High-Oleic Ready-to-Use Therapeutic Food Maintains Docosahexaenoic Acid Status in Severe Malnutrition

Ji Cheng Hsieh, Lei Liu, Mamane Zeilani, Scott Ickes, Indi Trehan, Ken Maleta, Christina Craig, Chrissie Thakwalakwa, Lauren Singh, J. Thomas Brenna, Mark J. Manary

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Objectives: Ready-to-use therapeutic food (RUTF) is the preferred treatment for uncomplicated severe acute malnutrition. It contains large amounts of linoleic acid and little α-linolenic acid, which may reduce the availability of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to the recovering child. A novel high-oleic RUTF (HO-RUTF) was developed with less linoleic acid to determine its effect on DHA and EPA status. Methods: We conducted a prospective, randomized, double-blind clinical effectiveness trial treating rural Malawian children with severe acute malnutrition. Children were treated with either HO-RUTF or standard RUTF. Plasma phospholipid fatty acid status was measured on enrollment and after 4 weeks and compared between the 2 intervention groups. Results: Among the 141 children enrolled, 48 of 71 receiving HO-RUTF and 50 of 70 receiving RUTF recovered. Plasma phospholipid samples were analyzed from 43 children consuming HO-RUTF and 35 children consuming RUTF. The change in DHA content during the first 4 weeks was +4% and-25% in the HO-RUTF and RUTF groups, respectively (P = 0.04). For EPA, the change in content was 63% and-24% in the HO-RUTF and RUTF groups, respectively (P < 0.001). For arachidonic acid, the change in content was-3% and 13% in the HO-RUTF and RUTF groups, respectively (P < 0.009). Conclusions: The changes in DHA and EPA seen in the children treated with HO-RUTF warrant further investigation because they suggest that HO-RUTF support improved polyunsaturated fatty acid status, necessary for neural development and recovery.

Original languageEnglish
Pages (from-to)138-143
Number of pages6
JournalJournal of pediatric gastroenterology and nutrition
Issue number1
StatePublished - Jul 23 2015


  • docosahexaenoic acid
  • eicosapentaenoic acid
  • linolenic acid
  • ready-to-use therapeutic food
  • severe acute malnutrition


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