Submitted to: Journal of Health, Population, and Nutrition
Publication Type: Peer reviewed journal
Publication Acceptance Date: 12/1/2005
Publication Date: 12/1/2005
Citation: Patel, M.P., Sandige, H.L., Ndekha, M.J., Briend, A., Ashorn, P., Manary, M.J. 2005. Supplemental feeding with ready-to-use therapeutic food in Malawian children at risk of malnutrition. Journal of Health, Population, and Nutrition. 23(4):351-357. Interpretive Summary: Children in the developing world who are underweight and at risk for becoming severely malnourished often receive supplementary food. The most common food given is corn/soy blend, but unfortunately this is not very effective in helping these children to gain weight. New approaches to helping these children are needed. A ready-to-use, peanut butter-based food was developed to supplement the diet of Malawian children at risk for severe malnutrition. Three hundred thirty-one children at risk for malnutrition were given this ready-to-use therapeutic food, and 41 children were given the standard corn/soy blend for up to 8 weeks. Fifty-eight percent of the children given the ready-to-use food gained substantial weight, compared to only 22% receiving corn/soy blend. Ready-to-use therapeutic food promotes better growth in underweight children when compared to corn/soy blend.
Technical Abstract: The study was a controlled, comparative clinical effectiveness trial of two supplementary feeding regimens in children at risk of malnutrition from seven centres in rural Malawi. Being at risk of malnutrition was defined as weight-for-height <85%, but >80% of the international standard. A stepped-wedge design with systematic allocation was used for assigning children to receive either ready-to-use therapeutic food (RUTF) (n=331) or micronutrient-fortified corn/soy-blend (n=41) for up to 8 weeks. The primary outcomes were recovery, defined as weight-for-height >90%, and the rate of weight gain. Children receiving RUTF were more likely to recover (58% vs 22%; difference 36%; 95% confidence interval [CI] 20-52) and had greater rates of weight gain (3.1 g/kg.d vs 1.4 g/kg x d; difference 1.7; 95% CI 0.8-2.6) than children receiving corn/soy-blend. The results of this preliminary work suggest that supplementary feeding with RUTF promotes better growth in children at risk of malnutrition than the standard fortified cereal/legume-blended food.