A novel fortified blended flour, corn-soy blend "plus-plus," is not inferior to lipid-based ready-to-use supplementary foods for the treatment of moderate acute malnutrition in Malawian children

Lacey N. LaGrone, Indi Trehan, Gus J. Meuli, Richard J. Wang, Chrissie Thakwalakwa, Kenneth Maleta, Mark J. Manary

Research output: Contribution to journalArticlepeer-review

65 Scopus citations

Abstract

Background: Children with moderate acute malnutrition (MAM) are often treated with fortified blended flours, most commonly a corn-soy blend (CSB). However, recovery rates remain <75%, lower than the rate achieved with peanut paste-based ready-to-use supplementary foods (RUSFs). To bridge this gap, a novel CSB recipe fortified with oil and dry skim milk, "CSB++," has been developed. Objective: In this trial we compared CSB++ with 2 RUSF products for the treatment of MAM to test the hypothesis that the recovery rate achieved with CSB++ will not be >5% worse than that achieved with either RUSF. Design: We conducted a prospective, randomized, investigatorblinded, controlled noninferiority trial involving rural Malawian children aged 6-59 mo with MAM. Children received 75 kcal CSB++ - kg -1 - d -1, locally produced soy RUSF, or an imported soy/whey RUSF for ≤12 wk. Results: The recovery rate for CSB++ (n = 763 of 888; 85.9%) was similar to that for soy RUSF (795 of 806, 87.7%; risk difference: 21.82%; 95% CI: 24.95%, 1.30%) and soy/whey RUSF (807 of 918, 87.9%; risk difference: 21.99%; 95% CI: 25.10%, 1.13%). On average, children who received CSB++ required 2 d longer to recover, and the rate of weight gain was less than that with either RUSF, although height gain was the same among all 3 foods studied. Conclusions: A novel, locally produced, fortified blended flour (CSB++) was not inferior to a locally produced soy RUSF and an imported soy/whey RUSF in facilitating recovery from MAM. The recovery rate observed for CSB++ was higher than that for any other fortified blended flour tested previously. This trial is registered at clinicaltrials. gov as NCT00998517.

Original languageEnglish
Pages (from-to)212-219
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Volume95
Issue number1
DOIs
StatePublished - Jan 1 2012

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