Specially formulated foods for treating children with moderate acute malnutrition in low- and middle-income countries

Lazzerini, Marzia; Rubert, Laura; Pani, Paola

doi:10.1002/14651858.cd009584.pub2

Cited by 93 publications

(119 citation statements)

References 223 publications

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“…Liquid nutritional supplement products among infants were, however, originally developed as a supplemental source of energy, proteins and/or specific nutrients for under- or mal-nourished children [16] and those diagnosed with “failure to thrive” (FTT), a non-specific diagnosis of growth failure stemming from a range of biological, psychosocial, and environmental factors [17]. Severe malnutrition is accompanied by pathophysiologic and adaptive changes that raise unique feeding challenges for nutritional rehabilitation.…”

Section: Promoting Healthy Growth: the Use And Claims Of Liquid-bamentioning

confidence: 99%

Promoting Healthy Growth or Feeding Obesity? The Need for Evidence-Based Oversight of Infant Nutritional Supplement Claims

2016

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The Developmental Origins of Health and Disease (DOHaD) model recognizes growth in infancy and childhood as a fundamental determinant of lifespan health. Evidence of long-term health risks among small neonates who subsequently grow rapidly poses a challenge for interventions aiming to support healthy growth, not merely drive weight gain. Defining healthy growth beyond “getting bigger” is essential as infant and young child feeding industries expand. Liquid-based nutritional supplements, originally formulated for undernourished children, are increasingly marketed for and consumed by children generally. Clarifying the nature of the evidentiary base on which structure/function claims promoting “healthy growth” are constructed is important to curb invalid generalizations. Evidence points to changing social beliefs and cultural practices surrounding supplementary feeding, raising specific concerns about the long-term health consequences of an associated altered feeding culture, including reduced dietary variety and weight gain. Reassessing the evidence for and relevance of dietary supplements’ “promoting healthy growth” claims for otherwise healthy children is both needed in a time of global obesity and an opportunity to refine intervention approaches among small children for whom rapid subsequent growth in early life augments risk for chronic disease. Scientific and health care partnerships are needed to consider current governmental oversight shortfalls in protecting vulnerable populations from overconsumption. This is important because we may be doing more harm than good.

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Section: Promoting Healthy Growth: the Use And Claims Of Liquid-bamentioning

confidence: 99%

Promoting Healthy Growth or Feeding Obesity? The Need for Evidence-Based Oversight of Infant Nutritional Supplement Claims

2016

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“…In the different published studies that have tested the effectiveness of nutritional products to treat MAM, the formulation of the products and the quantities given have varied; therefore there is no definitive consensus on the most effective way to treat children with MAM (15) . Most studies provided large quantities of supplementary foods (>2929 kJ/d (>700 kcal/d)), such that the energy content of the ration was either higher than or equal to the daily requirement for young children.…”

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confidence: 99%

Recovery rate of children with moderate acute malnutrition treated with ready-to-use supplementary food (RUSF) or improved corn–soya blend (CSB+): a randomized controlled trial

Medoua

Ntsama

Ndzana

et al. 2015

Public Health Nutr.

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Objective: To compare an improved corn-soya blend (CSB+) with a ready-to-use supplementary food (RUSF) to test the hypothesis that satisfactory recovery rate will be achieved with CSB+ or RUSF when these foods provide 50 % of the child's energy requirement, the 50 % remaining coming from usual diet. Design: A comparative efficacy trial study was conducted with moderately wasted children, using a controlled randomized design, with parallel assignment for RUSF or CSB+. Every child received a daily ration of 167 kJ (40 kcal)/kg body weight during 56 d with a follow-up performed every 14 d. Every caregiver received nutrition counselling at enrolment and at each follow-up visit. Setting: Health districts of Mvog-Beti and Evodoula in the Centre region of Cameroon. Subjects: Eight hundred and thirty-three children aged 6-59 months were screened and eighty-one malnourished children (weight-for-height Z-score between −3 and −2) aged 25-59 months were selected. Results: Of children treated with CSB+ and RUSF, 73 % (95 % CI 59 %, 87 %) and 85 % (95 % CI 73 %, 97 %), respectively, recovered from moderate acute malnutrition, with no significant difference between groups. The mean duration of treatment required to achieve recovery was 44 d in the RUSF group and 51 d in the CSB+ group (log-rank test, P = 0·0048). Conclusions: There was no significant difference in recovery rate between the groups. Both CSB+ and RUSF were relatively successful for the treatment of moderate acute malnutrition in children. Despite the relatively low ration size provided, the recovery rates observed for both groups were comparable to or higher than those reported in previous studies, a probable effect of nutrition education. Keywords Moderate acute malnutritionCorn-soya blend Ready-to-use supplementary food Child malnutrition is a major global health problem, contributing to increased morbidity and mortality, impaired intellectual development and working capacity, and increased risk of disease in adulthood (1) . Twenty per cent of the 7·6 million deaths per year recorded among children under 5 years of age can be attributed to undernutrition (2) . Moderate wasting and severe wasting represent acute forms of undernutrition, and children suffering from them face a markedly increased risk of death. It is estimated that moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) affect 52 million of children under 5 years of age worldwide. MAM is defined as weight-for-height between −3 SD and −2 SD below the median weight-for-height of the WHO child growth standards (weight-for-height Z-score (WHZ) between −3 and −2) without oedema (3) . Supplementary feeding programmes are designed to treat MAM and prevent the progression from MAM to SAM (4) , and thus have the potential to reduce child mortality and morbidity.A wide range of nutritional products are currently used to treat MAM (5) . These include fortified blended flours, especially corn-soya blend (CSB) prepared as porridge; BP5 biscuits; and lipid-based nutrient supplements, espe...

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“…En este sentido, se debe abogar por las recomendaciones del Grupo Asesor en Micronutrientes del MERCOSUR (21) y el programa de prevención y reducción de la anemia nutricional desarrollado por la Presidencia de la República, el Ministerio de Salud de Colombia y el Programa Mundial de Alimentos, en el marco de la estrategia de Atención Integral a la Primera Infancia "De Cero a Siempre" (22) , que priorizaron como estrategias para combatir la deficiencia de hierro del país, la diversificación de la dieta, la suplementación con hierro medicamentoso a mujeres gestantes y niños menores de dos años y la fortificación de alimentos. Estas iniciativas, han reportado tasas de retorno de hasta US$ 37 por dólar invertido, donde se incluyen beneficios en la función cognitiva en el ámbito escolar (23)(24)(25) .…”

Section: Discussionunclassified

Prevalencia y factores sociodemográficos asociados a la deficiencia de ferritina en niños de Colombia, 2010

Ramírez‐Vélez

Matínez-Torres

Meneses-Echávez

2014

Rev Peru Med Exp Salud Publica

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RESUMENObjetivos. Determinar la prevalencia y los factores sociodemográficos asociados a la deficiencia de ferritina en una muestra representativa de niños de Colombia. Materiales y métodos. Análisis secundario transversal de la Encuesta Nacional de la Situación Nutricional (ENSIN) realizada en Colombia el año 2010 en 3542 infantes entre 12 y 59 meses de edad. Los niveles plasmáticos de ferritina se determinaron por quimioluminiscencia y se consideraron como déficit de ferritina los valores < 12 µg/L, los factores sociodemográficos (sexo, edad, etnia, nivel socioeconómico, región y área geográfica) se recogieron mediante una encuesta estructurada. Todos los análisis se realizaron teniendo en cuenta la naturaleza compleja de la muestra. Resultados. Se encontró que el valor promedio de ferritina fue de 32,1 µg/L, (IC 95%: 30,6). El 10,6% (IC 95%: 9,3-12,0) de los niños presentaron niveles de ferritina menores a 12,0 µg/L. La regresión logística multivariable muestra que los niños de 12 a 23 (OR 5,1; IC 95%: 3,3-8,0) y 24 a 35 meses de edad (OR 2,4; IC 95%: 1,5-3,7), pertenecer al grupo étnico indígena (OR 1,8; IC 95%: 1,1-2,8), residir en la zona atlántico (OR 2,0; IC 95%: 1,1-3,6), o zona pacifica (OR 2,0; IC 95%: 1,1-3,6) se asociaron a una mayor probabilidad de presentar deficiencias de ferritina. Conclusiones. Se encontró una importante prevalencia de anemia por deficiencia de ferritina y diversos factores sociodemográficos contribuyeron con la probabilidad de incrementar este problema. Se recomienda intervenciones integrales donde estén involucrados los componentes nutricional y educativo. Palabras clave: Micronutrientes; Ferritinas; Niño; Factores de riesgo; Colombia (fuente: DeCS BIREME). PREVALENCE AND DEMOGRAPHIC FACTORS ASSOCIATED WITH FERRITIN DEFICIENCY IN COLOMBIAN CHILDREN, 2010 ABSTRACTObjectives. To determine prevalence and socio-demographic factors associated with ferritin deficiency in a representative sample of children in Colombia. Materials and methods. Cross sectional secondary data analysis of the National Survey on the Nutritional Situation (ENSIN) conducted in 2010 in Colombia in 3542 children between 12 and 59 months. Plasma ferritin levels were determined by chemiluminescence and values <12 ug/L were considered as deficit ferritin. Sociodemographic factors (sex, age, ethnicity, socioeconomic status, and geographical region) were collected using a structured questionnaire. All analyses were performed taking into account the complex nature of the sample. Results. It was found that the average value of ferritin was 32.1 g/L, (CI 95%: 30.7-35.6).10.6% (CI 95%: 9.3-12.0) of the children had ferritin levels less than 12.0 ug/L. The multivariate logistic regression shows that children aged 12 to 23 (OR 5.1, CI 95%: 3.3-8.0) and 24 to 35 months (OR 2.4, CI 95%: 1.5-3.7), belonging to the indigenous ethnic group (OR 1.8, CI 95%: 1.1-2.8), living in the Atlantic region (OR 2.0, CI 95%: 1.1 -3.6), or Pacific area (OR 2.0, CI 95%: 1.1-3.6) were associated with a higher probability of ferritin defic...

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Specially formulated foods for treating children with moderate acute malnutrition in low- and middle-income countries

Cited by 93 publications

References 223 publications

Promoting Healthy Growth or Feeding Obesity? The Need for Evidence-Based Oversight of Infant Nutritional Supplement Claims

Promoting Healthy Growth or Feeding Obesity? The Need for Evidence-Based Oversight of Infant Nutritional Supplement Claims

Recovery rate of children with moderate acute malnutrition treated with ready-to-use supplementary food (RUSF) or improved corn–soya blend (CSB+): a randomized controlled trial

Prevalencia y factores sociodemográficos asociados a la deficiencia de ferritina en niños de Colombia, 2010

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