Heather C Stobaugh1, Kelsey N Ryan2, Julie A Kennedy2, Jennifer B Grise2, Audrey H Crocker2, Chrissie Thakwalakwa3, Patricia E Litkowski4, Kenneth M Maleta3, Mark J Manary5, Indi Trehan6. 1. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; Departments of Pediatrics and. 2. Departments of Pediatrics and. 3. Departments of Community Health and. 4. Medicine, Washington University in St. Louis, St. Louis, MO; 5. Departments of Pediatrics and Departments of Community Health and Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX manary@kids.wustl.edu indi@alum.berkeley.edu. 6. Departments of Pediatrics and Paediatrics and Child Health, University of Malawi, Blantyre, Malawi; and manary@kids.wustl.edu indi@alum.berkeley.edu.
Abstract
BACKGROUND: The utility of dairy ingredients in the supplementary foods used in the treatment of childhood moderate acute malnutrition (MAM) remains unsettled. OBJECTIVE: We evaluated the effectiveness of a peanut-based ready-to-use supplementary food (RUSF) with soy protein compared with a novel RUSF containing dairy ingredients in the form of whey permeate and whey protein concentrate in the treatment of children with MAM. DESIGN: We conducted a randomized, double-blind clinical effectiveness trial involving rural Malawian and Mozambican children 6-59 mo of age with MAM treated with eithersoy RUSF or a novel whey RUSF treatment of ~75 kcal · kg(-1) · d(-1) for up to 12 wk. RESULTS: The proportion of children that recovered from MAM was significantly higher in the group that received whey RUSF (960 of 1144; 83.9%) than in the group that received soy RUSF (874 of 1086; 80.5%; P < 0.04; risk difference 3.4%, 95% CI: 0.3%, 6.6%). Children who consumed whey RUSF also demonstrated better growth markers, with a higher mean midupper arm circumference (MUAC) at the time of discharge (P < 0.009), greater MUAC gain during the course of treatment (P < 0.003), higher mean weight-for-height z score at discharge (P < 0.008), and greater weight gain (P < 0.05). No significant differences were identified in length gain or time to recovery between the 2 groups. CONCLUSION: This study highlights the importance of milk protein in the treatment of MAM, because the use of a novel whey RUSF resulted in higher recovery rates and improved growth than did soy RUSF, although the whey RUSF supplement provided less total protein and energy than the soy RUSF. This study was registered at clinicaltrials.gov as NCT01790048.
RCT Entities:
BACKGROUND: The utility of dairy ingredients in the supplementary foods used in the treatment of childhood moderate acute malnutrition (MAM) remains unsettled. OBJECTIVE: We evaluated the effectiveness of a peanut-based ready-to-use supplementary food (RUSF) with soy protein compared with a novel RUSF containing dairy ingredients in the form of whey permeate and whey protein concentrate in the treatment of children with MAM. DESIGN: We conducted a randomized, double-blind clinical effectiveness trial involving rural Malawian and Mozambicanchildren 6-59 mo of age with MAM treated with either soy RUSF or a novel whey RUSF treatment of ~75 kcal · kg(-1) · d(-1) for up to 12 wk. RESULTS: The proportion of children that recovered from MAM was significantly higher in the group that received whey RUSF (960 of 1144; 83.9%) than in the group that received soy RUSF (874 of 1086; 80.5%; P < 0.04; risk difference 3.4%, 95% CI: 0.3%, 6.6%). Children who consumed whey RUSF also demonstrated better growth markers, with a higher mean midupper arm circumference (MUAC) at the time of discharge (P < 0.009), greater MUAC gain during the course of treatment (P < 0.003), higher mean weight-for-height z score at discharge (P < 0.008), and greater weight gain (P < 0.05). No significant differences were identified in length gain or time to recovery between the 2 groups. CONCLUSION: This study highlights the importance of milk protein in the treatment of MAM, because the use of a novel whey RUSF resulted in higher recovery rates and improved growth than did soy RUSF, although the whey RUSF supplement provided less total protein and energy than the soy RUSF. This study was registered at clinicaltrials.gov as NCT01790048.
Authors: Heather C Stobaugh; Lucy B Bollinger; Sara E Adams; Audrey H Crocker; Jennifer B Grise; Julie A Kennedy; Chrissie Thakwalakwa; Kenneth M Maleta; Dennis J Dietzen; Mark J Manary; Indi Trehan Journal: Am J Clin Nutr Date: 2017-06-14 Impact factor: 7.045
Authors: Ilana R Cliffer; Laetitia Nikiema; Breanne K Langlois; Augustin N Zeba; Ye Shen; Hermann B Lanou; Devika J Suri; Franck Garanet; Kenneth Chui; Stephen Vosti; Shelley Walton; Irwin Rosenberg; Patrick Webb; Beatrice L Rogers Journal: Curr Dev Nutr Date: 2020-01-23
Authors: Christian Fabiansen; Charles W Yaméogo; Ann-Sophie Iuel-Brockdorf; Bernardette Cichon; Maren J H Rytter; Anura Kurpad; Jonathan C Wells; Christian Ritz; Per Ashorn; Suzanne Filteau; André Briend; Susan Shepherd; Vibeke B Christensen; Kim F Michaelsen; Henrik Friis Journal: PLoS Med Date: 2017-09-11 Impact factor: 11.069
Authors: Erica C Borresen; Lei Zhang; Indi Trehan; Nora Jean Nealon; Kenneth M Maleta; Mark J Manary; Elizabeth P Ryan Journal: Curr Dev Nutr Date: 2017-09-21