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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.
- Source :
- American Journal of Clinical Nutrition; Mar2015, Vol. 101 Issue 3, p632-645, 14p, 6 Charts, 6 Graphs
- Publication Year :
- 2015
-
Abstract
- Background: Moderate acute malnutrition (MAM), defined as weight-for-length z score between 23 and 22 or midupper arm circumference between 11.5 and 12.5 cm, affects ~33 million children aged < 5 y worldwide. Objective: The objective was to compare the effects of 4 dietary supplements for the treatment of MAM. Design: Twelve community health centers in rural Mali were randomly assigned to provide to 1264 MAM children aged 6-35 mo one of 4 dietary supplements containing ~500 kcal/d for 12 wk: 1) ready-to-use, lipid-based supplementary food (RUSF); 2) special corn-soy blend (CSB++); 3) locally processed, fortified flour (Misola); or 4) locally milled flours plus oil, sugar, and micronutrient powder (LMF). Results: In total, 1178 children (93.2%) completed the study. The adjusted mean (95% CI) change in weight (kg) from baseline was greater with RUSF than with the locally processed blends and was intermediate with CSB++ [1.16 (1.08, 1.24) for RUSF, 1.04 (0.96, 1.13) for CSB++, 0.91 (0.82, 0.99) for Misola, and 0.83 (0.74, 0.92) for LMF; P < 0.001]. For length change, RUSF and CSB++ differed significantly from LMF. Sustained recovery rates were higher with RUSF (73%) than with Misola (61%) and LMF (58%), P < 0.0001; CSB++ recovery rates (68%) did not differ from any of the other groups. Conclusions: 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. This trial was registered at clinicaltrials.gov as NCT01015950. [ABSTRACT FROM AUTHOR]
- Subjects :
- MALNUTRITION treatment
ENRICHED foods
BODY weight
C-reactive protein
CONFIDENCE intervals
CONVALESCENCE
DIETARY supplements
FERRITIN
FAT content of food
GRAIN
HEMOGLOBINS
PATIENT compliance
RESEARCH funding
STATURE
WEIGHT gain
SAMPLE size (Statistics)
RANDOMIZED controlled trials
BLIND experiment
ARM circumference
DATA analysis software
KAPLAN-Meier estimator
LOG-rank test
CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 00029165
- Volume :
- 101
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- American Journal of Clinical Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 101323655
- Full Text :
- https://doi.org/10.3945/ajcn.113.069807