Is the Inclusion of Animal Source Foods in Fortified Blended Foods Justified?

Abstract

Fortified blended foods (FBF) are used for the prevention and treatment of moderate acute malnutrition (MAM) in nutritionally vulnerable individuals, particularly children. A recent review of FBF recommended the addition of animal source food (ASF) in the form of whey protein concentrate (WPC), especially to corn-soy blends. The justification for this recommendation includes the potential of ASF to increase length, weight, muscle mass accretion and recovery from wasting, as well as to improve protein quality and provide essential growth factors. Evidence was collected from the following four different types of studies: (1) epidemiological; (2) ASF versus no intervention or a low-calorie control; (3) ASF versus an isocaloric non-ASF; and (4) ASF versus an isocaloric, isonitrogenous non-ASF. Epidemiological studies consistently associated improved growth outcomes with ASF consumption; however, little evidence from isocaloric and isocaloric, isonitrogenous interventions was found to support the inclusion of meat or milk in FBF. Evidence suggests that whey may benefit muscle mass accretion, but not linear growth. Overall, little evidence supports the costly addition of WPC to FBFs. Further, randomized isocaloric, isonitrogenous ASF interventions with nutritionally vulnerable children are needed.

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

“…In the larger context of the operational costs of a supplementary feeding program that includes staff, anthropometric equipment, logistical support, and facilities, this additional cost is quite minimal for the significantly higher recovery rate achieved. Although some have questioned whether the benefits of including dairy protein are worth the additional expense (6), this study provides evidence that their inclusion leads to improved outcomes in children with MAM with only a marginal increase in cost.…”

“…Whereas previous studies have shown positive correlations between the consumption of dairy protein and improved outcomes in undernourished populations (8-10), it was unclear whether those findings specifically were due to the type of protein in the food or simply the total amount of protein (6). Despite providing 33% less total protein and nearly 8% less total energy, outcomes were better in children receiving whey RUSF than in those receiving soy RUSF.…”

“…Despite its popularity, evidence supporting the use of whey in supplementary foods for malnourished children is limited (6). In this double-blind, randomized controlled clinical effectiveness trial, we compared 2 RUSF products (a soy RUSF and a novel whey RUSF) in the treatment of children with MAM.…”

Newly formulated, protein quality-enhanced, extruded sorghum-, cowpea-, corn-, soya-, sugar- and oil-containing fortified-blended foods lead to adequate vitamin A and iron outcomes and improved growth compared with non-extruded CSB+ in rats

“…Dietary variety beyond food aid may contribute to these findings as well. A 2014 review found that FBF containing isoenergetic, isonitrogenous sources of animal-source proteins did not enhance linear growth compared with plant proteins, suggesting that animal protein itself may not be needed to be included in FBF ( 17 ) . While total weight gained is used as a surrogate for protein efficiency, studies have also supported that weight gain is not an accurate surrogate for prevention of stunting, more accurately depicted by linear growth.…”

Novel Formulated Fortified Blended Foods Result in Improved Protein Efficiency and Hepatic Iron Concentrations Compared with Corn-Soy Blend Plus in Broiler Chickens

“…This process precooks FBFs, meaning that they require less time and resources to prepare. It has also been suggested that animal-source protein, such as whey protein concentrate (WPC), be included in FBFs (6); however, its costly inclusion has been questioned (11, 12). Plant protein alternatives, such as soy protein isolate (SPI), may be a less-expensive option that leads to similar product and nutritional outcomes (13).…”