Background: There is a growing evidence from experimental and observational studies on the importance of essential fatty acid (n-3 and n-6 fatty acids) in growth and cognitive development of children. The dietary intake of fats in most developing countries is usually lower than adequate levels. In Ghanaian children below five years of age, 19% are stunted, 5% are wasted and 11% are underweight. Stunting levels have decreased in the overall population, however, the situation still persist in Northern Ghana where 33% of all under-fives are stunted. The reason for this disparity is unknown, however, interventions have focused on vitamins, minerals and proteins, but none has focused fatty acids (FAs). Recent studies have utilized fat based supplements, however, none of the studies have assessed the FA status in Ghanaian children neither have the relationship between FA status and cognition been measured. Therefore the objective of this research was to measure whole blood levels of FA in Ghanaian children and to establish the association of the FA levels with growth and cognitive abilities. Methods: The study was conducted in two populations in Ghana: Northern Ghana population - Savelugu-Nanton district (n=306) and Southern Ghana - Upper Manya Krobo district (n=209). A drop of whole blood was collected on an antioxidant treated card. The dried blood spot was analyzed for FA composition using gas chromatography. Weight and height were measured, age and gender information were taken. Weight-for-height, height-for-age, body mass index-for-age and weight-for-length z-scores were calculated with the World Health Organization Anthro software suite. Executive function was assessed with dimensional change card sort (DCCS) task. Seeds, nuts and oils were collected from locations in Northern and Southern Ghana. Fats were extracted from these foods by acidified methanol. FA composition of extracts was measured using the DSQII quadruple GC/MS. Minerals in seeds were quantified with ICP emission spectroscopy. Results: In the Northern Ghana population, 8.0% of children were essential FA deficient and 10.6% of the Southern Ghanaian children were essential FA deficient as defined by T/T ratio >0.02. In Northern Ghana: 29.7% of the children were stunted, n-6 FAs were inversely associated with stunting and n-3 FAs are positively associated with executive function. In Southern Ghana: 22.0% of children were stunted and no FAs was associated with stunting. When the FAs were compared for both regions, n-3 FAs levels were significantly higher in the Southern Ghana population and n-6 FAs level were significantly higher in the Northern Ghana population. Although these results are just associations, they indicate the possible role of n-6 FAs in growth and n-3 FAs in cognition. Melon seeds (agushie), soybeans, palm oil, fermented dawadawa, neri and cashew nuts were identified as good sources of EFA and minerals.Conclusion: This dissertation demonstrates a strong association between whole blood essential fatty acids and growth and cognition. It further confirms the essentiality of n-6FAs in growth and gives insights on the relationship between n-3 FAs and cognition. Foods that contain EFAs in this population were also identified. These findings provide a basis of further research on how local foods can be used to eradicate malnutrition.
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