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

Ruth A Pobee; Jenifer I Fenton; Alla Sikorskii; Sarah K Zalwango; Isabella Felzer-Kim; Ilce M Medina; Bruno Giordani; Amara E Ezeamama

doi:10.1017/S1368980022000611

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

Public Health Nutr. 2022 Apr 4;25(5):1-11. doi: 10.1017/S1368980022000611. Online ahead of print.

Authors

Ruth A Pobee¹, Jenifer I Fenton¹, Alla Sikorskii², Sarah K Zalwango³, Isabella Felzer-Kim⁴, Ilce M Medina⁵, Bruno Giordani⁶, Amara E Ezeamama²

Affiliations

¹ Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA.
² Department of Psychiatry, Michigan State University, 909 Wilson Road, 322B West Fee Hall, East Lansing, MI48824, USA.
³ Directorate of Public Health and Environment, Kampala Capital City Authority, Kampala, Uganda.
⁴ College of Human Medicine, Michigan State University, East Lansing, MI, USA.
⁵ Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA.
⁶ Departments of Psychiatry, Neurology and Psychology, University of Michigan, Ann Arbor, MI, USA.

Abstract

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 α-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 = 0·31, 95 % CI: 0·03, 0·60), low Mead acid (SMD = 0·38, 95 % CI: 0·02, 0·74), low total n-9 (SMD = 0·44, 95 % CI: 0·08, 0·80) and low triene-to-tetraene ratio (SMD = 0·42, 95 % CI: 0·07, 0·77) predicted superior growth over 12 months. Conversely, low LA (SMD = -0·47, 95 % CI: -0·82, -0·12) and low total PUFA (sum of total n-3, total n-6 and Mead acid) (SMD = -0·33 to -0·39, 95 % CI: -0·71, -0·01) 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.

Keywords: Children; Linear growth; PUFA; Perinatal HIV exposure.