Table 1.

Association reported for polyunsaturated fatty acids and anorexia nervosa.

Authors, (Study location)	Ref	Subject and Study Design	PU FA examined	Key Findings
Langan et al, 1985 (USA)	[21]	17 hospitalized AN patients (16 female, 1 male) and 11 healthy female controls.	Plasma and phospholipids PUFA	AN patients had lower plasma stearic acid, lower phospholipid LA and total n-6 PUFA, and higher phospholipid DHA compared to controls.
Holman et al, 1995 (USA)	[22]	8 women with AN and 19 female controls	PUFA in plasma phospholipid, cholesteryl esters (CE), triglycerides (TG), and measurement of non-esterified fatty acids.	In AN: In phospholipids, LA was normal, GLA was elevated, the rest of n-6 PUFA were decreased. ALA was normal but the LC n-3 PUFA were subnormal. In CE, total PUFA, LA, and GLA were suppressed while EDA was elevated. In TG, AN had lower levels of GLA, osbond acid, ALA, DPA, free DGLA and ARA.
Zak et al, 2005 (Czech Republic)	[23]	16 women with AN and 25 healthy controls	PUFA in plasma cholesteryl esters (CE), triglycerides (TG), and phosphatidylcholine (PC).	In AN, a decrease of LA and overall n-6 PUFA were found in CE, TG, and PC. DHA was decreased but no change was found in overall n-3 PUFA in CE.
Swenne et al, May 2011 Dec. 2011 Aug. 2012 (Sweden)	[24–26]	220 patients with eating disorder (ED) and 39 healthy controls (May, 2011). 83 ED with depression and 133 ED without depression (Dec., 2011). 24 adolescents girls with ED with average > 10 kg weight loss at presentation (2012).	Plasma phospholipid and erythrocyte membranes (ERY) PUFA	AN had lower levels of LA, DGLA, total PUFA, total n-6 PUFA, and a higher level of DPA. No differences in EPA or DHA (May 2011). ED patients with depression had lower EPA, DHA, DPA, total LC-n-3 PUFA, and higher total LC n-6:n-3 PUFA and AA:DHA ratios compared to patients without depression (Dec. 2011). N-3 PUFA improved after weight gain. During weight loss, saturated and monounsaturated FA increased while LA decreased (2012).
Caspar-Bauguil et al, 2012 (France)	[27]	22 AN patients and 25 healthy controls.	RBC-phospholipids PUFA	RBC phospholipid LA was not different between the groups, but ALA was increased in AN and was inversely correlated with fat mass. EPA and DHA were reduced in AN. Total n-6 PUFA was positively correlated with fat mass. ALA was negatively correlated with fat mass.
Shih et al, 2016 (USA)	[15]	30 ill AN (IAN), 30 recovered AN (RecAN), and 36 healthy controls.	n-6 and n-3 PUFA, PUFA ratios, PUFA-derived eicosanoids.	Ill AN had higher levels of n-3 PUFA and n-6:n-3 ratios compared to RecAN and controls. AN had higher EPA:DPA and EPA:DHA ratios.