Abstract
Objective:
To determine if parenteral lipid minimization in infants results in essential fatty acid (EFA) deficiency.
Study Design:
Prospective study of infants >30 days old and >34 weeks postmenstrual age receiving parenteral lipid minimization (<1.5 g kg–1 per day) with either soybean oil or fish oil and >90% of total nutritional intake parenterally in the 14 days before a serum EFA sample. Nonparametric tests were used for statistical analyses with significance at 0.05.
Results:
Fifteen samples on soybean oil and nine on fish oil were included. Energy and macronutrient intakes and weight gain were similar between groups. Biochemical EFA deficiency occurred in 60% receiving soybean oil but none receiving fish oil (P<0.01). Average daily weight gain was 49% less in EFA deficient infants than EFA sufficient infants (P=0.02).
Conclusion:
Infants on lipid minimization with parenteral soybean oil, but not fish oil, are at high risk of biochemical EFA deficiency with slower weight gain.
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References
Cober MP, Teitelbaum DH . Prevention of parenteral nutrition-associated liver disease: lipid minimization. Curr Opin Organ Transplant 2010; 15 (3): 330–333.
Fallon EM, Le HD, Puder M . Prevention of parenteral nutrition-associated liver disease: role of ω-3 fish oil. Curr Opin Organ Transplant 2010; 15 (3): 334–340.
Hoffman DR, Boettcher JA, Diersen-Schade DA . Toward optimizing vision and cognition in term infants by dietary docosahexaenoic and arachidonic acid supplementation: a review of randomized controlled trials. Prostaglandins Leukot Essent Fatty Acids 2009; 81 (2–3): 151–158.
Martinez M . Tissue levels of polyunsaturated fatty acids during early human development. J Pediatr 1992; 120: S129–S138.
Postuma R, Pease PWB, Watts R, Taylor S, McEvoy FA . Essential fatty acid deficiency in infants. J Ped Surg 1978; 13 (4): 393–398.
Van Kranen HJ, Siezen CL . Encyclopedia of Cancer. Springer: Heidelberg, Germany, 2012; 260–265.
Higdon J. Essential Fatty Acids section on the Internet. 2003 [updated 2014; cited on 9 September 2016]. Available at http://lpi.oregonstate.edu/mic/other-nutrients/essential-fatty-acids#metabolism-bioavailability.
Wanten GJA, Caler PC . Immune modulation by parenteral lipid emulsions. Am J Clin Nutr 2007; 85 (5): 1171–1184.
Uauy R, Mena P, Wegher B, Nieto S, Salem N Jr . Long chain polyunsaturated fatty acid formation in neonates: effect of gestational age and intrauterine growth. Pediatr Res 2000; 47: 127–135.
Caldwell MD, Jonsson HT, Othersen B Jr . Essential fatty acid deficiency in an infant receiving prolonged parenteral alimentation. J Pediatr 1972; 81 (5): 894–898.
O’Neill JA Jr, Caldwell MD, Meng HC . Essential fatty acid deficiency in surgical patients. Ann Surg 1977; 185: 535–542.
Holman RT, Smythe L, Johnson S . Effect of sex and age on fatty acid composition of human serum lipids. Am J Clin Nutr 1979; 32: 2390–2399.
Mayo Foundation for Medical Education and Research. (2017, Jan 26). Fatty Acid Profile, Essential, Serum. Retrieved from www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/82426.
Wesson LG, Burr GO . The metabolic rate and respiratory quotients of rats on a fat-deficient diet. J Biol Chem 1931; 91: 525.
Superko HR, Superko AR, Lundberg GP, Margolis B, Garrett BD, Nasir K et al. Omega-3 fatty acid blood levels clinical significance update. Curr Cardiovasc Risk Rep 2014; 8 (11): 407.
Acknowledgements
This research was funded by an internal University of Oklahoma Section of Neonatal-Perinatal Medicine grant.
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The author is a site investigator for an unrelated multicenter lipid study sponsored by Fresenius Kabi. The author received an internal grant from The University of Oklahoma Health Sciences Center, Section of Neonatal-Perinatal Medicine.
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Ernst, K. Essential fatty acid deficiency during parenteral soybean oil lipid minimization. J Perinatol 37, 695–697 (2017). https://doi.org/10.1038/jp.2017.21
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DOI: https://doi.org/10.1038/jp.2017.21
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