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.

Heather C Stobaugh, Kelsey N Ryan, Julie A Kennedy, Jennifer B Grise, Audrey H Crocker, Chrissie Thakwalakwa, Patricia E Litkowski, Kenneth M Maleta, Mark J Manary, Indi Trehan

Journal: The American journal of clinical nutrition 2016;103(3):926-33

PMID: 26864368

Abstract

BACKGROUND

The utility of dairy ingredients in the supplementary foods used in the treatment of childhood moderate acute malnutrition (MAM) remains unsettled.

OBJECTIVE

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.

DESIGN

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.

RESULTS

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.

CONCLUSION

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. This study was registered at clinicaltrials.gov as NCT01790048.

© 2016 American Society for Nutrition.

Address: Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; Departments of Pediatrics and.; Departments of Pediatrics and.; Departments of Community Health and.; Medicine, Washington University in St. Louis, St. Louis, MO;; Departments of Pediatrics and Departments of Community Health and Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX [email protected] [email protected].; Departments of Pediatrics and Paediatrics and Child Health, University of Malawi, Blantyre, Malawi; and [email protected] [email protected].
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