With the hypothesis that dietary LC-PUFAS may favour small intestinal mucosa repair 21 severely malnourished patients (mean W/A -3 Z score on admission), <2 years of age, with diarrhea (15-90 days), dehydrated >5% and with multiple infections, were evaluated on admission and after 3 weeks recovery. They were fed ad libitum with a formula (67Kcal/100 ml) based on casein hydrolisate, glucose polimers and milk fat (Control group C, n=10), supplemented with a phospholipid concentrate purified from pig brain, which provided LC-PUFAs n-3 and n-6 series (Experimental group E, n=11). On admission, in C 4/9, 9/10 and 3/8 and in E 7/11, 10/12 and 6/11 patients had low lactase, sucrase-isomaltase and maltases levels (<10, <40 and<100U, respectively). 3 weeks later these figures were 4/9, 6/9 and 4/9 in C and 7/10, 7/10 and 5/10 in E. Light microscopy showed mild to moderate changes on admission, in both groups, after 3 weeks, partial recovery was observed in both groups. Tolerance to the formulas was good, reaching 158 and 169 mls/Kg day in C and E, between days 10-18 of follow up, respectivelly. After 3 weeks patients were clinically recovered, gaining weight (mean 0.33 and 0.24 points Z score for W/A in C and E, respectively (NS). Lipid profile(total lipids, phospholipids and triglycerides) in plasma, erythrocytes and jejunal biopsies showed significant increases of long chain (C18-c22) fatty acids of w-3 series in E.

CONCLUSION: Supplementation with PUFAs induced changes in lipid profile of blood and jejunal mucosa but this was not associated with better weight gain, increase of disacharidase activities or morphological recovery. Project European Union C11*CT92-0078.