Location: Children's Nutrition Research CenterTitle: High-oleic ready-to-use therapeutic food maintains docosahexaenoic acid status in severe malnutrition
|HSIEH, JI-CHENG - Washington University|
|LIU, LEI - Cornell University - New York|
|ZEILANI, MAMANE - Nutriset|
|ICKES, SCOTT - College Of William & Mary|
|TREHAN, INDI - Washington University|
|MALETA, KEN - University Of Malawi|
|CRAIG, CHRISTINA - Washington University|
|THAKWALAKWA, CHRISSIE - University Of Malawi|
|SINGH, LAUREN - Washington University|
|BRENNA, THOMAS - Cornell University - New York|
|MANARY, MARK - Children'S Nutrition Research Center (CNRC)|
Submitted to: Journal of Pediatric Gastroenterology and Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/22/2015
Publication Date: 7/1/2015
Citation: Hsieh, J., Liu, L., Zeilani, M., Ickes, S., Trehan, I., Maleta, K., Craig, C., Thakwalakwa, C., Singh, L., Brenna, T., Manary, M.J. 2015. High-oleic ready-to-use therapeutic food maintains docosahexaenoic acid status in severe malnutrition. Journal of Pediatric Gastroenterology and Nutrition. 61(1):138-143.
Interpretive Summary: Severe malnutrition is treated with peanut butter-based ready to use therapeutic food. The types of oils in peanut are not optimal for brain growth and development because they block the synthesis of key fat components. A clinical trial was undertaken with a different type of peanut, called high oleic peanuts, to treat severe malnutrition. The chemical types of fats were measured in the children's blood. It was found that high oleic peanuts are more conducive to brain growth, and might well be used to create a superior therapeutic food.
Technical Abstract: Ready-to-use therapeutic food (RUTF) is the preferred treatment for uncomplicated severe acute malnutrition. It contains large amounts of linoleic acid and little a-linolenic acid, which may reduce the availability of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to the recovering child. A novel high-oleic RUTF (HO-RUTF) was developed with less linoleic acid to determine its effect on DHA and EPA status. We conducted a prospective, randomized, double-blind clinical effectiveness trial treating rural Malawian children with severe acute malnutrition. Children were treated with either HO-RUTF or standard RUTF. Plasma phospholipid fatty acid status was measured on enrollment and after 4 weeks and compared between the 2 intervention groups. Among the 141 children enrolled, 48 of 71 receiving HO-RUTF and 50 of 70 receiving RUTF recovered. Plasma phospholipid samples were analyzed from 43 children consuming HO-RUTF and 35 children consuming RUTF. The change in DHA content during the first 4 weeks was +4% and -25% in the HO-RUTF and RUTF groups, respectively (P=0.04). For EPA, the change in content was 63% and -24% in the HO-RUTF and RUTF groups, respectively (P<0.001). For arachidonic acid, the change in content was -3% and 13% in the HO-RUTF and RUTF groups, respectively (P<0.009). The changes in DHA and EPA seen in the children treated with HO-RUTF warrant further investigation because they suggest that HO-RUTF support improved polyunsaturated fatty acid status, necessary for neural development and recovery.