Malian children with moderate acute malnutrition who are treated with lipid-based dietary supplements have greater weight gains and recovery rates than those treated with locally produced cereal-legume products: a community-based, cluster-randomized trial

Ackatia-Armah, Robert S; McDonald, Christine M; Doumbia, Seydou; Erhardt, Juergen; Hamer, Davidson H.; Brown, Kenneth H.

doi:10.3945/ajcn.113.069807

Cited by 74 publications

(89 citation statements)

References 28 publications

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“…For example, no differences in growth were found in 6- to 12-month-old infants consuming soya, casein or rice formula along with complementary feeding ( 40 ) . In infant studies, plant protein sources have been as efficacious as other ready-to-use foods for growth ( 41 , 42 ) , despite possibly poor protein quality identified in our study. Dietary variety beyond food aid may contribute to these findings as well.…”

Section: Discussionmentioning

confidence: 69%

Newly formulated, protein quality-enhanced, extruded sorghum-, cowpea-, corn-, soya-, sugar- and oil-containing fortified-blended foods lead to adequate vitamin A and iron outcomes and improved growth compared with non-extruded CSB+ in rats

et al. 2017

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Corn and soyabean micronutrient-fortified-blended foods (FBF) are commonly used for food aid. Sorghum and cowpeas have been suggested as alternative commodities because they are drought tolerant, can be grown in many localities, and are not genetically modified. Change in formulation of blends may improve protein quality, vitamin A and Fe availability of FBF. The primary objective of this study was to compare protein efficiency, Fe and vitamin A availability of newly formulated extruded sorghum-, cowpea-, soya- and corn-based FBF, along with a current, non-extruded United States Agency for International Development (USAID) corn and soya blend FBF (CSB+). A second objective was to compare protein efficiency of whey protein concentrate (WPC) and soya protein isolate (SPI) containing FBF to determine whether WPC inclusion improved outcomes. Eight groups of growing rats (n 10) consumed two white and one red sorghum–cowpea (WSC1 + WPC, WSC2 + WPC, RSC + WPC), white sorghum–soya (WSS + WPC) and corn–soya (CSB14 + WPC) extruded WPC-containing FBF, an extruded white sorghum–cowpea with SPI (WSC1 + SPI), non-extruded CSB+, and American Institute of Nutrition (AIN)-93G, a weanling rat diet, for 4 weeks. There were no significant differences in protein efficiency, Fe or vitamin A outcomes between WPC FBF groups. The CSB+ group consumed significantly less food, gained significantly less weight, and had significantly lower energy efficiency, protein efficiency and length, compared with all other groups. Compared with WSC1 + WPC, the WSC1 + SPI FBF group had significantly lower energy efficiency, protein efficiency and weight gain. These results suggest that a variety of commodities can be used in the formulation of FBF, and that newly formulated extruded FBF are of better nutritional quality than non-extruded CSB+.

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Section: Discussionmentioning

confidence: 69%

Newly formulated, protein quality-enhanced, extruded sorghum-, cowpea-, corn-, soya-, sugar- and oil-containing fortified-blended foods lead to adequate vitamin A and iron outcomes and improved growth compared with non-extruded CSB+ in rats

et al. 2017

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“…Few studies have reported on morbidity in children with moderate wasting or moderate acute malnutrition (MAM) [9][10][11][12][13][14][15] and most based only on symptom-recall. Current case definitions of MAM includes children with moderate wasting and/or a mid-upper arm circumference (MUAC) between 115 and 125 mm [16].…”

Section: Introductionmentioning

confidence: 99%

Children with moderate acute malnutrition have inflammation not explained by maternal reports of illness and clinical symptoms: a cross-sectional study in Burkina Faso

et al. 2016

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Background: Morbidity plays an important role in the development of and recovery from malnutrition. Morbidity in children with moderate acute malnutrition (MAM) has not been described in detail and it is unclear how morbidity compares to serum levels of acute phase proteins (APPs) which indicate systemic inflammation and which can impede response to therapeutic nutritional interventions. The objective of this study was to describe morbidity in children with MAM and to assess to what extent maternally reported and clinically diagnosed morbidity explain the variation in APPs. Methods: A cross-sectional sub study was conducted as part of a nutrition intervention trial among 6-23 months old children with MAM residing in Burkina Faso. Morbidity data collection at baseline included 2 week maternal recalls and physical examinations. Multivariate ANCOVA models were used to explore the associations between morbidity and C-reactive protein (CRP) as well as α 1 -acid glycoprotein (AGP). These models were also used to determine to what extent morbidity explains variation in APPs.

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“…Compared with the efficacy of milk-based products, certain milk-free formulations have been shown to be equivalent in the management of MAM (183,(192)(193)(194) , whereas in other studies, these formulations were less effective regarding the treatment of MAM (155,(195)(196)(197)(198)(199)(200) as well as SAM (201) . While a reduced efficacy of preparations without milk was generally most pronounced in children below the age of 2 years, it has been suggested that milk-free products should be used preferentially in the treatment of undernourished children older than 2 years, whereas the younger age group may depend more on products containing dairy products, especially if breast-feeding has been terminated (201,202) .…”

Section: Strategies To Reduce the Costs Of Milk-based Ready-to-use Foodsmentioning

confidence: 99%

Milk products in the dietary management of childhood undernutrition – a historical review

Scherbaum

Srour²

2017

Nutr. Res. Rev.

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The present narrative review outlines the use of milk products in infant and young child feeding from early history until today and illustrates how research findings and technical innovations contributed to the evolution of milk-based strategies to combat undernutrition in children below the age of 5 years. From the onset of social welfare initiatives, dairy products were provided by maternal and child health services to improve nutrition. During the last century, a number of aetiological theories on oedematous forms of undernutrition were developed and until the 1970s the dogma of protein deficiency was dominant. Thereafter, a multifactorial concept gained acceptance and protein quality was emphasised. During the last decades, research findings demonstrated that the inclusion of dairy products in the management of severe acute malnutrition is most effective. For children suffering from moderate acute malnutrition the evidence for the superiority of milk-based diets is less clear. There is an unmet need for evaluating locally produced milk-free alternatives at lower cost, especially in countries that rely on imported dairy products. New strategies for the dietary management of childhood undernutrition need to be developed on the basis of research findings, current child feeding practices, socio-cultural conditions and local resources. Exclusive and continued breast-feeding supported by community-based nutrition programmes using optimal combinations of locally available complementary foods should be compared with milk product-based interventions.

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Malian children with moderate acute malnutrition who are treated with lipid-based dietary supplements have greater weight gains and recovery rates than those treated with locally produced cereal-legume products: a community-based, cluster-randomized trial

Abstract: RUSF was more effective, but more costly, than other dietary supplements for the treatment of MAM; CSB++ yielded intermediate results. The benefits of treatment should be considered in relation to product costs and availability.

Cited by 74 publications

References 28 publications

Newly formulated, protein quality-enhanced, extruded sorghum-, cowpea-, corn-, soya-, sugar- and oil-containing fortified-blended foods lead to adequate vitamin A and iron outcomes and improved growth compared with non-extruded CSB+ in rats

Newly formulated, protein quality-enhanced, extruded sorghum-, cowpea-, corn-, soya-, sugar- and oil-containing fortified-blended foods lead to adequate vitamin A and iron outcomes and improved growth compared with non-extruded CSB+ in rats

Children with moderate acute malnutrition have inflammation not explained by maternal reports of illness and clinical symptoms: a cross-sectional study in Burkina Faso

Milk products in the dietary management of childhood undernutrition – a historical review

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