Association of serum PUFA and linear growth over 12 months among 6-10 years old Ugandan children with or without HIV

Objective: To quantify PUFA-associated improvement in linear growth among children aged 6-10 years. Design: Serum fatty acids (FA), including essential FA (EFA) (linoleic acid (LA) and alpha-linolenic acid (ALA)) were quantified at baseline using GC-MS technology. FA totals by class (n-3, n-6, n-9, PUFA and SFA) and FA ratios were calculated. Height-for-age Z-score (HAZ) relative to WHO population reference values were calculated longitudinally at baseline, 6 and 12 months. Linear regression models estimated PUFA, HIV status and their interaction-associated standardised mean difference (SMD) and 95 % CI in HAZ over 12 months. Setting: Community controls and children connected to community health centre in Kampala, Uganda, were enrolled. Participants: Children perinatally HIV-infected (CPHIV, n 82), or HIV-exposed but uninfected (CHEU, n 76) and community controls (n 78). Results: Relative to highest FA levels, low SFA (SMD = 0 center dot 31, 95 % CI: 0 center dot 03, 0 center dot 60), low Mead acid (SMD = 0 center dot 38, 95 % CI: 0 center dot 02, 0 center dot 74), low total n-9 (SMD = 0 center dot 44, 95 % CI: 0 center dot 08, 0 center dot 80) and low triene-to-tetraene ratio (SMD = 0 center dot 42, 95 % CI: 0 center dot 07, 0 center dot 77) predicted superior growth over 12 months. Conversely, low LA (SMD = -0 center dot 47, 95 % CI: -0 center dot 82, -0 center dot 12) and low total PUFA (sum of total n-3, total n-6 and Mead acid) (SMD = -0 center dot 33 to -0 center dot 39, 95 % CI: -0 center dot 71, -0 center dot 01) predicted growth deficit over 12 months follow-up, regardless of HIV status. Conclusion: Low n-3 FA (ALA, EPA and n-3 index) predicted growth deficits among community controls. EFA sufficiency may improve stature in school-aged children regardless of HIV status. Evaluating efficacy of diets low in total SFA, sufficient in EFA and enriched in n-3 FA for improving child growth is warranted.

Automated summary

This study aimed to quantify the relationship between PUFA (polyunsaturated fatty acids) and linear growth in children aged 6-10 years. The results showed that low levels of SFA (saturated fatty acids), Mead acid, total n-9, and the triene-to-tetraene ratio predicted better growth over 12 months. On the other hand, low levels of LA (linoleic acid) and total PUFA (the sum of total n-3, total n-6, and Mead acid) predicted growth deficits over the 12-month follow-up, regardless of HIV status.