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

American Journal of Clinical Nutrition

Volumn 103, Issue 3, 2016, Pages 926-933

  Stobaugh, Heather C ^a,b   Ryan, Kelsey N ^b   Kennedy, Julie A ^b   Grise, Jennifer B ^b   Crocker, Audrey H ^b   Thakwalakwa, Chrissie ^c   Litkowski, Patricia E ^b   Maleta, Kenneth M ^c   Manary, Mark J ^b,c,e   Trehan, Indi ^b,d  

^a TUFTS UNIVERSITY   (United States)

^b WASHINGTON UNIVERSITY   (United States)

^c Departments of Community Health   (Malawi)

^d UNIVERSITY OF MALAWI   (Malawi)

^e BAYLOR COLLEGE OF MEDICINE   (United States)

Author keywords

Moderate acute malnutrition; Ready to use supplementary food; Wasting; Whey permeate; Whey protein

Indexed keywords

MILK PROTEIN; WHEY PROTEIN; PROTEIN INTAKE; SOYBEAN PROTEIN;

ANTHROPOMETRY; ARM CIRCUMFERENCE; ARTICLE; ATTRIBUTABLE RISK; CHILD; CHILDHOOD DISEASE; CONTROLLED STUDY; DEMOGRAPHY; DIET SUPPLEMENTATION; DIETARY INTAKE; DOUBLE BLIND PROCEDURE; FOOD; HUMAN; INFANT; MALAWIAN; MALNUTRITION; MODERATE ACUTE MALNUTRITION; MORTALITY RATE; MOZAMBICAN; PEANUT; PERIPHERAL EDEMA; RANDOMIZED CONTROLLED TRIAL; READY TO USE SUPPLEMENTARY FOOD; WEIGHT GAIN; WHEY; ARACHIS; COMPARATIVE STUDY; DAIRY PRODUCT; DIET THERAPY; DIETARY SUPPLEMENT; DRUG EFFECTS; FAST FOOD; FEMALE; FORTIFIED FOOD; MALE; MOZAMBIQUE; PHARMACOLOGY; PRESCHOOL CHILD; PROTEIN INTAKE; THERAPEUTIC USE; TREATMENT OUTCOME;

ARACHIS; CHILD, PRESCHOOL; DAIRY PRODUCTS; DIETARY PROTEINS; DIETARY SUPPLEMENTS; DOUBLE-BLIND METHOD; FAST FOODS; FEMALE; FOOD, FORTIFIED; HUMANS; INFANT; MALE; MALNUTRITION; MILK PROTEINS; MOZAMBIQUE; SOYBEAN PROTEINS; TREATMENT OUTCOME; WEIGHT GAIN; WHEY; WHEY PROTEINS;

EID: 84959900371     PISSN: 00029165     EISSN: 19383207     Source Type: Journal    
DOI: 10.3945/ajcn.115.124636     Document Type: Article

References (48)

1. Matilsky DK, Maleta K, Castleman T, Manary MJ. Supplementary feeding with fortified spreads results in higher recovery rates than with a corn/soy blend in moderately wasted children. J Nutr 2009; 139:773-8
2. Nackers F, Broillet F, Oumarou D, Djibo A, Gaboulaud V, Guerin PJ, Rusch B, Grais RF, Captier V. Effectiveness of ready-to-use therapeutic food compared to a corn/soy-blend-based pre-mix for the treatment of childhood moderate acute malnutrition in Niger. J Trop Pediatr 2010; 56:407-13
3. Lagrone L, Cole S, Schondelmeyer A, Maleta K, Manary MJ. Locally produced ready-to-use supplementary food is an effective treatment of moderate acute malnutrition in an operational setting. Ann Trop Paediatr 2010;30:103-8
4. LaGrone LN, Trehan I, Meuli GJ, Wang RJ, Thakwalakwa C, Maleta K, Manary MJ. A novel fortified blended flour, corn-soy blend 'plusplus," is not inferior to lipid-based ready-to-use supplementary foods for the treatment of moderate acute malnutrition in Malawian children. Am J Clin Nutr 2012;95:212-9
5. Wang RJ, Trehan I, LaGrone LN,Weisz AJ, Thakwalakwa CM, Maleta KM, Manary MJ. Investigation of food acceptability and feeding practices for lipid nutrient supplements and blended flours used to treat moderate malnutrition. J Nutr Educ Behav 2013;45:258-63
6. Noriega KE, Lindshield BL. Is the inclusion of animal source foods in fortified blended foods justified? Nutrients 2014;6:3516-35
7. Dewey K. Meeting protein needs at 6 to 24 months of age. Food Nutr Bull 2013;34:240-1
8. Murphy SP, Allen LH. Nutritional importance of animal source foods. J Nutr 2003;133(11 Suppl 2):3932S-5S
9. Grillenberger M, Neumann CG, Murphy SP, Bwibo NO, van't Veer P, Hautvast JG, West CE. Food supplements have a positive impact on weight gain and the addition of animal source foods increases lean body mass of Kenyan schoolchildren. J Nutr 2003;133(11 Suppl 2): 3957S-64S
10. Oakley E, Reinking J, Sandige H, Trehan I, Kennedy G, Maleta K, Manary M. A ready-to-use therapeutic food containing 10% milk is less effective than one with 25% milk in the treatment of severely malnourished children. J Nutr 2010;140:2248-52
11. Shah NP. Effects of milk-derived bioactives: an overview. Br J Nutr 2000;84(Suppl 1):S3-10
12. Marshall K. Therapeutic applications of whey protein. Altern Med Rev 2004;9:136-56
13. Hoppe C, Molgaard C, Michaelsen KF. Cow's milk and linear growth in industrialized and developing countries. Annu Rev Nutr 2006;26: 131-73
14. Michaelsen KF, Hoppe C, Roos N, Kaestel P, Stougaard M, Lauritzen L, Molgaard C, Girma T, Friis H. Choice of foods and ingredients for moderately malnourished children 6 months to 5 years of age. Food Nutr Bull 2009;30(3 Suppl):S343-404
15. Hoppe C, Molgaard C, Dalum C, Vaag A, Michaelsen KF. Differential effects of casein versus whey on fasting plasma levels of insulin, IGF-1 and IGF-1/IGFBP-3: results from a randomized 7-day supplementation study in prepubertal boys. Eur J Clin Nutr 2009;63: 1076-83
16. Hoppe C, Andersen GS, Jacobsen S, Molgaard C, Friis H, Sangild PT, Michaelsen KF. The use of whey or skimmed milk powder in fortified blended foods for vulnerable groups. J Nutr 2008;138:145S-61S
17. Pierce KM, Callan JJ, McCarthy P, O'Doherty JV. The interaction between lactose level and crude protein concentration on piglet postweaning performance, nitrogen metabolism, selected faecal microbial populations and faecal volatile fatty acid concentrations. Anim Feed Sci Technol 2007;132:267-82
18. Pierce KM, Sweeney T, Brophy PO, Callan JJ, Fitzpatrick E, McCarthy P, O'Doherty JV. The effect of lactose and inulin on intestinal morphology, selected microbial populations and volatile fatty acid concentrations in the gastro-intestinal tract of the weanling pig. Anim Sci 2006;82:311-8
19. Bj'rnvad CR, Thymann T, Budek AZ, Nielsen DH, M'lgaard C, Michaelsen KF, Sangild PT. Gastrointestinal and body growth in colostrum-deprived piglets in response to whey, casein or soy protein diets. Livest Sci 2007;109:30-3
20. World Health Organization. WHO, UNICEF, WFP and UNHCR consultation on the programmatic aspects of the management of moderate acute malnutrition in children under five years of age. Geneva (Switzerland): World Health Organization; 2010
21. Annan RA, Webb P, Brown R. Management of moderate acute malnutrtion (MAM): current knowledge and practice. CMAM Forum Technical Brief: September 2014
22. Chang CY, Trehan I, Wang RJ, Thakwalakwa C, Maleta K, Deitchler M, Manary MJ. Children successfully treated for moderate acute malnutrition remain at risk for malnutrition and death in the subsequent year after recovery. J Nutr 2013;143:215-20
23. Trehan I, Banerjee S, Murray E, Ryan KN, Thakwalakwa C, Maleta KM, Manary MJ. Extending supplementary feeding for children younger than 5 years with moderate acute malnutrition leads to lower relapse rates. J Pediatr Gastroenterol Nutr 2015;60:544-9
24. Briend A, Maire B, Fontaine O, Garenne M. Mid-upper arm circumference and weight-for-height to identify high-risk malnourished under-five children. Matern Child Nutr 2012;8:130-3
25. Berkley J, Mwangi I, Griffiths K, Ahmed I, Mithwani S, English M, Newton C, Maitland K. Assessment of severe malnutrition among hospitalized children in rural Kenya: comparison of weight for height and mid upper arm circumference. JAMA 2005;294:591-7
26. Rasmussen J, Andersen A, Fisker AB, Ravn H, Sodemann M, Rodrigues A, Benn CS, Aaby P. Mid-upper-arm-circumference and mid-upper-arm circumference z-score: the best predictor of mortality? Eur J Clin Nutr 2012;66:998-1003
27. Goossens S, Bekele Y, Yun O, Harczi G, Ouannes M, Shepherd S. Midupper arm circumference based nutrition programming: evidence for a new approach in regions with high burden of acute malnutrition. PLoS One 2012;7:e49320
28. Lin CA, Boslaugh S, Ciliberto HM, Maleta K, Ashorn P, Briend A, Manary MJ. A prospective assessment of food and nutrient intake in a population of Malawian children at risk for kwashiorkor. J Pediatr Gastroenterol Nutr 2007;44:487-93
29. Hotz C, Gibson RS. Complementary feeding practices and dietary intakes from complementary foods amongst weanlings in rural Malawi. Eur J Clin Nutr 2001;55:841-9
30. World Health Organization. World Health Statistics. Geneva (Switzerland): World Health Organization; 2015
31. Phuka J, Ashorn U, Ashorn P, Zeilani M, Cheung YB, Dewey KG, Manary M, Maleta K. Acceptability of three novel lipid-based nutrient supplements among Malawian infants and their caregivers. Matern Child Nutr 2011;7:368-77
32. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G∗Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009;41:1149-60
33. Grenov B, Nielsen A-LH, M'lgaaard C, Michaelsen KF. Evaluation of whey permeate in the treatment of moderate malnutrition. University of Copenhagen: Copenhagen (Denmark); 2012
34. World Health Organization. Technical note: Supplementary foods for the management of moderate acute malnutrition in infants and children 6-59 months of age. Geneva (Switzerland): World Health Organization, 2012
35. Food and Agriculture Organization. Dietary protein quality evaluation in human nutrition. Rome (Italy): Food and Agriculture Organization; 2013
36. Rutherfurd SM, Fanning AC, Miller BJ, Moughan PJ. Protein digestibility-corrected amino acid scores and digestible indispensable amino acid scores differentially describe protein quality in growing male rats. J Nutr 2015;145:372-9
37. Manary MJ. Local production and provision of ready-to-use therapeutic food (RUTF) spread for the treatment of severe childhood malnutrition. Food Nutr Bull 2006;27(3 Suppl):S83-9
38. Coates J, Swindale A, Bilinsky P. Household Food Insecurity Access Scale (HFIAS) for measurement of food access: indicator guide. Washington (DC): USAID; 2007
39. Trehan I, Manary MJ. Management of severe acute malnutrition in low-income and middle-income countries. Arch Dis Child 2015;100: 283-7
40. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weightfor- length, weight-for-height and body mass index-for-age: Methods and development. Geneva (Switzerland): World Health Organization; 2006
41. Blackwell N,Myatt M, Allafort-Duverger T, Balogoun A, Ibrahim A, Briend A. Mothers Understand And Can do it (MUAC): a comparison of mothers and community health workers determining mid-upper arm circumference in 103 children aged from 6 months to 5 years. Arch Public Health 2015;73:26
42. Bahwere P, Banda T, Sadler K, Nyirenda G, Owino V, Shaba B, Dibari F, Collins S. Effectiveness of milk whey protein-based ready-to-use therapeutic food in treatment of severe acute malnutrition in Malawian under-5 children: a randomised, double-blind, controlled non-inferiority clinical trial. Matern Child Nutr 2014;10:436-51
43. Trehan I, Goldbach HS, LaGrone LN, Meuli GJ,Wang RJ, Maleta KM, Manary MJ. Antibiotics as part of the management of severe acute malnutrition. N Engl J Med 2013;368:425-35
44. Torres-Rodriguez A, Higgins SE, Vicente JLS, Wolfenden AD, Gaona- Ramirez G, Barton JT, Tellez G, Donoghue AM, Hargis BM. Effect of lactose as a prebiotic on turkey body weight under commercial conditions. J Appl Poult Res 2007;16:635-41
45. Nyeko R, Kalyesubula I, Mworozi E, Bachou H. Lactose intolerance among severely malnourished children with diarrhoea admitted to the nutrition unit, Mulago hospital, Uganda. BMC Pediatr 2010;10:31
46. Kerac M, Bunn J, Seal A, Thindwa M, Tomkins A, Sadler K, Bahwere P, Collins S. Probiotics and prebiotics for severe acute malnutrition (PRONUT study): a double-blind efficacy randomised controlled trial in Malawi. Lancet 2009;374:136-44
47. Subramanian S, Huq S, Yatsunenko T, Haque R, Mahfuz M, Alam MA, Benezra A, DeStefano J, Meier MF, Muegge BD, et al. Persistent gut microbiota immaturity in malnourished Bangladeshi children. Nature 2014;510:417-21
48. Webb P, Roberts BL, Rosenberg IH, Schlossman N, Wanke C, Bagriansky J, Sadler K, Johnson Q, Tilahun J, Masterson A, et al. Improving the nutritional quality of U.S. food aid: recommendations for changes to products and programs. Boston (MA): Tufts University; 2011