Food allergy in small children carries a risk of essential fatty acid deficiency, as detected by elevated serum mead acid proportion of total fatty acids

Marita Paassilta,Elina Kuusela,Riina Lemponen,Matti Korppi,Minna Kaila,Seppo T Nikkari

doi:10.1186/1476-511x-13-180

Abstract

BackgroundElevated serum Mead acid as a proportion of total fatty acids is an indirect marker of a deficiency of essential fatty acids (EFA). The aim of the study was to evaluate the symptoms and nutrition of food-allergic children with elevated or normal serum Mead acid.MethodsSerum fatty acid compositions from 400 children were studied by clinical indications, mostly by suspicion of deficiency of EFA due to inadequate nutrition. A Mead acid level exceeding 0.21% (percentage of total fatty acids) was considered to be a specific sign of an insufficient EFA supply. From a total of 31 children with elevated Mead acid (MEADplus group), 23 (74%) had food allergy. The symptoms and dietary restrictions of this MEADplus group of food allergic children were compared to 54 age-and sex-matched controls with food allergy but normal Mead acid proportions (MEADminus group) before and 6 months after the serum fatty acid determination.ResultsAt the beginning of the 6-month follow-up, 44% of the food allergic children in both MEADplus and MEADminus groups were on an elimination diet. These diets did not differ between the two groups and we were not able to document an association between the severity of elimination diet and elevated Mead acid proportion. However, the MEADplus children were on average more symptomatic than MEADminus children. In the MEADplus group, food allergy presented with skin symptoms in 100% (vs. 70% in the MEADminus group, p < 0.001) and with vomiting or diarrhea in 70% (vs. 44% in the MEADminus group, p < 0.05). Clinical suspicion of malnutrition resulted in increase in the use of vegetable oil and milk-free margarine in both groups from <50% to 65-74% during the follow-up. After 6 months, 64% of the MEADplus children with food allergy had been sent to a control serum fatty acid analysis. Of these children, Mead acid had declined to normal level in 69%, and remained elevated in 31%.ConclusionsSevere symptoms of food allergy combined with elimination diets in children may lead to insufficient nutrition presenting with elevated serum Mead acid. Adding of supplementary polyunsaturated fat to the diet should be considered in these children.

Highlights

Elevated serum Mead acid as a proportion of total fatty acids is an indirect marker of a deficiency of essential fatty acids (EFA)
Of the studied 400 children who had been sent to serum fatty acid analysis on clinical bases, 39 had a Mead acid level exceeding 0.21%, which was considered to be a specific sign of an insufficient EFA supply [8] (Figure 1)
The MEADminus group was formed from 54 food allergic children with Mead acid in the normal range

Summary

Introduction

Elevated serum Mead acid as a proportion of total fatty acids is an indirect marker of a deficiency of essential fatty acids (EFA). The aim of the study was to evaluate the symptoms and nutrition of food-allergic children with elevated or normal serum Mead acid. Fat supply especially that of EFAs, may be insufficient in children with restricted diet due to different malabsorption syndromes and even due to food allergy [3,4,5]. The production of Mead acid is indirectly associated with the supply of the EFAs in the diet, and an elevated Mead acid in serum is an indicator of essential fatty acid deficiency [4,8,9]. The genes and pathways involved in the synthesis of Mead acid (20:3n-9) were identified just recently [10]

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