Tohoku J. Exp. Med., 2009, 217(1)

The Nutrient Formula Containing Eicosapentaenoic Acid and Docosahexaenoic Acid Benefits the Fatty Acid Status of Patients Receiving Long-Term Enteral Nutrition

MITSUTOSHI MUNAKATA,^{1, 2} MASAZUMI NISHIKAWA,³ NORIKO TOGASHI,⁴ EIKO NIO,⁴ YASUKO KOBAYASHI,⁵ KIYOSHI OMURA,⁵ KAZUHIRO HAGINOYA,¹ SOICHIRO TANAKA,¹ TAKUYA ABE,^3,6 TAKANORI HISHINUMA,⁶ NOBUKAZU CHIDA,⁴ SHIGERU TSUCHIYA² and AKIRA ONUMA¹

¹Division of Pediatric Neurology, Takuto Rehabilitation Center for Children, Sendai, Japan
²Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan
³Department of Food Management, School of Food, Agricultural and Environmental Sciences, Miyagi University, Sendai, Japan
⁴EKO-RYOUIKUEN Hospital Home for Children and Persons with Severe Motor and Intellectual Disabilities, Sendai, Japan
⁵Division of Pediatric Neurology, Nishitaga National Hospital, Sendai, Japan
⁶Division of Pharmacotherapy, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan

Currently, various formulas with different fatty acid compositions are used for enteral nutrition (EN). All formulas contain various concentrations of essential fatty acids: linoleic acid (LA) and α-linolenic acid (ALA); LA is biotransformed into arachidonic acid (AA) and ALA into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in vivo. Some formulas contain preformed EPA and DHA. However, the effects of the differences in the fatty acid composition on the fatty acid status of patients receiving long-term EN is not clear. We measured serum fatty acid concentrations in 50 patients with neurological diseases receiving long-term EN. The data were then compared retrospectively with reference to the fatty acid compositions of the formulas used. All of the patients received almost their entire nutritional intake via EN for at least 1 year. Blood samples were obtained just before injecting the EN solution. Among the formulas that did not include EPA or DHA, formulas with low ALA concentrations were associated with low serum EPA and DHA. Conversely, the ALA-enriched formulas with reduced LA concentrations significantly increased EPA and DHA levels, although the levels remained lower than the control values. With the formula containing EPA and DHA, the EPA and DHA levels reached control values. Therefore, the fatty acid composition of the EN formulas affected the fatty acid status of patients receiving long-term EN. Formulas containing preformed EPA and DHA with suitable amounts of essential fatty acids may benefit these patients.

keywords —— enteral nutrition; essential fatty acid; arachidonic acid; eicosapentaenoic acid; docosahexaenoic acid; dysphagia.

© 2009 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2009, 217, 23-28

Correspondence: Mitsutoshi Munakata, M.D., Ph.D., Department of Pediatrics, Tohoku University School of Medicine, Sendai 980-8574, Japan.

e-mail: m-munakata@umin.ac.jp