Essential fatty acids in the nutrition of severely neurologically disabledchildren

Essential fatty acids (EFA) are important for the normal development and fu nctioning of the brain, retina and immune competent cells. Severely neurolo gically handicapped children often have feeding difficulties, and the compo sition of the diet may be critical with respect to an optimal nutrient cont ent. The aim of the present investigation was to evaluate if the dietary in takes and serum phospholipid concentrations of EFA were adequate in a group of severely neurologically impaired children in an institution. To achieve this, a prospective study was done. The investigation showed low dietary i ntakes of both n-6 fatty acids (FA) and n-3 FA. The serum concentrations of total n-6 FA, linoleic acid and 22:6n-3 (docosahexaenoic acid) as proporti ons of the total serum phospholipid FA concentration were initially low. Th e serum concentrations of 20:3n-9 and 22:5n-6 cholesterol, triacylglycerol, total saturated FA, total monounsaturated FA and apolipoproteins A-I and B were high compared with levels in a reference group of healthy children. F ollowing supplementation with fish oil and soyabean oil, the serum lipid pr ofile approached normal. We conclude that the study children had suboptimal intakes of EFA and that elevated serum concentrations of 20:3n-9 and 22:5n 6 were useful serological markers of suboptimal EFA status. Recommended die tary allowances for EFA given as a percentage of energy underestimate EFA r equirements in children with a low energy intake. Severely disabled childre n with feeding difficulties should probably be monitored with serum phospho lipid FA measurements or calculation of dietary absolute intakes of EFA.