Portal de Periódicos da CAPES

Effectiveness of milk whey protein‐based ready‐to‐use therapeutic food in treatment of severe acute malnutrition in M alawian under‐5 children: a randomised, double‐blind, controlled non‐inferiority clinical trial

2014; Wiley; Volume: 10; Issue: 3 Linguagem: Inglês

10.1111/mcn.12112

1740-8709

Paluku Bahwere, Theresa Banda, Kate Sadler, Gertrude Nyirenda, Victor Owino, Bina Shaba, Filippo Dibari, Steve Collins,

Food Security and Health in Diverse Populations

Abstract The cost of ready‐to‐use therapeutic food ( RUTF ) used in community‐based management of acute malnutrition has been a major obstacle to the scale up of this important child survival strategy. The current standard recipe for RUTF [peanut‐based RUTF ( P ‐ RUTF ) ] is made from peanut paste, milk powder, oil, sugar, and minerals and vitamins. Milk powder forms about 30% of the ingredients and may represent over half the cost of the final product. The quality of whey protein concentrates 34% ( WPC 34) is similar to that of dried skimmed milk ( DSM ) used in the standard recipe and can be 25–33% cheaper. This blinded, parallel group, randomised, controlled non‐inferiority clinical trial tested the effectiveness in treating severe acute malnutrition ( SAM ) of a new RUTF formulation WPC ‐ RUTF in which WPC 34 was used to replace DSM . Average weight gain (non‐inferiority margin Δ = −1.2 g kg −1 day −1 ) and recovery rate (Δ = −10%) were the primary outcomes, and length of stay ( LOS ) was the secondary outcome (Δ = +14 days). Both per‐protocol ( PP ) and intention‐to‐treat ( ITT ) analyses showed that WPC ‐ RUTF was not inferior to P ‐ RUTF for recovery rate [difference and its 95% confidence interval ( CI ) of 0.5% (95% CI –2.7, 3.7) in PP analysis and 0.6% (95% CI –5.2, 6.3) in ITT analysis] for average weight gain [0.2 (−0.5; 0.9) for both analyses] and LOS [−1.6 days (95% CI , −4.6, 1.4 days) in PP analysis and −1.9 days (95% CI , −4.6, 0.8 days) for ITT analysis]. In conclusion, whey protein‐based RUTF is an effective cheaper alternative to the standard milk‐based RUTF for the treatment of SAM .