Location: Children's Nutrition Research CenterTitle: Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: A randomized, double-blind clinical trial Author
|Stobaugh, Heather - Tufts University|
|Ryan, Kelsey - Washington University|
|Kennedy, Julie - Washington University|
|Grise, Jennifer - Washington University|
|Crocker, Audrey - Washington University|
|Thakwalakwa, Chrissie - University Of Malawi|
|Litkowski, Patricia - Washington University|
|Maleta, Kenneth - University Of Malawi|
|Manary, Mark - Children'S Nutrition Research Center (CNRC)|
|Trehan, Indi - Washington University|
Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/22/2015
Publication Date: 3/1/2016
Citation: Stobaugh, H.C., Ryan, K.N., Kennedy, J.A., Grise, J.B., Crocker, A.H., Thakwalakwa, C., Litkowski, P.E., Maleta, K.M., Manary, M.J., Trehan, I. 2016. Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: A randomized, double-blind clinical trial. American Journal of Clinical Nutrition. 103(3):926-933.
Interpretive Summary: This study compared two types of protein in ready to use supplementary food (RUSF) that is used to treat children with moderate malnutrition. Children that received the RUSF with milk protein had a higher recovery rates and better weight gain than children that received RUSF with soy protein. This highlighted the importance of milk protein in the treatment of children with moderate malnutrition.
Technical Abstract: The utility of dairy ingredients in the supplementary foods used in the treatment of childhood moderate acute malnutrition (MAM) remains unsettled. 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. We conducted a randomized, double-blind clinical effectiveness trial involving rural Malawian and Mozambican children 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. 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. 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.