期刊论文详细信息
Lipids in Health and Disease
Food allergy in small children carries a risk of essential fatty acid deficiency, as detected by elevated serum mead acid proportion of total fatty acids
Seppo T Nikkari3  Minna Kaila2  Riina Lemponen1  Matti Korppi4  Elina Kuusela4  Marita Paassilta4 
[1] School of Health Sciences, University of Tampere, Tampere, Finland;Hjelt Institute, University of Helsinki, Helsinki, Finland;University of Tampere School of Medicine and Fimlab Laboratories, Tampere, Finland;Paediatric Research Centre, Tampere University and University Hospital, Tampere, Finland
关键词: Mead acid;    Elimination diet;    Child;    Food allergy;    Essential fatty acid deficiency;   
Others  :  1145519
DOI  :  10.1186/1476-511X-13-180
 received in 2014-11-11, accepted in 2014-11-27,  发布年份 2014
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【 摘 要 】

Background

Elevated serum Mead acid as a proportion of total fatty acids is an indirect marker of a deficiency of essential fatty acids (EFA). The aim of the study was to evaluate the symptoms and nutrition of food-allergic children with elevated or normal serum Mead acid.

Methods

Serum fatty acid compositions from 400 children were studied by clinical indications, mostly by suspicion of deficiency of EFA due to inadequate nutrition. A Mead acid level exceeding 0.21% (percentage of total fatty acids) was considered to be a specific sign of an insufficient EFA supply. From a total of 31 children with elevated Mead acid (MEADplus group), 23 (74%) had food allergy. The symptoms and dietary restrictions of this MEADplus group of food allergic children were compared to 54 age-and sex-matched controls with food allergy but normal Mead acid proportions (MEADminus group) before and 6 months after the serum fatty acid determination.

Results

At the beginning of the 6-month follow-up, 44% of the food allergic children in both MEADplus and MEADminus groups were on an elimination diet. These diets did not differ between the two groups and we were not able to document an association between the severity of elimination diet and elevated Mead acid proportion. However, the MEADplus children were on average more symptomatic than MEADminus children. In the MEADplus group, food allergy presented with skin symptoms in 100% (vs. 70% in the MEADminus group, p < 0.001) and with vomiting or diarrhea in 70% (vs. 44% in the MEADminus group, p < 0.05). Clinical suspicion of malnutrition resulted in increase in the use of vegetable oil and milk-free margarine in both groups from <50% to 65-74% during the follow-up. After 6 months, 64% of the MEADplus children with food allergy had been sent to a control serum fatty acid analysis. Of these children, Mead acid had declined to normal level in 69%, and remained elevated in 31%.

Conclusions

Severe symptoms of food allergy combined with elimination diets in children may lead to insufficient nutrition presenting with elevated serum Mead acid. Adding of supplementary polyunsaturated fat to the diet should be considered in these children.

【 授权许可】

   
2014 Paassilta et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Maloney J, Nowak-Wegrzyn A: Educational clinical case series for pediatric allergy and immunology: allergic proctocolitis, food protein-induced enterocolitis syndrome and allergic eosinophilic gastroenteritis with protein-losing gastroenteropathy as manifestations of non-IgE-mediated cow's milk allergy. Pediatr Allergy Immunol 2007, 18:360-367.
  • [2]Mehta H, Groetch M, Wang J: Growth and nutritional concerns in children with food allergy. Curr Opin Allergy Clin Immunol 2013, 13:275-279.
  • [3]Socha P, Koletzko B, Swiatkowska E, Pawlowska J, Stolarczyk A, Socha J: Essential fatty acid metabolism in infants with cholestasis. Acta Paediatr 1998, 87:278-283.
  • [4]Fokkema MR, Smit EN, Martini IA, Woltil HA, Boersma ER, Muskiet FA: 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. Prostaglandins Leukot Essent Fatty Acids 2002, 67:345-356.
  • [5]Aldámiz-Echevarría L, Bilbao A, Andrade F, Elorz J, Prieto JA, Rodríguez-Soriano J: Fatty acid deficiency profile in children with food allergy managed with elimination diets. Acta Paediatr 2008, 97:1572-1576.
  • [6]Fulco AJ, Mead JF: Metabolism of essential fatty acids. Origin of 5,8,11-eicosatrienoic acid in the fat-deficient rat. J Biol Chem 1959, 234:1411-1416.
  • [7]Lerner R, Lindström P, Berg A, Johansson E, Rosendahl K, Palmblad J: Development and characterization of essential fatty acid deficiency in human endothelial cells in culture. Proc Natl Acad Sci U S A 1995, 92:1147-1151.
  • [8]Siguel EN, Chee KM, Gong J, Schaefer EJ: Criteria for essential fatty acid deficiency in plasma as assessed by capillary column gas-liquid chromatography. Clin Chem 1987, 33:1869-1873.
  • [9]Olafsdottir AS, Thorsdottir I, Wagner KH, Elmadfa I: Polyunsaturated fatty acids in the diet and breast milk of lactating icelandic women with traditional fish and cod liver oil consumption. Ann Nutr Metab 2006, 50:270-276.
  • [10]Ichi I, Kono N, Arita Y, Haga S, Arisawa K, Yamano M, Nagase M, Fujiwara Y, Arai H: Identification of genes and pathways involved in the synthesis of Mead acid (20:3n-9), an indicator of essential fatty acid deficiency. Biochim Biophys Acta 1841, 2014:204-13.
  • [11]Williams CM, Burdge G: Long-chain n-3 PUFA: plant v. marine sources. Proc Nutr Soc 2006, 65:42-50.
  • [12]Farquharson J, Cockburn F, Patrick WA, Jamieson EC, Logan RW: Infant cerebral cortex phospholipid fatty-acid composition and diet. Lancet 1992, 340:810-813.
  • [13]Innis SM: Dietary omega 3 fatty acids and the development of brain. Brain Res 2008, 1237:35-43.
  • [14]Innis SM: Omega-3 Fatty acids and neural development to 2 years of age: do we know enough for dietary recommendations? J Pediatr Gastroenterol Nutr 2009, 48:S16-24.
  • [15]Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B: Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2008, 46:99-110.
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