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Patients with Anorexia Nervosa Demonstrate Deficiencies of Selected Essential Fatty Acids, Compensatory Changes in Nonessential Fatty Acids and Decreased Fluidity of Plasma Lipids^1,2,

Ralph T. Holman, Catherine E. Adams^*,,, Ralph A. Nelson^,,, Simeon J. E. Grater^,,, Jerzy A. Jaskiewicz, Susan B. Johnson and John W. Erdman, Jr.^*,3

^* Department of Food Science College of Medicine, University of Illinois, Urbana, IL 61801 Department of Research, Carle Clinic, Carle Foundation Hospital, Urbana, IL 61801 Hormel Institute, University of Minnesota, Austin, MN 55912

The objective of this study was to assess the essential fatty acid status of patients with anorexia nervosa. Blood was collected from eight fasting female anorexia nervosa patients with a mean of 81% ideal body weight. Fatty acid composition of phospholipids, nonesterified fatty acids, triglycerides and cholesteryl esters of plasma were determined by capillary gas chromatography to indicate polyunsaturated fatty acids status compared with 19 healthy female adults <25 y old. Subjects with anorexia nervosa showed polyunsaturated fatty acid deficiencies in plasma phospholipids different from simple nutritional essential fatty acid deficiency or chronic malnutrition. The phospholipid profile showed significantly lower (n-6) and (n-3) elongation and desaturation products, and elevated short-chain saturated, short-chain monounsaturated, branched-chain and odd-chain fatty acids. These elevations indicate enhancement of biosynthesis of alternative fatty acids that only partially compensated for the loss of polyunsaturated fatty acids in providing membrane "fluidity." Calculated mean melting point of the fatty acids of phospholipids in patients with anorexia nervosa was elevated 7.7°C above normal values. These results demonstrate that patients with anorexia nervosa have deficiencies of selected essential fatty acids, compensatory changes in nonessential fatty acids and decreased fluidity of plasma lipids.

KEY WORDS: • essential fatty acids • humans • plasma phospholipids • membrane fluidity

¹ Supported by the Carle Foundation, National Institutes of Health Program Project Grant HL08214, by the Hormel Foundation (Austin, MN) and by Scotia Pharmaceuticals, Ltd. (Woodbridge Meadows, England).

² The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 USC section 1734 solely to indicate this fact.

³ To whom correspondence and reprint requests should be addressed.

Manuscript received 6 January 1994. Revision accepted 10 August 1994.