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

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 readyto-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 w75 kcal $ kg 21 $ d 21 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-forheight 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.Am J Clin Nutr 2016;103:926-33.

Organic whey as a source of Lactobacillus strains with selected technological and antimicrobial properties

“…Recent studies have reported the beneficial effects of whey protein on the health of children, adults and elderly. The growing interest in whey has been noted (Stobaugh et al, 2016).…”

Children with moderate acute malnutrition have inflammation not explained by maternal reports of illness and clinical symptoms: a cross-sectional study in Burkina Faso

“…Few studies have reported on morbidity in children with moderate wasting or moderate acute malnutrition (MAM) [9][10][11][12][13][14][15] and most based only on symptom-recall. Current case definitions of MAM includes children with moderate wasting and/or a mid-upper arm circumference (MUAC) between 115 and 125 mm [16].…”

Milk products in the dietary management of childhood undernutrition – a historical review

“…Ready-to-use supplementary foods (RUSF), with a higher energy density and adjusted micronutrient compositions, were developed for moderately wasted children, as well as pregnant and lactating women (124,(175)(176)(177) . The inclusion of milk protein in RUSF appears beneficial in children recovering from MAM (155) . Two recent intervention studies in Guinea-Bissau demonstrated that RUSF with a higher dairy protein content (33 %) were superior to RUSF with a lower content (15 %) in the community-based management of undernourished preschool children and mothers (154,178) .…”