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

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.