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Linoleic acid absorption in children with cystic fibrosis
Insights
Children with cystic fibrosis (CF) absorb linoleic acid better from monoglyceride form than triglyceride. Pancreatic enzymes and acid reducers improve absorption of safflower oil in CF patients.
Area of Science:
- Nutritional Science
- Gastroenterology
- Pediatrics
Background:
- Cystic Fibrosis (CF) impacts nutrient absorption due to exocrine pancreatic insufficiency.
- Linoleic acid, an essential fatty acid, requires efficient digestion and absorption.
- Understanding optimal fatty acid delivery in CF is crucial for nutritional management.
Purpose of the Study:
- To compare the absorption of linoleic acid from different lipid formulations in children with CF.
- To evaluate the effect of pancreatic enzymes on linoleic acid absorption from triglyceride and monoglyceride forms.
- To investigate the impact of acid-reducing medications on safflower oil absorption in CF.
Main Methods:
- Children with CF and controls consumed safflower oil (triglyceride), linoleic acid monoglyceride (LAM), or hydrolyzed safflower oil (free fatty acid).
- Plasma linoleic acid levels were measured over 4 hours post-ingestion.
- Absorption was assessed with and without pancreatic enzyme replacement therapy.
- The effect of antacid and cimetidine co-administration was examined in a subset of CF patients.
Main Results:
- Linoleic acid absorption was significantly higher from LAM compared to safflower oil in children with CF without pancreatic enzymes.
- Free fatty acid form showed minimal absorption in both CF and control groups.
- Pancreatic enzymes enhanced linoleic acid absorption from triglyceride but not LAM in CF patients.
- Concomitant use of antacid and cimetidine improved safflower oil absorption in some CF children.
Conclusions:
- Linoleic acid monoglyceride offers a more readily absorbed source of this essential fatty acid in children with CF.
- Pancreatic enzyme therapy is beneficial for triglyceride-based fat absorption, but less critical for monoglycerides.
- Acid-reducing agents may play a role in optimizing fat digestion and absorption in CF patients.
Abstract:
When safflower oil (triglyceride) was consumed without pancreatic enzymes by children with cystic fibrosis (CF), there was no rise in mean plasma linoleic acid levels over the next 4 h. When linoleic acid monoglyceride (LAM) was consumed, the increase in plasma linoleic acid levels was significantly greater than for safflower oil at 2 (p less than 0.02), 3 (p less than 0.01), and 4 h (p less than 0.01). When free fatty acid (hydrolyzed safflower oil) was ingested, there was almost no increase in plasma linoleic acid levels in CF or control children. The absorption of linoleic acid from triglyceride, but not from LAM, was greater when the CF children also took pancreatic enzymes. Three children with CF had greater increases in plasma linoleic acid levels following ingestion of safflower oil when they took antacid and cimetidine with their pancreatic capsules, compared to when they only took the pancreatic capsules.