Essential fatty acid status and cognition in children with chronic intestinal failure
In brief
Nearly 1 in 3 children with intestinal failure had essential fat deficiency
In this small study, 5 of 17 children receiving home parenteral nutrition met criteria for essential fatty acid deficiency. Those children scored lower in working memory and cognitive processing than peers without deficiency, but the cross-sectional study cannot show that deficiency caused the differences. Larger prospective studies are needed to confirm the link and guide screening and lipid provision.
- Journal
- Journal of pediatric gastroenterology and nutrition (Q1)
- Published
- 26 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Xavier W Werner, Suzanne M C van Zundert, Aysenur Demirok, Marc A Benninga, Kim J Oostrom, Merit M Tabbers
- PMID
- 42929348
- DOI
- 10.1002/jpn3.70628
Why clinicians should know about it
- Picked for Pediatric Surgery (top studies of the week, 1 November 2026): Chronic intestinal failure cognition informs lifelong outcomes after bowel loss
Abstract
OBJECTIVES: Children with chronic intestinal failure (CIF) are at risk of cognitive delays, but the underlying mechanisms remain unclear. Essential fatty acid deficiency (EFAD) may impair brain development. Lipid restrictions in home parenteral nutrition (HPN) used to prevent intestinal failure-associated liver disease may increase EFAD risk. We assessed EFA status and cognitive functioning in children with CIF and examined associations with EFAD. METHODS: In this cross-sectional cohort study, children aged 4-17 years with CIF receiving HPN were included. EFAD was defined as a triene-to-tetraene ratio >0.007 with low linoleic and α-linolenic acid and elevated mead acid. Cognition was assessed using the Wechsler Intelligence Scale for Children (Fifth Edition) or Wechsler Preschool and Primary Scale of Intelligence (Fourth Edition); Full-Scale Intelligence Quotient (FSIQ) and index scores were compared with normative data and between EFAD and non-EFAD groups. EFA status was measured in erythrocyte membranes by gas chromatography. RESULTS: 17 of 23 eligible children participated (74%); 5 (29%) met EFAD criteria. Mean FSIQ was 90.7 ± 18.1 (p = 0.051 vs. normative mean). In children with EFAD, multiple cognitive domains were significantly lower than normative means. Compared with non-EFAD children, children with EFAD had a lower Cognitive Proficiency Index and Working Memory Index (CPI: 81.2 ± 6.3 vs. 103.8 ± 18.3, p = 0.018; WMI: 88.8 ± 9.9 vs. 108.0 ± 13.7, p = 0.013). CONCLUSIONS: EFAD was common in children with CIF and associated with lower working memory and processing efficiency. These findings support optimizing parenteral lipid provision to meet EFA requirements and considering EFAD screening. Larger prospective studies are needed to confirm these findings.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.