Degree Of Undernutrition Research Articles

Exploring the factors associated with undernutrition among 6–59 months children residing in slum areas of the south-western region, Bangladesh

ABSTRACT This study aimed to explore the undernutrition and its associated factors among children aged 6–59 months residing in slum areas of southwestern Bangladesh. A validated administered questionnaire was used to collect data from 600 slum children. Logistic regression models were employed to identify the factors associated with undernutrition. The prevalence of underweight, stunted, and wasted were 34.5%, 31.3%, and 26.2%, respectively. The odds of undernutrition were higher in 6–23-month-olds and mothers had ≥ 3 under-five children. Maternal education, timely complementary feeding, latrine type, and worm infestation were significantly associated with the degrees of undernutrition.

Relationship Between Nutritional Status and Severity of Cerebral Palsy: A Multicentre Cross-Sectional Study

Nutritional problems are common in children with cerebral palsy (CP), yet the relationship between nutritional status and the severity of CP is unclear. To describe the nutritional status and characteristics of children with CP, and to explore the relationship between severity of CP and nutritional status in children. This multicentre cross-sectional study included children with CP in China. Weight and height were measured and converted to z-scores. Gross Motor Function Classification System (GMFCS), Eating and Drinking Ability Classification System (EDACS), Subjective Global Nutritional Assessment (SGNA), social life ability, and blood indicators were tested. All 1,151 participants were given oral-feeding and 50.8% of them demonstrated undernutrition. Compared with those in GMFCS or EDACS levels I-III, the odds of moderate and severe undernutrition were 2.6 and 8.9 times higher in GMFCS levels IV and V, and 4.3 and 12.6 times higher in EDACS levels IV and V, respectively. Except for serum 25-hydroxyvitamin D, no significant differences were found in blood indicators among normal, undernourished and overnourished groups. Degrees of undernutrition in children with CP are correlated with the severity of eating and drinking dysfunction and with gross motor impairment. Blood indicators may not reflect nutritional status in children with CP.

Nature, Prevalence, and Impact of Undernutrition on Intelligence Among School Children: A Cross-Sectional Study from South India

Good nutrition is a basic criterion for optimum health, productivity, and overall functional efficiency. The children who had malnutrition in their early years secured poor cognitive test scores in school years compared to children with optimal nutrition. The present study aimed to associate the degrees of undernutrition and intelligence among school children. This is a cross-sectional study that included 600 children aged 6 and 12 years, and assessed the anthropometry and intelligence quotient levels through appropriate scales. The results revealed that the higher percentage of stunted, underweight, and thinness were highly associated with below-average intelligence, which was more than two times greater risk compared to the percentage with the degrees of undernutrition to the above-average intelligence. The children’s age, gender, birth weight, and socioeconomic status were also strongly associated with the intelligence quotient level. This study offers new insight for formulating the policies and intervention programs in the future.

Effects of undernutrition on mortality and morbidity among adults living with HIV in sub-Saharan Africa: a systematic review and meta-analysis

BackgroundUndernutrition is one of the most common problems among people living with HIV, contributing to premature death and the development of comorbidities within this population. In Sub-Saharan Africa (SSA), the impacts of these often inter-related conditions appear in a series of fragmented and inconclusive studies. Thus, this review examines the pooled effects of undernutrition on mortality and morbidities among adults living with HIV in SSA.MethodsA systematic literature search was conducted from PubMed, EMBASE, CINAHL, and Scopus databases. All observational studies reporting the effects of undernutrition on mortality and morbidity among adults living with HIV in SSA were included. Heterogeneity between the included studies was assessed using the Cochrane Q-test and I2 statistics. Publication bias was assessed using Egger’s and Begg’s tests at a 5% significance level. Finally, a random-effects meta-analysis model was employed to estimate the overall adjusted hazard ratio.ResultsOf 4309 identified studies, 53 articles met the inclusion criteria and were included in this review. Of these, 40 studies were available for the meta-analysis. A meta-analysis of 23 cohort studies indicated that undernutrition significantly (AHR: 2.1, 95% CI: 1.8, 2.4) increased the risk of mortality among adults living with HIV, while severely undernourished adults living with HIV were at higher risk of death (AHR: 2.3, 95% CI: 1.9, 2.8) as compared to mildly undernourished adults living with HIV. Furthermore, the pooled estimates of ten cohort studies revealed that undernutrition significantly increased the risk of developing tuberculosis (AHR: 2.1, 95% CI: 1.6, 2.7) among adults living with HIV.ConclusionThis review found that undernutrition has significant effects on mortality and morbidity among adults living with HIV. As the degree of undernutrition became more severe, mortality rate also increased. Therefore, findings from this review may be used to update the nutritional guidelines used for the management of PLHIV by different stakeholders, especially in limited-resource settings.

The survival prognosis of elderly undernourished inpatients admitted to the internal medical department of an emergency hospital as assessed using the nutritional screening, tool CONUT (for CONtrolling NUTritional status).

CONUT, a tool for "CONtrolling NUTritional status" assesses the nutritional status of a subject by taking into account their serum albumin level, total cholesterol level and total lymphocyte count. Elderly undernourished inpatients admitted to the internal medical department were divided into two groups, those who left the hospital and those who died in the hospital. The goal of this study was to analyze whether or not the CONUT score, serum albumin level, total cholesterol level and total lymphocyte count could predict the survival prognosis of elderly undernourished inpatients and to show the ratio of patients discharged with artificial hydration and nutrition (AHN). We divided elderly undernourished inpatients into two groups, those who left the hospital (229 patients) and those who died in the hospital (363 patients), and examined the serum albumin level, total cholesterol level and total lymphocyte count within 10 days before discharge or death. Based on the degree of undernutrition as determined by CONUT, we further classified the patients 4-into four levels of nutrition status, normal, light undernutrition, moderate undernutrition and severe undernutrition. In addition, based on the serum albumin level, total cholesterol level and total lymphocyte count, the patients were also classified 4-into four levels of nutrition status, and we calculated the ratio of AHN patients in the discharged group. On comparing the discharge and death groups according to the degree of undernutrition, serum albumin level, total cholesterol level and total lymphocyte count, significant differences were found between the groups of all nutrition statuses except moderate undernutrition. Furthermore, the patients with moderate undernutrition status demonstrated no statistically significant difference in both groups, except the serum albumin level. Among the discharged patients, the ratio of AHN was 37.0% in those with a normal nutrition status and more than 50% in the patients with light to severe undernutrition. We calculated and scored the serum albumin level, total cholesterol level, total lymphocyte count and the degree of undernutrition according to CONUT in elderly undernourished inpatients admitted to the internal medical department of an emergency hospital.We then divided the patients into groups, based on death or discharge from the hospital as well as nutrition status, normal, light undernutrition, moderate undernutrition and severe undernutrition. Therefore, comparing the groups based on their death or discharge, their nutrition status was found to be helpful for predicting the prognosis.

Assessment of energy requirements in patients with short bowel syndrome by using the doubly labeled water method

Short bowel syndrome (SBS) is a serious malabsorption disorder, and dietetic management of patients with SBS is extremely challenging. Once the degree of undernutrition has been assessed, successful dietary intervention is contingent on an accurate estimation and provision of energy needs. We quantified total energy expenditure (TEE) in patients with SBS by using the doubly labeled water (DLW) method to inform energy needs and nutritional therapy goals. In this observational study, TEE was measured in 22 participants, 11 with SBS and 11 sex-, age-, and body mass index (BMI)-matched controls (non-SBS), for 14 d with the DLW method. Predicted energy requirements were determined by using the Escott-Stump equation and compared with TEE determined with DLW. Resting energy expenditure was measured by using indirect calorimetry, and an accelerometer was also used to determine physical activity level. Participants were aged (mean ± SD) 53 ± 8 y. Measured TEE was significantly higher than predicted TEE for the SBS group (1875 ± 276 compared with 1517 ± 175 kcal/d, P = 0.001) and also for the non-SBS group (2393 ± 445 compared with 1532 ± 178 kcal/d, P < 0.01). Measured TEE was significantly lower in the SBS group than in the non-SBS group (P < 0.01); however, predicted TEE did not differ significantly between the groups (P = 0.84). No significant differences were seen between measured and predicted resting energy expenditure either within or between groups. Measured TEE in patients with SBS was significantly higher than predicted by using standard equations but also lower than values for age-, BMI-, and sex-matched non-SBS controls. Currently used formulas in clinical practice appear to underestimate energy requirements of patients with SBS, and revision is needed to prevent underfeeding and improve long-term prognosis. This trial was registered at clinicaltrials.gov as NCT02113228.

Association of plasma hormones, nutritional status, and stressful life events in anorexia nervosa patients

The aim of the current study was to analyze the relationships between plasma hormones, body weight parameters and stressful life events in anorexia nervosa (AN). 72 females in the active phase of AN were evaluated. 52 healthy women constituted the control group. RIA kits were used to measure plasma hormone levels. The concentrations of leptin, insulin, IGF-1, triiodothyronine, LH, FSH, estradiol, and testosterone were significantly lower and those of cortisol and growth hormone significantly higher in the AN than the control group. No hormonal differences between restrictive and binge-purging AN subtypes were found. Leptin, IGF-1, gonadotropins, and sex steroids correlated significantly negatively and growth hormone positively with total reduction of body weight or the degree of undernutrition. Associations were also found between lower insulin concentration and family violence, lower cortisol and psychiatric diseases in the family, higher testosterone and patient's alcohol or drug abuse. The changed activity of the somatotropin-somatomedin, gonadal, and corticotrophin axes corresponds to the clinical stage of AN. Plasma IGF-1 seems to be the most sensitive and useful independent hormonal marker of cachexia.

Living Environs and Nutritional Status of Children from an Urban Indian Slum: An Analysis of Associative Factors

Growing urbanization gives rise to slums, which are densely populated peri-urban areas housing underprivileged populations. The nutritional status of children in slum areas can be compromised due to poor living environs despite availability of many urban health care facilities. The present cross- sectional study was undertaken to determine the nutritional status of children residing in slum and analyze the various associative factors. The study area was Ghousianagar, a slum in city of Mysore from South India. A sample of 676 children (2-11 years of age, males, 310 and females, 366) from two schools was chosen for detailed anthropometry. Data were also collected on living conditions, economic and literacy levels of parents and nutritional status of mothers (n=200) through standard techniques. The results revealed that the living conditions of children were highly unhygienic. Only in 36% of families both parents were literate. Children from all age groups exhibited different degrees of malnutrition which worsened with increasing age. Only 8% of children were normal and the rest suffered with different degrees of undernutrition. Stunting and wasting were significantly influenced by age and gender of children. Under associative factors studied, weight for age of children was significantly associated with economic status of family and maternal BMI. Weight for height was associated with economic status, family size and maternal BMI. Height for age exhibited marginal association with family size. It can be said that adverse living environment and limited resources influenced the nutritional status of children adversely.

Undernutrition in Santal children: A biochemical and hematological study

The nutritional status of the children can be measured by biochemical and hematological parameters and dietary assessment. The objectives of the present study were to evaluate the causes of the undernutrition in the surveyed Santal children, where high degree of undernutrition exists, by measuring selected hematological and biochemical parameters and dietary intake. Nutritional status was assessed by height-for-age Z-score. Total count of red blood cells (RBC count), packed cell volume (PCV), hemoglobin concentration (Hb%), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) were measured. Biochemical parameters such as serum iron, total iron binding capacity (TIBC), serum ferritin, serum transferrin, transferrin saturation (TS) and serum albumin were also measured. Serum iron, serum ferritin, transferrin saturation, hemoglobin level and serum albumin of stunted children were significantly lower (p<0.05) than those in children of normal stature. Total iron binding capacity and serum transferrin of stunted children were significantly higher (p<0.05) than the values in children of normal stature. More than 29% of surveyed children were suffering from iron deficiency. Hemoglobin concentration was found to be strongly associated (p<0.001) with the nutritional status. Dietary intake of almost all nutrients in all age groups was found to be lower than the recommended dietary allowances (RDA) in both sexes. A mild iron deficiency was found in stunted Santal children. The stunting may be associated with the deficiency of specific nutrients such as iron and protein in surveyed Santal children.

A 15-year study on the treatment of undernourished children at a nutrition rehabilitation centre (CREN), Brazil

To build a life table and determine the factors related to the time of treatment of undernourished children at a nutrition rehabilitation centre (CREN), São Paulo, Brazil. Nutritional status was assessed from weight-for-age, height-for-age and BMI-for-age Z-scores, while neuropsychomotor development was classified according to the milestones of childhood development. Life tables, Kaplan-Meier survival curves and Cox multiple regression models were employed in data analysis. CREN (Centre of Nutritional Recovery and Education), São Paulo, Brazil. Undernourished children (n 228) from the southern slums of São Paulo who had received treatment at CREN under a day-hospital regime between the years 1994 and 2009. The Kaplan-Meier curves of survival analysis showed statistically significant differences in the periods of treatment at CREN between children presenting different degrees of neuropsychomotor development (log-rank = 6·621; P = 0·037). Estimates based on the multivariate Cox model revealed that children aged ≥24 months at the time of admission exhibited a lower probability of nutritional rehabilitation (hazard ratio (HR) = 0·49; P = 0·046) at the end of the period compared with infants aged up 12 months. Children presenting slow development were better rehabilitated in comparison with those exhibiting adequate evolution (HR = 4·48; P = 0·023). No significant effects of sex, degree of undernutrition or birth weight on the probability of nutritional rehabilitation were found. Age and neuropsychomotor developmental status at the time of admission to CREN are critical factors in determining the duration of treatment.

Dietary patterns, food and macronutrient intakes among adults in three ethnic groups in rural Kenya

To compare dietary patterns and food and macronutrient intakes among adults in three ethnic groups in rural Kenya. In the present cross-sectional study, dietary intake was estimated in adult volunteers using two non-consecutive interactive 24 h recalls. Dietary patterns were assessed from the number of meals and snacks per day and from the food items and major food groups registered, and their contribution to energy intake (EI) was calculated. Anthropometric values were measured and sociodemographic data obtained using a questionnaire. A cross-sectional study was conducted in the Bondo, Kitui and Transmara districts of rural Kenya. A high prevalence of food insecurity in Kenya underlines the importance of describing the dietary patterns and intakes in different Kenyan ethnic groups. A total of 1163 (61 % women) adult Luo, Kamba and Maasai, with a mean age of 38·6 (range: 18-68) years, volunteered to participate. Dietary patterns and food groups contributing to EI differed significantly among the ethnic groups. Mean EI ranged from 5·8 to 8·6 MJ/d among women and from 7·2 to 10·5 MJ/d among men, with carbohydrates contributing between 55·7 % and 74·2 % and fat contributing between 14·5 % and 30·2 % of total EI. Mean protein intake ranged from 0·72 to 1·3 g/kg per d, and EI:BMR ratio ranged between 1·1 and 1·6 in both sexes, and was highest among the Luo. Prevalence of underweight (BMI < 18·5 kg/m2) was 13·7 %, 20·5 % and 24·2 % in the Luo, Kamba and Maasai, respectively. The degree of food insecurity measured as a degree of undernutrition and as dietary patterns differed considerably among the ethnic groups. The Maasai and Kamba in particular were exposed to food insecurity.

Dyslipidaemia and undernutrition in children from impoverished areas of Maceió, state of Alagoas, Brazil.

Chronic undernutrition causes reduced growth and endocrine adaptations in order to maintain basic life processes. In the present study, the biochemical profiles of chronically undernourished children were determined in order to test the hypothesis that chronic undernutrition also causes changes in lipid profile in pre-school children. The study population comprised 80 children aged between 12 and 71 months, including 60 with moderate undernutrition [height-for-age Z (HAZ) scores ≤ −2 and > −3] and 20 with severe undernutrition (HAZ scores ≤ −3). Socioeconomic, demographic and environmental data were obtained by application of a questionnaire, and anthropometric measurements and information relating to sex, age and feeding habits were collected by a trained nutritionist. Blood samples were analysed for haemoglobin, vitamin A, insulin-like growth factor 1 (IGF-1) and serum lipids, while cortisol was assayed in the saliva. Faecal samples were submitted to parasitological investigation. Analysis of variance and χ2 methods were employed in order to select the variables that participated in the multivariate logistic regression analysis. The study population was socioeconomically homogeneous, while the lack of a treated water supply was clearly associated with the degree of malnutrition. Most children were parasitised and anaemia was significantly more prevalent among the severely undernourished. Levels of IGF-1 decreased significantly with increasing severity of undernutrition. Lipid analysis revealed that almost all of the children had dyslipidemia, while low levels of high-density lipoprotein were associated with the degree of undernutrition. It is concluded that chronic malnutrition causes endocrine changes that give rise to alterations in the metabolic profile of pre-school children.

Optimizing protein intake in preterm infants

Optimizing protein intake in preterm infants

The effects of pre-weaning undernutrition on the expression levels of free radical deactivating enzymes in the mouse brain

A mild degree of undernutrition brought about by restricting the amount of food in the diet is known to alter the life span of an animal. It has been hypothesised that this may be related to the effects of undernutrition on an animals anti-oxidant defense system. We have therefore, used real-time PCR (rt-PCR) techniques to determine the levels of mRNA expression for manganese superoxide dismutase (MnSOD), copper/zinc superoxide dismutase (Cu/ZnSOD), glutathione peroxidase 1 (GPx 1) and catalase in the brains of Quackenbush mice undernourished from conception until 21-post-natal days of age. It was found that 21- and 61-day-old undernourished mice had a deficit in the expression of Cu/ZnSOD in both the cerebellum and forebrain regions compared to age-matched controls. The expression of MnSOD was found to be greater in the cerebellum, but not the forebrain region, of 21-day-old undernourished mice. There were no significant differences in the expression of GPx 1 and catalase between control and undernourished or previously undernourished mice. Our results confirm that undernutrition during the early life of a mouse may disrupt some of the enzymes involved in the anti-oxidant defense systems.

Medical Findings in Outpatients With Anorexia Nervosa

Approximately 0.5% to 1% of college-aged women have anorexia nervosa and most of them live in the community. However, few clinical data exist regarding community-dwelling women with anorexia nervosa. The objective of this study was to determine the prevalences of common medical findings for these women. Cross-sectional, community-based study of 214 women with anorexia nervosa as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Participants were recruited through advertisements and community-based referrals to a study investigating skeletal health in outpatients with anorexia nervosa. The prevalences of medical findings among the 214 participants were as follows: anemia, 38.6%; leukocytopenia, 34.4%; hyponatremia, 19.7%; hypokalemia, 19.7%; bradycardia, 41.3%; hypotension, 16.1%; hypothermia, 22.4%; elevation of alanine aminotransferase concentration, 12.2%; osteopenia, 51.7%; osteoporosis, 34.6%; and primary amenorrhea, 14.8%. Moreover, 30% of the women reported histories of bone fractures. Except for leukocytopenia (P = .01), bone loss (P = .04), and bradycardia (P = .01), the probability of specific medical findings could not be predicted by the degree of undernutrition. These results demonstrate a high prevalence of medical findings in community-dwelling women with anorexia nervosa. Therefore, women with anorexia nervosa should be carefully followed up with regular physical examinations and laboratory assessments. In addition, low weight, particularly in conjunction with the abnormalities reported, should prompt the consideration of a diagnosis of anorexia nervosa.

Meals in nursing homes.

Undernutrition is present among 33% of nursing home residents in Denmark. Hence, it is relevant to examine the meal situation at nursing homes to single out factors that may increase or reduce the residents' food intake. In the ongoing Danish nursing home debate it is claimed that a new type of nursing home improves the residents' meal situation with a positive effect on nutrition. The aim of this work is to test the general hypothesis that (i) residents appreciate the meal situation in these nursing homes and (ii) nutritional status of the residents is improved in this type of nursing home. This study was carried out in four Danish nursing homes at various locations in Denmark. The methods used are qualitative interviews and observations at four nursing homes in combination with measurement of body mass index (BMI) at two of the four nursing homes. Undernutrition is defined as a BMI below 20. The study could not confirm the general hypothesis, as a consistent improvement in the meal situation was not found in the nursing homes studied. But an indication of improved nutritional status was found in two of the nursing homes where the degree of undernutrition was lower than generally found in Denmark. Furthermore, the study indicated that the staff and the residents conceived the nursing homes differently.

Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials

Background & Aims: A system for screening of nutritional risk is described. It is based on the concept that nutritional support is indicated in patients who are severely ill with increased nutritional requirements, or who are severely undernourished, or who have certain degrees of severity of disease in combination with certain degrees of undernutrition. Degrees of severity of disease and undernutrition were defined as absent, mild, moderate or severe from data sets in a selected number of randomized controlled trials (RCTs) and converted to a numeric score. After completion, the screening system was validated against all published RCTs known to us of nutritional support vs spontaneous intake to investigate whether the screening system could distinguish between trials with a positive outcome and trials with no effect on outcome. Methods: The total number of randomized trials identified was 128. In each trial, the group of patients was classified with respect to nutritional status and severity of disease, and it was determined whether the effect of nutritional intervention on clinical outcome was positive or absent. Results: Among 75 studies of patients classified as being nutritionally at-risk, 43 showed a positive effect of nutritional support on clinical outcome. Among 53 studies of patients not considered to be nutritionally at-risk, 14 showed a positive effect ( P=0.0006). This corresponded to a likelihood ratio (true positive/false positive) of 1.7 (95% CI: 2.3–1.2). For 71 studies of parenteral nutrition, the likelihood ratio was 1.4 (1.9–1.0), and for 56 studies of enteral or oral nutrition the likelihood ratio was 2.9 (5.9–1.4). Conclusion: The screening system appears to be able to distinguish between trials with a positive effect vs no effect, and it can therefore probably also identify patients who are likely to benefit from nutritional support.

Nutrition problems of hospitalised children in a developing country: Thailand.

Nutritional assessment reveals the nutritional status of a patient. It thereby helps identify each patient's need for specific nutritional care and facilitates early intervention. Generally, the common nutrition and nutrition-related problems in hospitalised paediatric patients are: protein energy malnutrition in various degrees; vitamin deficiencies such as A, B1, B2, niacin, folic acid, K and E; mineral deficiencies such as Zn, Fe, Ca, Mg, P, K and Na; essential fatty acid deficiencies; carbohydrate intolerance; maldigestion and malabsorption; and overweight and obesity. However, there is limited information about nutritional status of hospitalised patients in some countries, especially in developing countries. In Thailand, it was found that the prevalence of hospital malnutrition in children aged 1-15 years in the paediatric ward was similar (50-60%) to that of a study conducted 10 years earlier. In another study of micronutrients in 45 paediatric AIDS patients (aged 3-46 months), high prevalences of malnutrition, anaemia and mineral deficiencies were found. For convenience in clinical practice, body mass index (BMI) values for use as an indicator in the assessment of undernutrition in children whose heights are less than 145 cm have been published. These BMI values have been tested and retested using normal children and patients with various degrees of undernutrition and were found to be reliable and valid. Therefore, nutritional status must be assessed in all hospitalised patients. At the very least, weight and height (length) should be obtained.

Sip feed prescribing in primary care: an audit of current practice in Greater Glasgow Health Board, Glasgow, UK

Summary Background and aims: Prior to September 1995, prescribing of sip feeds had been increasing at a higher rate than any other part of the drugs bill. An increase in requests for information on the use of these products led the Prescribing Advisers Department to seek funding for a 1‐year project to document current practice in this area and produce guidelines for GPs, their practice nurses and district nurses. Methods: Questionnaires were completed by GPs (n=52), district nurses (n=94) and dietetic departments (n= 8) concerning current practice. In addition, 90 patients were interviwed and in all but one instance case notes were also consulted. Results: The most significant findings were that Primary Care staff see palliative care as one of the main areas of usage of these products and that 40% of patients were found to have some degree of undernutrition. The majority of patients interviewed were elderly and 10% of patients interviewed were in nursing homes. A significant proportion of patients interviewed had commenced sip feeds whilst in hospital. The majority of patients reported receiving no advice on diet with only one GP making written dietary advice available to patients. Finally, district nurses view company representatives as the most useful source of information on these products. Conclusions: In response to these findings, the project included the development of a standard communication form from secondary to primary care, dietary information resource development, development of guidelines on oral nutrition support in Primary Care and GP and district nurse training

Essential fatty acid metabolism in infants with cholestasis

Long‐chain polyunsaturated fatty acids are important for the growth and early development of the central nervous system. Cholestatic infants suffer from fat malabsorption and disturbed lipid metabolism and therefore may be at risk of developing polyunsaturated fatty acid depletion. The aims of this study were to determine essential fatty acid status in cholestatic infants and to study the relationship to disease severity, degree of undernutrition, antioxidant status and mode of feeding. Twenty‐four‐hour dietary records were obtained in 34 cholestatic infants, and measurements were taken of skin fold thicknesses, bilirubin levels, activities of serum alanine aminotransferase, alkaline phosphatase, gamma‐glutamyl transpeptidase, prothrombin time, serum concentrations of albumin, bile acids, total lipids, phospholipids, cholesterol, vitamins A and E, the fatty acid composition of plasma phospholipids and plasma lipid peroxides expressed as thiobarbiturate reactive substance (TBARS). Plasma phospholipid fatty acids and TBARS were also determined in 12 age‐matched healthy control infants. The cholestatic patients had very low percentage values of phospholipid essential fatty acids, particularly linoleic acid (18:2ω‐6, median 14.74% vs 20.76% in controls,p &lt; 0:001) and its major metabolite arachidonic acid (20:4ω‐6, 6.80 vs 7.87%,p= 0:04). The patients’essential fatty acid depletion was reflected by increased levels of the non‐essential fatty acids, Mead acid (20:3ω)‐9, 0.74 vs 0.21%, p&lt; 0:001) and palmitoleic acid (16:1ω‐7, 2.20 vs 0.43%, p&lt; 0:001). Polyunsaturated fatty acid profiles did not differ between infants with biliary atresia (n= 13) and those with intrahepatic cholestasis (n= 21), or between 17 infants with severe malnutrition (all skin folds &lt; 10th percentile) and mild malnutrition (at least two skin folds &gt; 10th percentile). TBARS were significantly higher in cholestatic patients than in controls (2.74 vs 0.85 nmol ml‐1,p &lt; 0:001) and correlated with direct (r= 0:41, p= 0:02) and total bilirubin. The daily dietary intake of linoleic acid (per 100 kcal) correlated with plasma phospholipid linoleic acid (r= 0:38,p= 0:037) and total ω‐6 fatty acids (r= 0:38,p= 0:036). Breastfed cholestatic infants (n= 6) had higher values of the ω‐3 long‐chain polyunsaturated fatty acids docosapentanoic acid (22:5ω‐3, 0.47 vs 0.28%, p= 0:0006) and docosahexanoic acid (22:6ω‐3, 2.39 vs 1.73%, p= 0:01) than formula‐fed infants, while disease severity was similar in the two groups. In conclusion, cholestatic infants are at high risk of essential fatty acid depletion, which appears to be related to fat malabsorption, hepatic essential fatty metabolism, enhanced lipid peroxidation and dietary intake.