Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Lipids and cardiovascular/metabolic health

Whole-blood fatty acids and inflammation in European children: the IDEFICS Study



Fatty acids are hypothesized to influence cardiovascular disease risk because of their effect on inflammation. The aim of this study is to assess the relationship between whole-blood fatty acids (WBFAs) and high-sensitivity C-reactive protein (hs-CRP) in European children.


A total of 1401 subjects (697 boys and 704 girls) aged between 2 and 9 years from the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects in Children and infantS) study were measured in this cross-sectional analysis. The sample was divided into three categories of hs-CRP. Associations between WBFA and hs-CRP were assessed by logistic regression models adjusting for body mass index (BMI), country, age, breastfeeding, mother’s education and hours of physical activity.


Linoleic acid (LA) (P=0.013, 95% confidence interval (CI): 0.822–0.977) and sum of n-6 WBFA (P=0.029, 95% CI: 0.866–0.992) concentrations were associated with lower concentrations of hs-CRP in boys. In girls, a high ratio of eicosapentaenoic acid (EPA)/arachidonic acid (AA) was associated (P=0.018, 95% CI: 0.892–0.989) with lower hs-CRP concentrations. In contrast, sum of blood n-6 highly unsaturated fatty acids (P=0.012, 95% CI: 1.031–1.284), AA (P=0.007, 95% CI: 1.053–1.395) and AA/LA ratio (P=0.005, 95% CI: 1.102–1.703) were associated (P<0.05) with higher concentrations of hs-CRP in girls.


The n-6 WBFAs (sum of n-6 FA and LA) were associated with lower hs-CRP in boys and with higher hs-CRP in girls (AA, sum of n-6 highly unsaturated and AA/LA ratio). More studies are needed to identify the optimal levels of WBFAs to avoid low-grade inflammation in children considering the differences by sex and BMI.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2


  1. Greenberg AS, Obin MS . Obesity and the role of adipose tissue in inflammation and metabolism. Am J Clin Nutr 2006; 83: 461S–465SS.

    Article  CAS  Google Scholar 

  2. Montero D, Walther G, Perez-Martin A, Roche E, Vinet A . Endothelial dysfunction, inflammation, and oxidative stress in obese children and adolescents: markers and effect of lifestyle intervention. Obes Rev 2011; 13: 441–455.

    Article  Google Scholar 

  3. Warnberg J, Moreno LA, Mesana MI, Marcos A . Inflammatory mediators in overweight and obese Spanish adolescents. The AVENA Study. Int J Obes Relat Metab Disord 2004; 28 (Suppl 3), S59–S63.

    Article  Google Scholar 

  4. Ross R . Atherosclerosis–an inflammatory disease. N Engl J Med 1999; 340: 115–126.

    Article  CAS  Google Scholar 

  5. De Caterina R, Liao JK, Libby P . Fatty acid modulation of endothelial activation. Am J Clin Nutr 2000; 71 (1 Suppl), 213S–223S.

    Article  CAS  Google Scholar 

  6. Cook DG, Mendall MA, Whincup PH, Carey IM, Ballam L, Morris JE et al. C-reactive protein concentration in children: relationship to adiposity and other cardiovascular risk factors. Atherosclerosis 2000; 149: 139–150.

    Article  CAS  Google Scholar 

  7. Jarvisalo MJ, Harmoinen A, Hakanen M, Paakkunainen U, Viikari J, Hartiala J et al. Elevated serum C-reactive protein levels and early arterial changes in healthy children. Arterioscler Thromb Vasc Biol 2002; 22: 1323–1328.

    Article  CAS  Google Scholar 

  8. Ford ES . C-reactive protein concentration and cardiovascular disease risk factors in children: findings from the National Health and Nutrition Examination Survey 1999-2000. Circulation 2003; 108: 1053–1058.

    Article  CAS  Google Scholar 

  9. Dowd JB, Zajacova A, Aiello AE . Predictors of inflammation in U.S. children aged 3-16 years. Am J Prev Med 2010; 39: 314–320.

    Article  Google Scholar 

  10. Brown AA, Hu FB . Dietary modulation of endothelial function: implications for cardiovascular disease. Am J Clin Nutr 2001; 73: 673–686.

    Article  CAS  Google Scholar 

  11. Nettleton JA, Steffen LM, Mayer-Davis EJ, Jenny NS, Jiang R, Herrington DM et al. Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr 2006; 83: 1369–1379.

    Article  CAS  Google Scholar 

  12. Basu A, Devaraj S, Jialal I . Dietary factors that promote or retard inflammation. Arterioscler Thromb Vasc Biol 2006; 26: 995–1001.

    Article  CAS  Google Scholar 

  13. De Caterina R, Libby P . Control of endothelial leukocyte adhesion molecules by fatty acids. Lipids 1996; 31: S57–S63.

    Article  CAS  Google Scholar 

  14. He K, Liu K, Daviglus ML, Jenny NS, Mayer-Davis E, Jiang R et al. Associations of dietary long-chain n-3 polyunsaturated fatty acids and fish with biomarkers of inflammation and endothelial activation (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol 2009; 103: 1238–1243.

    Article  CAS  Google Scholar 

  15. Calder PC, Ahluwalia N, Brouns F, Buetler T, Clement K, Cunningham K et al. Dietary factors and low-grade inflammation in relation to overweight and obesity. Br J Nutr 2011; 106 (Suppl 3), S5–S78.

    Article  CAS  Google Scholar 

  16. Pischon T, Hankinson SE, Hotamisligil GS, Rifai N, Willett WC, Rimm EB . Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women. Circulation 2003; 108: 155–160.

    Article  CAS  Google Scholar 

  17. Superko HR, Superko SM, Nasir K, Agatston A, Garrett BC . Omega-3 fatty acid blood levels: clinical significance and controversy. Circulation 2013; 128: 2154–2161.

    Article  Google Scholar 

  18. Calder PC . n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 2006; 83 (6 Suppl), 1505S–1519S.

    Article  CAS  Google Scholar 

  19. Ferrucci L, Cherubini A, Bandinelli S, Bartali B, Corsi A, Lauretani F et al. Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers. J Clin Endocrinol Metab 2006; 91: 439–446.

    Article  CAS  Google Scholar 

  20. Lemaitre RN, King IB, Mozaffarian D, Kuller LH, Tracy RP, Siscovick DS . n-3 Polyunsaturated fatty acids, fatal ischemic heart disease, and nonfatal myocardial infarction in older adults: the Cardiovascular Health Study. Am J Clin Nutr 2003; 77: 319–325.

    Article  CAS  Google Scholar 

  21. Bokor S, Dumont J, Spinneker A, Gonzalez-Gross M, Nova E, Widhalm K et al. Single nucleotide polymorphisms in the FADS gene cluster are associated with delta-5 and delta-6 desaturase activities estimated by serum fatty acid ratios. J Lipid Res 2010; 51: 2325–2333.

    Article  CAS  Google Scholar 

  22. Marangoni F, Colombo C, Galli C . A method for the direct evaluation of the fatty acid status in a drop of blood from a fingertip in humans: applicability to nutritional and epidemiological studies. Anal Biochem 2004; 326: 267–272.

    Article  CAS  Google Scholar 

  23. Ahrens W, Bammann K, Siani A, Buchecker K, De Henauw S, Iacoviello L et al. The IDEFICS cohort: design, characteristics and participation in the baseline survey. Int J Obes (Lond) 2011; 35 (Suppl 1), S3–S15.

    Article  Google Scholar 

  24. Peplies J, Fraterman A, Scott R, Russo P, Bammann K . Quality management for the collection of biological samples in multicentre studies. Eur J Epidemiol 2010; 25: 607–617.

    Article  CAS  Google Scholar 

  25. Joshi-Barve S, Barve SS, Amancherla K, Gobejishvili L, Hill D, Cave M et al. Palmitic acid induces production of proinflammatory cytokine interleukin-8 from hepatocytes. Hepatology 2007; 46: 823–830.

    Article  CAS  Google Scholar 

  26. Laine PS, Schwartz EA, Wang Y, Zhang WY, Karnik SK, Musi N et al. Palmitic acid induces IP-10 expression in human macrophages via NF-kappaB activation. Biochem Biophys Res Commun 2007; 358: 150–155.

    Article  CAS  Google Scholar 

  27. Itakura H, Yokoyama M, Matsuzaki M, Saito Y, Origasa H, Ishikawa Y et al. Relationships between plasma fatty acid composition and coronary artery disease. J Atheroscler Thromb 2011; 18: 99–107.

    Article  CAS  Google Scholar 

  28. De Caterina R, Zampolli A . Omega-3 fatty acids, atherogenesis, and endothelial activation. J Cardiovasc Med (Hagerstown) 2007; 8 (Suppl 1), S11–S14.

    Article  Google Scholar 

  29. Rise P, Tragni E, Ghezzi S, Agostoni C, Marangoni F, Poli A et al. Different patterns characterize Omega 6 and Omega 3 long chain polyunsaturated fatty acid levels in blood from Italian infants, children, adults and elderly. Prostaglandins Leukot Essent Fatty Acids 2013; 89: 215–220.

    Article  CAS  Google Scholar 

  30. UNESCO. United Nations Educational Scientific and Cultural Organization. International Standard Classification of Education (ISCED) [WWW document] URL

  31. Santaliestra-Pasias AM, Mouratidou T, Verbestel V, Bammann K, Molnar D, Sieri S et al. Physical activity and sedentary behaviour in European children: the IDEFICS study. Public Health Nutr 2013; 8: 1–12.

    Google Scholar 

  32. Stomfai S, Ahrens W, Bammann K, Kovacs E, Marild S, Michels N et al. Intra- and inter-observer reliability in anthropometric measurements in children. Int J Obes (Lond) 2011; 35 (Suppl 1), S45–S51.

    Article  Google Scholar 

  33. Nappo A, Iacoviello L, Fraterman A, Gonzalez-Gil EM, Hadjigeorgiou C, Marild S et al. High-sensitivity C-reactive protein is a predictive factor of adiposity in children: results of the identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) study. J Am Heart Assoc 2013; 2: e000101.

    Article  Google Scholar 

  34. Nozue T, Yamamoto S, Tohyama S, Fukui K, Umezawa S, Onishi Y et al. Effects of serum n-3 to n-6 polyunsaturated fatty acids ratios on coronary atherosclerosis in statin-treated patients with coronary artery disease. Am J Cardiol 2013; 111: 6–11.

    Article  CAS  Google Scholar 

  35. Ninomiya T, Nagata M, Hata J, Hirakawa Y, Ozawa M, Yoshida D et al. Association between ratio of serum eicosapentaenoic acid to arachidonic acid and risk of cardiovascular disease: The Hisayama Study. Atherosclerosis 2013; 231: 261–267.

    Article  CAS  Google Scholar 

  36. Adkins Y, Kelley DS . Mechanisms underlying the cardioprotective effects of omega-3 polyunsaturated fatty acids. J Nutr Biochem 2010; 21: 781–792.

    Article  CAS  Google Scholar 

  37. Serhan CN, Clish CB, Brannon J, Colgan SP, Chiang N, Gronert K . Novel functional sets of lipid-derived mediators with antiinflammatory actions generated from omega-3 fatty acids via cyclooxygenase 2-nonsteroidal antiinflammatory drugs and transcellular processing. J Exp Med 2000; 192: 1197–1204.

    Article  CAS  Google Scholar 

  38. Calder PC, Grimble RF . Polyunsaturated fatty acids, inflammation and immunity. Eur J Clin Nutr 2002; 56 (Suppl 3), S14–S19.

    Article  CAS  Google Scholar 

  39. Decsi T, Kennedy K . Sex-specific differences in essential fatty acid metabolism. Am J Clin Nutr 2011; 94 (6 Suppl), 1914S–1919S.

    Article  CAS  Google Scholar 

  40. Childs CE, Romeu-Nadal M, Burdge GC, Calder PC . Gender differences in the n-3 fatty acid content of tissues. Proc Nutr Soc 2008; 67: 19–27.

    Article  CAS  Google Scholar 

  41. Crowe FL, Skeaff CM, Green TJ, Gray AR . Serum n-3 long-chain PUFA differ by sex and age in a population-based survey of New Zealand adolescents and adults. Br J Nutr 2008; 99: 168–174.

    Article  CAS  Google Scholar 

  42. Pufal MA, Moulin CC, Casagrande DS, Padoin AV, Suessenbach SP, Barhouch AS et al. Prevalence of overweight in children of obese patients: a dietary overview. Obes Surg 2012; 22: 1220–1224.

    Article  Google Scholar 

Download references


This work was done as part of the IDEFICS Study and was published on behalf of its European Consortium ( The information in this document reflects the views of the authors and is provided as is. We gratefully acknowledge the financial support of the European Community within the Sixth RTD Framework Programme Contract No. 016181 (FOOD). Isabelle Sioen is financially supported by the Research Foundation–Flanders (Grant No. 1.2.683.14.N.00).

Author information

Authors and Affiliations



Corresponding author

Correspondence to E M González-Gil.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

González-Gil, E., Santabárbara, J., Siani, A. et al. Whole-blood fatty acids and inflammation in European children: the IDEFICS Study. Eur J Clin Nutr 70, 819–823 (2016).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links