Maria Grazia Bruzzese

Developmental quotient at 24 months and fatty acid composition of diet in early infancy: a follow up study

AIM A follow up study of developmental quotient (DQ) at 24 months of toddlers whose diets in early infancy differed in fatty acid composition, and in whom an association between diet and DQ was observed at 4 months. METHODS 81 toddlers were distributed among three groups according to early type of diet: standard infant formula (SFo, n = 30); long chain polyunsaturated fatty acid (LC-PUFA) enriched formula (LCPFo, n  = 26); human milk (HM, n = 25). DQ at 24 months was assessed by Brunet-Lézine’s psychomotor developmental test. A subgroup (n = 20; SFo 8; LCPFo 6; HM 6) was tested for erythrocyte phosphatidylcholine and phosphatidylethanolamine. RESULTS No DQ differences were found by analysis of variance. Neither DQ nor erythrocyte docosahexaenoic acid at 4 months were predictors of DQ scores at 24 months. Phosphatidylcholine arachidonic and docosahexaenoic acid correlated positively, and phosphatidylcholine linoleic acid and phosphatidylethanolamine eicosapentaenoic acid negatively, with DQ. Multiple regression analysis including these variables explained 52% of interindividual DQ variance. A strong association was found between the erythrocyte phosphatidylcholine arachidonic/linoleic acid ratio and DQ (r= 0.75; p = 0.0001). CONCLUSIONS The diet/DQ association found at 4 months was not predictive of DQ scores at 24 months. Irrespective of dietary or genetic factors, there appears to be a strong correlation between the LC-PUFA composition of the red cell membrane and higher neurodevelopmental performance.

Plasma long-chain fatty acids and the degree of obesity in Italian children.

Aim: To examine whether the plasma levels of long‐chain polyunsaturated fatty acids (LC‐PUFAs) are associated with the degree of obesity in children. Methods: Sixty‐seven normolipidaemic obese children, aged 8–12 y, and 67 age‐ and sex‐matched normal‐weight children were included in the study. Obesity was defined in accordance with the International Obesity Task Force. BMI z‐scores were calculated. Fasting blood samples were analysed for insulin, glucose, lipid profile and fatty acid (FA) levels (expressed as % total FA). Insulin resistance was estimated by homeostatic model assessment (HOMA). Results: Compared with normal‐weight children, obese children exhibited lower mean plasma total PUFA (37.8% vs 39.7%), ω‐6 PUFAs (35.0% vs 36.8%) and C22:6 ω‐3‐to‐C18:3 ω‐3 ratio (5.52 vs 7.61), and higher total monounsaturated FA (26.6% vs 25.0%), C18:3 ω‐3 (0.28% vs 0.25%) and C20:5 ω‐3 (0.45% vs 0.39%). In obese children, the BMI z‐score was negatively related to plasma PUFA, ω‐3 PUFAs, C22:6 ω‐3, and the C22:6 ω‐3‐to‐C20:6 ω‐6 and C22:6 ω‐3‐to‐C18:3 ω‐3 ratios, and positively with total saturated FA and C20:3 ω‐9.

Dietary and circulating polyunsaturated fatty acids in cystic fibrosis: are they related to clinical outcomes?

Objective: To assess the relationship between dietary intakes, plasma phospholipid (PL) fatty acid profile and clinical parameters in children with cystic fibrosis (CF) in comparison to healthy controls. Patients and Methods: A cross-sectional survey including 37 patients with CF (ages 8.0 ± 2.9 yrs) and a reference group of 68 healthy children (ages 8.0 ± 0.7 yrs) was carried out by means of a food-frequency questionnaire. At enrolment, all subjects underwent blood sampling for plasma PL fatty acids (FA). In CF patients, pulmonary function tests (forced expiratory volume in 1 second and forced vital capacity), anthropometric measurements and the Shwachman score were also determined. Results: In CF patients, mean z score for weight and height (−0.35 ± 1.16 and −0.28 ± 0.99) were lower than controls (0.83 ± 1.73 and 0.55 ± 1.11, respectively). Patients with CF showed higher energy intakes (110 ± 43 kcal/d) compared with controls (75 ± 22 kcal/d; P < 0.0001), with higher intake of total (saturated and monounsaturated) fats and lower intake of polyunsaturated FA (3.9 ± 1.0% of total macronutrient intake vs 4.3 ± 1.2%, P = 0.05). In CF patients, plasma and PL levels of linoleic and docosahexaenoic acids were lower, whereas those of arachidonic acid were similar compared with controls. The Shwachman score showed significant positive associations with plasma PL levels of arachidonic acid and total n-6 long-chain FA (r = 0.32, P = 0.05, and r = 0.35, P = 0.03, respectively). Conclusions: The data give suggestions that fat intake and CF-associated biomechanisms are bound in a vicious circle, concurring to create the clinical and biochemical picture of CF. The quantity and quality of fat supplementation in CF need careful attention to balance the fat supply with polyunsaturated FA.

The effects of n-3 and n-6 polyunsaturated fatty acids on plasma lipids and fatty acids of treated phenylketonuric children

Dietary-treated phenylketonuric patients (PKUs) display low levels of long-chain polyunsaturated fatty acids (PUFA) in plasma lipids. In a 6-month clinical trial we observed a decrease of triglycerides and an increase of n-3 long-chain PUFA in plasma of PKUs supplemented with fish oil, while no major differences in respect to the baseline values were found in a group supplemented with blackcurrant oil. A more complete source of long-chain PUFA of both the n-6 and n-3 series should be investigated for dietary supplementation of PKU patients.

Low levels of linoleic acid in plasma total lipids of HIV-1 seropositive children.

OBJECTIVE To assess the plasma fatty acid status of a group of well-nourished children with the human immunodeficiency virus type-1 (HIV-1) and how this relates to the blood total CD4+ lymphocyte count. SUBJECTS Fourteen HIV-1 seropositive children at various stages of disease and with adequate growth indices were assessed and compared to a control group of 30 healthy children. RESULTS The concentrations (mg/dL) of plasma total fatty acids were not different between the two groups. HIV-1 seropositive children presented lower levels of 18-C essential polyunsaturated fatty acids (PUFA: linoleic acid, LA, and alpha-linolenic acid) and higher levels of their 20-C long-chain derivatives (di-homo-gamma-linolenic acid, arachidonic acid, AA, and eicosapentaenoic acid) and docosahexaenoic acid in their plasma total lipids. The lowest plasma LA levels were observed in the subgroup of patients with more advanced stages of disease. In bivariate analyses the plasma LA levels related positively (Spearman r = 0.50, p = 0.06), while the LA/AA ratio related negatively (Spearman r = -0.51, p = 0.06), to the total CD4+ count. CONCLUSIONS Childhood HIV-1 infection is associated with changes in plasma fatty acid profile suggestive of an increased PUFA turnover. Decreased levels of LA (together with higher plasma AA levels) appear to be associated with more advanced clinical and biochemical stages of disease.