Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods

Dibari, Filippo; Bahwere, Paluku; Huerga, Helena; Irena, Abel Hailu; Owino, Victor; Collins, Steve; Seal, Andrew

doi:10.1016/j.nut.2012.04.016

Cited by 19 publications

(19 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar to the findings from Kenya,15,26 we found that patients reported complaints about the unfamiliar taste of RUSF. In Kenya, it was common to mix RUSF with local foods to overcome unwanted taste and dietary monotony.…”

Section: Discussionsupporting

confidence: 88%

Use, perceptions, and acceptability of a ready-to-use supplementary food among adult HIV patients initiating antiretroviral treatment: a qualitative study in Ethiopia

Olsen

Tesfaye²,

Kæstel³

et al. 2013

PPA

View full text Add to dashboard Cite

ObjectivesReady-to-use supplementary foods (RUSF) are used increasingly in human immunodeficiency virus (HIV) programs, but little is known about how it is used and viewed by patients. We used qualitative methods to explore the use, perceptions, and acceptability of RUSF among adult HIV patients in Jimma, Ethiopia.MethodsThe study obtained data from direct observations and 24 in-depth interviews with HIV patients receiving RUSF.ResultsParticipants were generally very motivated to take RUSF and viewed it as beneficial. RUSF was described as a means to fill a nutritional gap, to “rebuild the body,” and protect it from harmful effects of antiretroviral treatment (ART). Many experienced nausea and vomiting when starting the supplement. This caused some to stop supplementation, but the majority adapted to RUSF. The supplement was eaten separately from meal situations and only had a little influence on household food practices. RUSF was described as food with “medicinal qualities,” which meant that many social and religious conventions related to food did not apply to it. The main concerns about RUSF related to the risk of HIV disclosure and its social consequences.ConclusionHIV patients view RUSF in a context of competing livelihood needs. RUSF intake was motivated by a strong wish to get well, while the risk of HIV disclosure caused concerns. Despite the motivation for improving health, the preservation of social networks was prioritized, and nondisclosure was often a necessary strategy. Food sharing and religious fasting practices were not barriers to the acceptability of RUSF. This study highlights the importance of ensuring that supplementation strategies, like other HIV services, are compatible with the sociocultural context of patients.

show abstract

Section: Discussionsupporting

confidence: 88%

Use, perceptions, and acceptability of a ready-to-use supplementary food among adult HIV patients initiating antiretroviral treatment: a qualitative study in Ethiopia

Olsen

Tesfaye²,

Kæstel³

et al. 2013

PPA

View full text Add to dashboard Cite

show abstract

“…In Malawi, 92.4% of participants reported consuming the recommended amount (140 g) the day prior to clinical visit [26], while in Ethiopia, 74% reported eating the recommended portion (200g LNS+30g whey or soy protein) in the prior three days [46]. In Kenya, participants in a cross-over randomized control trial ate more than 75% of the daily dosage of peanut-based LNS (250g) on 87.7% of days under direct observation (compared to 86.1% of days for a soy maize blend) [42]. In Ghana, 96% of participants reported consuming the recommended 20g “every time” [17].…”

Section: Discussionmentioning

confidence: 99%

“I Have Remained Strong Because of That Food”: Acceptability and Use of Lipid-Based Nutrient Supplements Among Pregnant HIV-Infected Ugandan Women Receiving Combination Antiretroviral Therapy

et al. 2014

View full text Add to dashboard Cite

We evaluated the acceptability and use of macronutrient supplementation among HIV-infected pregnant Ugandan women receiving antiretroviral therapy in a clinical study (NCT 00993031). We first conducted formative research among 56 pregnant and lactating women to select a supplement regimen. Acceptability and use of the supplementation regimen [35 sachets of lipid-based nutrient supplements (LNS) and 4 or 6 kg of instant soy porridge for the household provided monthly] were evaluated among 87 pregnant women. Organoleptic assessments of LNS were favorable. Participants reported consuming LNS a mean of 6.1 days per week, and adherence to recommended consumption behaviors (e.g. frequency, quantity, not sharing) was >80%. Few women reported negative social consequences of supplementation. The majority of participants also consumed most of the porridge intended for the household. In sum, LNS was acceptable and used regularly. Larger studies to evaluate physical and psychosocial consequences of LNS during pregnancy among HIV-infected women are warranted.

show abstract

“…They include soybeanmaize-sorghum ready-to-use therapeutic food (SMS RUTF), soybeanmaize-sorghum ready-to-use supplementary foods (SMS RUSF) and soybean-maize-sorghum ready-to-use complementary food (SMS RUCF). Acceptability and efficacy of SMS-RUF have been tested for treatment and prevention of malnutrition [13][14][15] among children in resource poor settings. The impact of consumption of SMS-RUCF on breast milk intake has also been assessed [16].…”

Section: Introductionmentioning

confidence: 99%

Estimated Iron and Zinc Bioavailability in Soybean-Maize-Sorghum Ready to Use Foods: Effect of Soy Protein Concentrate and Added Phytase

PO¹,

Egli²

2016

J Food Process Technol

View full text Add to dashboard Cite

Citation: Akomo PO, Egli I, Okoth MW, Bahwere P, Cercamondi CI, et al. (2016) AbstractEfficacy and cost of nutritional supplements are critical in addressing malnutrition. Use of cheaper and locally available ingredients in manufacturing ready-to-use foods (RUF) can potentially reduce cost and increase access to supplements in resource-poor settings. Soy protein concentrate (SPC) is a cheaper source of protein and can potentially replace the more expensive milk powder in RUF. However, SPC contains phytic acid (PA) which inhibits mineral bioavailability. PA may be degraded by the enzyme phytase. This study aimed to determine the effect of replacing skim milk powder (MP) with SPC and of added phytase on bioavailability of iron and zinc in soybean-maize-sorghum RUF.RUF samples were made using either SPC or MP. Phytase was added to food samples with either low (<5%) or high (>50%) moisture prior to estimation of bioavailability of iron and zinc by in vitro dialysability. Compared to samples with MP, SPC-based foods had significantly higher content of PA (0.84 g/100 g vs. 0.57 g/100 g; p<0.001); lower bioavailability of iron (2.79% vs. 4.85%; p<0.001) and lower zinc bioavailability (3.61% vs. 8.69% for zinc; p<0.001). After one hour of incubation at 35°C, 68% of PA in high-moisture foods and 10% of PA in low moisture foods were degraded. The data indicate that replacing MP with SPC in SMS RUF increases PA content with subsequent reduction of bioavailability of iron and zinc. Added phytase significantly reduces PA content in high moisture foods and may potentially remain active in the Stomach where moisture is high. Adding such a phytase could be a promising approach to increase iron and zinc bioavailability from SMS RUFs and provide cheaper locally produced formulations for addressing malnutrition in resource-poor settings.

show abstract

Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods

Cited by 19 publications

References 24 publications

Use, perceptions, and acceptability of a ready-to-use supplementary food among adult HIV patients initiating antiretroviral treatment: a qualitative study in Ethiopia

Use, perceptions, and acceptability of a ready-to-use supplementary food among adult HIV patients initiating antiretroviral treatment: a qualitative study in Ethiopia

“I Have Remained Strong Because of That Food”: Acceptability and Use of Lipid-Based Nutrient Supplements Among Pregnant HIV-Infected Ugandan Women Receiving Combination Antiretroviral Therapy

Estimated Iron and Zinc Bioavailability in Soybean-Maize-Sorghum Ready to Use Foods: Effect of Soy Protein Concentrate and Added Phytase

Contact Info

Product

Resources

About