Essential fatty acid status in tube‐fed children with medical complexity: A cross‐sectional study

Abstract Objective Essential fatty acid deficiency (EFAD) occurs when daily nutrition provisions lack sufficient linoleic acid or a‐linolenic acid. Signs, symptoms, and sequelae are nonspecific but impact health and quality of life. The objective of this study was to determine the incidence of EFAD among pediatric patients with chronic, complex healthcare needs. Methods This single‐center, cross‐sectional study included individuals from a specialty clinic designed for children with medical complexity. Clinically stable, exclusively tube‐fed patients aged 4–21 years were prospectively enrolled to collect a serum fatty acid panel. Individual fatty acids, anthropometrics and diet history were analyzed with descriptive statistics and linear regression analysis. Results Among 77 patients, the median triene:tetraene (T:T) ratio was 0.022 (interquartile range 0.019–0.028). Overall, linoleic, a‐linolenic, and mead acid levels were within standard reference ranges with median levels of 3266, 101, and 22 nmol/mL, respectively. Two patients met criteria for biochemical EFAD with T:T ratios of 0.052 and 0.062. There was no difference in T:T ratio by formula type. There was a negative correlation with daily calorie intake and T:T ratio. Patients identified as overweight had slightly higher average T:T ratios. Conclusions The incidence of EFAD in this cohort was low at 2.6%. Fatty acid profiles do not need to be collected routinely. However, they should be considered if signs and symptoms of deficiency are present or in the setting of other identified risk factors, specifically obesity or additional reasons for calorie restriction below 40 kilocalories per kilogram daily.