Document Detail

Impact of fatty acid status on immune function of children in low-income countries.
MedLine Citation:
PMID:  21366869     Owner:  NLM     Status:  MEDLINE    
In vitro and animal studies point to numerous mechanisms by which fatty acids, especially long-chain polyunsaturated fatty acids (LCPUFA), can modulate the innate and adaptive arms of the immune system. These data strongly suggest that improving the fatty acid supply of young children in low-income countries might have immune benefits. Unfortunately, there have been virtually no studies of fatty acid/immune interactions in such settings. Clinical trial registers list over 150 randomized controlled trials (RCTs) involving PUFAs, only one in a low-income setting (the Gambia). We summarize those results here. There was evidence for improved growth and nutritional status, but the primary end point of chronic environmental enteropathy showed no benefit, possibly because the infants were still substantially breastfed. In high-income settings, there have been RCTs with fatty acids (usually LCPUFAs) in relation to 18 disease end points, for some of which there have been numerous trials (asthma, inflammatory bowel disease and rheumatoid arthritis). For these diseases, the evidence is judged reasonable for risk reduction for childhood asthma (but not in adults), as yielding possible benefit in Crohn's disease (insufficient evidence in ulcerative colitis) and for convincing evidence for rheumatoid arthritis at sufficient dose levels, though formal meta-analyses are not yet available. This analysis suggests that fatty acid interventions could yield immune benefits in children in poor settings, especially in non-breastfed children and in relation to inflammatory conditions such as persistent enteropathy. Benefits might include improved responses to enteric vaccines, which frequently perform poorly in low-income settings, and these questions merit randomized trials.
Andrew M Prentice; Liandré van der Merwe
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Maternal & child nutrition     Volume:  7 Suppl 2     ISSN:  1740-8709     ISO Abbreviation:  Matern Child Nutr     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-03     Completed Date:  2011-05-12     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  101201025     Medline TA:  Matern Child Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  89-98     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
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MeSH Terms
Arthritis, Rheumatoid / immunology
Asthma / immunology
Breast Feeding
Developing Countries
Dietary Supplements
Fatty Acids, Unsaturated / metabolism*
Infant Nutritional Physiological Phenomena / immunology*
Inflammatory Bowel Diseases / immunology
Meta-Analysis as Topic
Randomized Controlled Trials as Topic
Grant Support
MC_U123261357//Medical Research Council; MC_U123292699//Medical Research Council; MC_U123292700//Medical Research Council; MC_U123292701//Medical Research Council
Reg. No./Substance:
0/Fatty Acids, Unsaturated

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