Fatty acids normalize without help in girls with eating disorders

By Helen Albert

Omega-3 essential fatty acid supplementation is unnecessary for adolescent girls with eating disorders and weight-loss eating disorder, as levels normalize once they return to normal weight, say researchers.

Ingemar Swenne and Agneta Rosling (Uppsala University, Sweden) do acknowledge, however, that girls with long-term disease who are resistant to treatment may benefit from such supplementation.

Essential omega-3 fatty acids have been shown to decrease below recommended levels in people with weight-loss eating disorder. This has caused concern, as low levels of these fatty acids have been linked to an increased risk for depression and supplementation has been suggested as a preventative measure.

As reported in Acta Paediatrica, Swenne and Rosling assessed whether essential fatty acid levels return to normal without supplementation during nutritional rehabilitation of 24 adolescent girls with weight-loss eating disorders (17 anorexia nervosa; seven eating disorder - not otherwise specified).

The girls had lost at least 10 kg over the previous year as a result of their disorder, were aged 14.3 years on average before treatment, and had a mean body mass index (BMI) of 15.0 kg/m².

For comparison purposes, 39 healthy teenage girls of a similar age (15.5 years on average) and with a mean body mass index of 21.2 kg/m² were also recruited.

Fatty acid levels in erythrocyte membranes were taken from blood samples as a measure of fatty acid status at enrollment (for controls and patients) and at 1 year follow up (patients).

The patients underwent nutritional rehabilitation, and at 1 year had achieved an average BMI at the lower end of normal (19.0 kg/m²).

Levels of total polyunsaturated fatty acids (PUFAs) as a proportion of total fatty acids were low at enrollment in the girls with eating disorders (37.8), but at 1 year they had returned to almost normal levels (40.8) when compared with controls (41.0). Their omega-3 fatty acid status also improved from baseline.

"Adequate nutrition, normalization of eating behaviors, weight gain and the consequent return to normalization of metabolism and endocrine function are sufficient to ensure normalization of essential fatty acid status," say Swenne and Rosling.

"Supplementation with omega-3 polyunsaturated fatty acids does not appear warranted," they add. But, they caution that their study was small and of limited duration and suggest that patients with long-term weight loss may benefit from dietary supplementation to reduce their risk for depression.

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