Fatty acid status and dietary intake of children and their caregivers from three distinct communities

Abstract

Background: Dietary fat intake particularly of omega-3 and omega-6 fatty acids play an important role in growth and development and influence the risk of nutrition related non communicable diseases. These dietary intakes are reflected in the red blood cell (RBC) fatty acid profile. Aim: The aim of this study was to assess the fatty acid profile (%) of red blood cell membrane phospholipids in relation to the dietary intake of South African children aged 2 to 5 years, and of their mothers/caregivers from three communities, each with distinct dietary patterns. Method: In this cross-sectional observational study, approximately 105 children, aged: 2-5 years and their mother/caregivers were selected from three different geographical areas. These included; the urban community of De Aar (n=105), the urban coastal community Ocean View (n=93) and the rural community of Sekhukhune District (n=104). The red blood cell membrane total phospholipid fatty acid profile was determined by gas chromatography. A 24-hour dietary recall was done for each child and mother/caregiver as well as a socio-demographic questionnaire answered by each mother/caregiver. The mean and standard deviations of the RBC fatty acids were determined and compared through an analysis of variance (ANOVA) test followed by a Bonferroni post hoc test. Age and gender were controlled for in the children and age was controlled for in the mothers/caregivers. The median dietary intake (quartile range) was compared between communities by a Kruskal-Wallis test. The relationship between RBC membrane total phospholipid fatty acid profile and dietary fatty acid intake was done by stratifying the data for the three groups combined into tertiles according to RBC fatty acid profile and comparing the median (quartile range) of the dietary fatty acid intake in the different strata. Results: In the children, the total dietary fat, SFA and PUFA and omega-3 intake of De Aar (34.2%, 11.9%, 5.9% and 0.2% of energy, respectively) and Ocean View (33.0%, 11.2%, 7.4% and 0.2% of energy, respectively) was significantly different to Sekhukhune (19.9%, 6.5%, 3.0% and 0.1% of energy, respectively). Eicosaipentanoic (EPA) and docosahexaenoic (DHA) and α-linolenic acid (ALA) mean intake in children in all three sites was lower than recommended. In children from De Aar the RBC membrane total phospholipids contained significantly higher SFA and trans-fat percentages, while children in Sekhukhune District had significantly higher PUFA, omega-6 and omega-3 percentages. The linoleic acid (LA) profile in children from Ocean View was significantly higher than in those from De Aar and Sekhukhune District. The mother/caregivers’ dietary fat intake of total fat, SFA, PUFA and trans-fat was significantly higher in De Aar (31.7%, 10.5%, 6.3% and 0.2% of energy respectively) and Ocean View (37.4%, 12.1%, 8.5% and 0.59% of energy respectively) in comparison to Sekhukhune District (15.7%, 3.0%, 3.2% and 0.02% energy respectively). PUFA intakes were significantly higher in Ocean View (8.5% of energy). EPA, DHA and ALA dietary intakes were lower than recommended. The mother/caregiver’s RBC membrane total phospholipid SFA percentage was significantly higher in mothers/caregivers from De Aar and Ocean View whereas those from Sekhukhune District had significantly higher PUFA and omega-3 percentage. Conclusion: Differences particularly between the urban areas of De Aar and Ocean View and the rural area of Sekhukhune District were observed in dietary fat intake which was reflected in the red blood cell membrane total phospholipid fatty acid profile for children and mother/caregivers. Dietary omega-3 fatty acid intake was low in both children and mother/caregivers from all three study sites and is of concern.