0001). The supplementation amount in this study was not associated with vitamin A toxicity.

Cardiovascular disease risk factors and diet of Fulani pastoralists of northern Nigeria.

BACKGROUND: The Fulani of northern Nigeria are seminomadic pastoralists who consume a diet rich in saturated fats, do not use tobacco, are lean, and have an active lifestyle. Little is known about their serum lipid profiles and corresponding risk of cardiovascular disease. OBJECTIVE: We measured serum lipid, homocysteine, folate, and vitamin B-12 concentrations in Fulani men and women and assessed the nutrient content of their diet. DESIGN: Blood samples from 42 men (18-64 y old) and 79 women (15-77 y old) living in the Jos Plateau of Nigeria were analyzed for cholesterol (total, HDL, and LDL), triacylglycerol, homocysteine, folate, and vitamin B-12 serum concentrations. Body composition was determined by bioelectrical impedance analysis. Dietary information was obtained with use of a 7-d dietary recall and a food-frequency questionnaire. Results were compared with US referent ranges. RESULTS: The mean energy content of the Fulani diet was relatively low (men, 6980 kJ; women, 6213 kJ) and the mean protein content was high (men, 20% of energy; women, 16% of energy). Nearly one-half of energy was provided by fat, and one-half of that was derived from saturated fatty acids. The diet provided marginal to adequate amounts of vitamins B-12, B-6, and C but only one-third of the US recommended dietary allowance for folate. The mean total cholesterol, HDL-cholesterol, and triacylglycerol concentrations of Fulani adults were within the referent ranges; the mean LDL-cholesterol concentration of Fulani adults below the range; and the mean serum homocysteine concentration of Fulani men above the range. Homocysteine and folate concentrations were inversely correlated for both men and women. CONCLUSIONS: Despite a diet high in saturated fat, Fulani adults have a lipid profile indicative of a low risk of cardiovascular disease. This finding is likely due to their high activity level and their low total energy intake.

Assessment of the skeletal health of healthy Nigerian men and women using quantitative ultrasound.

The dietary intake of calcium by African populations, particularly in sub-Saharan Africa, is relatively low compared to the recommended intake for US adults. However, the rate of osteoporotic fractures in West African women is reported to be less than that for Caucasian populations. Because there is little published data regarding the skeletal status of African men and women, we used quantitative ultrasound (QUS) to assess the bone density of 435 Nigerian women and 321 Nigerian men between 16 and 89 years of age. A progressive decline in bone quality was observed beginning at about 40 years of age for both men and women. The mean stiffness index (SI) for the women between 20 and 35 years of age (n = 186) in this study was 102 +/- 17. The equation that best described the age versus SI relationship for women was SI = 79.7 + 1.887 (age) + -0.043 (age)2 + 0.00020 (age)3. For Nigerian men, the peak SI of 115 +/- 17 was seen in the 20- to 29-year-old age group. For men, the SI values remained above 100 until about age 60 years when a significant decline in SI was then observed. The best-fit curve of SI versus age for men was SI = 134.9 - 1.27 (age) + 0.019 (age)2 - 0.00014 (age)3. The broadband ultrasound attenuation (BUA), speed of sound (SOS), and SI values for the Nigerian men and women were comparable to or higher than those reported for Caucasian and Asian populations. These data should serve as reference values for adult men and women in sub-Saharan Africa.

Nutrient content of earthworms consumed by Ye'Kuana Amerindians of the Alto Orinoco of Venezuela.

For the Makiritare (Ye'Kuana) native people of the Alto Orinoco (Venezuela), earthworms (Anellida: Glossoscolecidae) are an important component of the diet. Two species in particular are widely consumed: 'kuru' (Andiorrhinus kuru n. sp.) and 'motto' (Andiorrhinus motto). We analysed eviscerated kuru body proper, and whole and smoked preparations of motto for their content of protein and amino acids, fatty acids and 20 minerals and trace elements. The samples contained large amounts of protein (64.5-72.9% of dry weight), essential amino acids, calcium and iron together with notable quantities of other important elements, indicating that these earthworms contain potentially useful quantities of many nutrients that are critical to the health of the humans who consume them.

Ascorbic acid intakes and plasma levels in healthy elderly.

The data presented show that elderly men have significantly lower plasma ascorbic acid concentrations than elderly women at similar intakes of ascorbic acid. We hypothesize that this difference is due to lower renal tubular reabsorption of ascorbic acid in elderly men. The finding that more than half of the healthy elderly men had plasma ascorbic acid levels less than 0.3 mg/dl with daily intakes of ascorbic acid in the range of 40 to 50 mg raises concern about the rationale of lowering the RDA for vitamin C from the current value of 60 mg to 40 mg for men and 30 mg for women. This recommendation is inconsistent with efforts to improve the health status of elderly Americans by assuring adequate intakes of all essential nutrients. Our data do not allow us to determine an optimal intake of ascorbic acid for the elderly. The possibility of increased health benefits associated with intakes that exceed the current RDA of 60 mg needs to be examined. We believe, however, that a prudent approach to both of these questions would be to recommend that elderly receive a daily ascorbic acid intake that would allow plasma concentration to be maintained at or near 1.0 mg/dl. The daily level of intake required to maintain this level would be approximately 125 mg and 75 mg in healthy elderly men and women respectively. These intakes would assure adequate body reserves of ascorbic acid.

Correlation between the content of intermediate chain-length fatty acids and copper in the milk of Fulani women.

Intermediate chain-length fatty acids (C10-C14) in human milk triglycerides provide an easily absorbable fuel that provide a significant amount of the energy needed for growth during the first few months of life. The C10-C14 fatty acid and trace mineral content of human milk is variable. In this report we examined the relationship between the content of calcium, copper, magnesium, manganese, phosphorus, and zinc, and the weight percentage of C10-C14 fatty acids in milk from 33 Fulani women in northern Nigeria between 2 and 24 weeks post-gestation. The milk from these women contained proportions of C10-C14 fatty acids that were comparable to those reported for other populations around the world, as were the concentrations of Ca, Cu, Mg, Mn, Zn and P. Significant correlations were observed between the milk content of Cu and the wt% of C10 (P=0. 005, r=0.475), C12 (P=0.001, r=0.539), C14 (P=0.44, r=0.352) and the total intermediate chain-length fatty acids (P=0.008, r=0.450). No correlations were observed between these fatty acids and any of the other five minerals. We speculate that the relationship between Cu and fatty acids could be related to a requirement for Cu by an enzyme required for C10-C14 fatty acid biosynthesis (e.g. decanoyl deacylase) in mammary tissue, or to some unique Cu binding properties of the intermediate chain length fatty acids.

Nutritional status and intermediate chain-length fatty acids influence the conservation of essential fatty acids in the milk of northern Nigerian women.

The milk of 89 women in northern Nigeria was analyzed for the fatty acid composition of the total milk lipids, and assessed for the effect nutritional status has on the conservation of essential and non-essential fatty acids when the proportions of C(10)-C(14)fatty acids are increased. The women were stratified on the basis of their body mass index, and calculations were made to estimate the effects of a 3.3-fold increase in the proportion of C(10)-C(14)fatty acids on the proportion of alpha-linolenic acid, docosahexaenoic acid, linoleic acid and arachidonic in total milk lipids. In the well-nourished group (group III, body mass index >23 kg/m(2)), the critical n-3 and n-6 fatty acids were not conserved, while in poorly nourished women (group I, body mass index <19 kg/m(2)), marked conservation of alpha-linolenic acid, docosahexaenoic acid, arachidonic acid, and palmitic acid was seen. Poor nutritional status of the mother appears to promote selective retention of critical essential and non-essential fatty acids in the milk lipid fraction.

The fatty acid composition of the serum phospholipids of children with sickle cell disease in Nigeria.

The purpose of this study was to determine the fatty acid composition of the serum phospholipids of children with sickle cell disease (SCD) in Nigeria and to compare the relative fluidity of the acyl chains of the serum phospholipids of controls versus the subjects with SCD. It is widely accepted that the fatty acid composition of an individual's serum phospholipids reflects that of their tissue phospholipids. An alteration in the fatty acid composition of membrane phospholipids could affect critical membrane-dependent enzymes and processes (e.g., ion and solute transport, hormone-receptor interactions, signal transduction pathways). We found a significant reduction in the content of polyunsaturated n-3 fatty acids in the phospholipids of subjects with SCD which could result in a reduction of the fluidity of their tissue membranes. Specifically, there was a 40-50% reduction in the proportion of total n-3 fatty acids in subjects with SCD. On the basis of calculated melting points and double bond indices of the acyl chains of the serum phospholipids, the phospholipids of the children with SCD are less fluid relative to those of their healthy counterparts. In addition, we determined that linoleic acid, arachidonic acid, and stearic acid were the major determinants of the fluidity of the acyl chains of the serum phospholipids of the healthy controls and children with SCD.

Correlation of the fatty acid composition and fluid property of the cholesteryl esters in the serum of Nigerian children with sickle cell disease and healthy controls.

In a previous study conducted in Nigeria, we found that children with sickle cell disease (SCD) had exceedingly low total serum cholesterol levels (mean=100-102mg/dl). The fact that significant reductions in the levels of certain polyunsaturated fatty acids (PUFA) have been documented in the serum phospholipids of these same SCD subjects led us to inquire as to the fatty acid composition of the cholesteryl esters (CE) in their serum. Lecithin:cholesterol acyl transferase (LCAT), the enzyme in blood that catalyzes the reaction in which tissue cholesterol is acylated prior to its removal from cell membranes, is relatively specific for certain PUFA. CE in blood serum from 43 male and 42 female children with SCD, ages 4-18 years, and equal numbers of age- and gender-matched controls were analyzed for their fatty acid composition. Relative to the non-SCD controls, the CE of the SCD subjects contained 9% less linoleic acid, 16% less arachidonic acid, 40% less alpha-linolenic acid, 50% less eicosapentaenoic acid, and 36% less docosahexaenoic acid, but 15% more palmitic acid and 10% more oleic acid. Overall, the acyl chains of the CE of the SCD subjects were less fluid than those of the controls, as determined by comparison of their mean melting points (MMP) and double bond indices (DBI). MMP and DBI were both estimated from the individual constituent fatty acids comprising the CE acyl chains. The strongest correlations between MMP and fatty acid mole percent were seen with palmitic acid and linoleic acid. These results show that the fatty acid composition of the serum CE of children with SCD is abnormal relative to controls who do not have this hematologic disorder. We speculate that suboptimal fatty acid nutrition in Nigerian children with SCD compromises their ability to remove cholesterol from their tissues due to preference of the LCAT enzyme for PUFA, thereby accounting, in part at least, for the low total serum cholesterol levels one finds in children with SCD.