Open AccessHigh‐Oleic Ready‐to‐Use Therapeutic Food Maintains Docosahexaenoic Acid Status in Severe Malnutrition
Author(s) -
Hsieh JiCheng,
Liu Lei,
Zeilani Mamane,
Ickes Scott,
Trehan Indi,
Maleta Ken,
Craig Christina,
Thakwalakwa Chrissie,
Singh Lauren,
Brenna J. Thomas,
Manary Mark J.
Publication year - 2015
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000000741
Subject(s) - medicine , docosahexaenoic acid , linoleic acid , severe acute malnutrition , eicosapentaenoic acid , malnutrition , population , oleic acid , polyunsaturated fatty acid , endocrinology , physiology , fatty acid , biochemistry , biology , environmental health
Objectives: Ready‐to‐use therapeutic food (RUTF) is the preferred treatment for uncomplicated severe acute malnutrition. It contains large amounts of linoleic acid and little α‐linolenic acid, which may reduce the availability of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to the recovering child. A novel high‐oleic RUTF (HO‐RUTF) was developed with less linoleic acid to determine its effect on DHA and EPA status. Methods: We conducted a prospective, randomized, double‐blind clinical effectiveness trial treating rural Malawian children with severe acute malnutrition. Children were treated with either HO‐RUTF or standard RUTF. Plasma phospholipid fatty acid status was measured on enrollment and after 4 weeks and compared between the 2 intervention groups. Results: Among the 141 children enrolled, 48 of 71 receiving HO‐RUTF and 50 of 70 receiving RUTF recovered. Plasma phospholipid samples were analyzed from 43 children consuming HO‐RUTF and 35 children consuming RUTF. The change in DHA content during the first 4 weeks was +4% and −25% in the HO‐RUTF and RUTF groups, respectively ( P = 0.04). For EPA, the change in content was 63% and −24% in the HO‐RUTF and RUTF groups, respectively ( P < 0.001). For arachidonic acid, the change in content was −3% and 13% in the HO‐RUTF and RUTF groups, respectively ( P < 0.009). Conclusions: The changes in DHA and EPA seen in the children treated with HO‐RUTF warrant further investigation because they suggest that HO‐RUTF support improved polyunsaturated fatty acid status, necessary for neural development and recovery.