Delivering improved nutrition: Dairy ingredients in food aid productsJournal/Periodical: Food Nutr BullCitation: Food Nutr Bull. 2016 Mar;37(1 Suppl):S6-S13. doi: 10.1177/0379572116629780
This paper presents a historical review of the development and evolution of food assistance programs. The first program was implemented in the US in 1954, and over 60 years has fed over 3 billion people in 150 countries. The initial focus was on providing enough food to meet humanitarian, emergency needs. More recently efforts now consider the value of providing high quality formulated food products to prevent or treat malnutrition during gestation and the first 2 years of life. Dairy ingredients were included in early formulations, but were temporarily removed due to cost vs value questions. They are now incorporated in formulations for the treatment of severe acute malnutrition in children up to 5 years. Research demonstrating the value of dairy ingredients in the treatment of other forms of malnutrition may provide an argument for their inclusion in other forms of food supplements, particularly if the amount necessary to see a benefit has a minimal impact on cost.
Severe Acute Malnutrition , Children Under 5 , Children Under 2 , Milk-Specific Research
What works? Interventions for maternal and child undernutrition and survival.Journal/Periodical: LancetSeries Number: BHUTTA_2008aCitation: 371(9610): 417-40.
What interventions affect maternal and child undernutrition and nutrition-related outcomes? Although strategies for breastfeeding promotion have a large effect on survival, their effect on stunting is small. In populations with sufficient food, education about complementary feeding reduced stunting. Provision of food supplements (with or without education) in populations with insufficient food reduced stunting. Management of severe acute malnutrition according to WHO guidelines reduced the case-fatality rate by 55%. The authors used a cohort model to assess the potential effect of these interventions on mothers and children in the 36 countries that include 90% of children with stunted linear growth. The model showed that existing interventions designed to improve nutrition and prevent related disease could reduce stunting at 36 months by 36%; mortality between birth and 36 months by about 25%; and disability-adjusted life-years associated with stunting, severe wasting, intrauterine growth restriction, and micronutrient deficiencies by about 25%.
Severe Acute Malnutrition , Children Under 5 , Moderate Malnutrition , Children Under 2
Protein quality in the first thousand days of lifeJournal/Periodical: Food Nutr BullCitation: Food Nutr Bull. 2016 Mar;37(1 Suppl):S14-21. doi: 10.1177/0379572116629259
This review article examines the impact of protein quality in the prevention of stunting and on the treatment of moderate and acute malnutrition. The time period of review is the first 1,000 days of life, ie, day of conception to 2 yrs of age. Protein intake during pregnancy has a positive impact on the birth weight of the infant, and dairy proteins in particular had greater positive effects than other sources of protein. Protein deprivation of infants leads to stunting, and ecological data indicate that populations with high protein intakes have fewer cases of stunted children. Preliminary evidence suggests that the presence of cow's milk in the diets of children is one of the factors associated with a lower risk of stunting. Children with moderate acute malnutrition (MAM) are treated with a variety of formulated foods, some of which contain dairy ingredients while others do not. Both types show benefit in alleviating MAM, but those containing dairy ingredients provided greater improvements and shorter time to recovery.
Severe Acute Malnutrition , Children Under 2 , Milk-Specific Research , Adults
Supplementary feeding with fortified spreadsJournal/Periodical: Journal of NutritionSeries Number: MATILSKY_2009aCitation: Vol. 139(4): 773-78.
Based on eight weeks of treatment, children receiving milk/peanut and soy/peanut nutritional spreads had similar recovery rates to moderate wasting, both significantly higher than the alternative supplementary food, corn-soy blend. Fortified spreads appear to be superior to corn-soy blend as supplementary foods for moderately wasted Malawian children.
Moderate Malnutrition , Children Under 2 , Formula Comparisons , Milk-Specific Research
Maternal and child undernutrition: consequences for adult health and human capital.Journal/Periodical: The LancetSeries Number: VICTORA_2008aCitation: 371(9609): 340-57.
This study undertook systematic review of findings from low-income and middle-income countries including cohort studies in Brazil, Guatemala, India, Philippines, and South Africa. Undernutrition was strongly associated, both in the review of published work and in new analyses, with shorter adult height, less schooling, reduced economic productivity, and—for women—lower offspring birthweight. Height-for-age at 2 years was the best predictor of human capital and undernutrition is associated with lower human capital. We conclude that damage suffered in early life leads to permanent impairment.
Children Under 5 , Moderate Malnutrition , Children Under 2 , Adults
Cereals and pulse-based ready-to-use therapeutic foodJournal/Periodical: Am J Clin Nutr.Citation: Am J Clin Nutr. 2016 Apr;103(4):1145-61. doi: 10.3945/ajcn.115.119537. Epub 2016 Mar 1
The purpose of this study was to compare the effects of two RUTFs in young children with severe acute malnutrition (SAM) in the Democratic Republic of Congo. One RUTF contained soya-maize-sorghum (SMS-RUTF) while the other consisted of standard peanut paste based RUTF (P-RUTF). The SMS-RUTF contained 38.6% dehulled soybeans, 4% maize and 10% sorghum and provided a protein:energy of 11.9%. The P-RUTF contained 25% dried skim milk and 26% peanut paste, and provided protein:energy of 12%, so these formulations were comparable in terms of protein:energy. The primary endpoints measured were recovery rates, length of stay, and weight gain; secondary endpoints included hemoglobin and body composition indices. About 880 children participated in the main study, but secondary endpoints were not collected on all. The results showed that in children 6-23 months of age, the recovery rate in the SMS-RUTF group was inferior to that of the P-RUTF group. However, in children 24-59 months of age, there was no difference between the treatments in terms of recovery rate. Weight gains and lengths of stay were not different between the two treatments in both age groups. There also were no significant differences in any of the body composition indices between treatment groups, and hemoglobin was significantly better in the SMS-RUTF group.
Severe Acute Malnutrition , Children Under 5 , Children Under 2 , Milk-Specific Research
Immuno-enhancing Property of Dietary Whey Protein in Mice: Role of Glutathione.Journal/Periodical: Clinical and Investigative MedicineSeries Number: BOUNOUS_1989aCitation: 12: 154-61.
The spleen cells' immune response to sheep red blood cells of mice fed a 20 g whey protein/100 g diet is substantially higher than that of mice fed an equivalent casein diet of similar nutritional efficiency. This indicates that the observed immune-enhancing effect of the whey protein mixture is dependent on the overall amino acid pattern resulting from the contribution of all its protein components.
Whey-Specific Research , HIV-AIDS
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 childrenJournal/Periodical: American Journal of Clinical NutritionSeries Number: Lagrone_2012Citation: 2012 Jan; Vol. 95, 212-219
This prospective, randomized, controlled trial looked at 2,712 children aged 6-59 months with moderate acute malnutrition (MAM) in southern Malawi. They compared the recovery (WHZ>-2) of the children on three different treatments: 1. A corn soy blend plus plus (CSB++) which was a corn soy blend fortified with oil and dry skim milk. 2. A locally produced ready to use supplement food (RUSF). 3. A commercially available soy/whey RUSF, Plumpynut. Children were followed for a total of 7 visits, including baseline analysis with findings that children on CSB++ took an average two days longer to recover than the other two treatment groups which had an average recovery time of 23 days. CSB++ requires a large amount of water for preparation so the child would have to consume eight times the mass of food per day when compared to the RUSF treatment. Results showed that RUSF improved weight gain but soy/whey RUSF was superior in imporoving Mid-upper arm circumference (MUAC) when compared to just soy RUSF. This was the first study to show that CSB++ may have similar effects on improvement in MAM as RUSF products.
Children Under 5 , Moderate Malnutrition , Formula Comparisons
Comparison of the effectiveness of a milk-free soy-maize-sorghum-based...Journal/Periodical: Maternal and Child NutritionCitation: doi: 10.1111/mcn.12054 2013
This study compared the effects of milk-free soy/maize/sorghum RUTF vs milk based RUTF on recovery rates and weight gain in children with SAM. The results showed that the milk-based RUTF achieved better recovery rates and rates of weight gain than the milk-free RUTF, particularly in children less than 2 yrs. The study did not prove equivalence between the two RUTFs, as had been hypothesized.
Severe Acute Malnutrition , Children Under 5 , Formula Comparisons , Milk-Specific Research
Effects of two micronutrient-fortified food aid products containing different levels..
This study tested the efficacy of two micronutrient-rich ready to use supplementary foods (MR-RUSF) in 411 children aged 6-24 months. Children randomly received MNR-RUSF sachets which provided 250 calories and contained either 15 or 33 percent dairy protein or no supplement. Both the 15% supplement and the combined 15 and 33% supplements improved hemoglobin levels compared to controls. Supplements did not improve weight or length gains overall but did improve gain in weight-for-age Z scores in infants who had a baseline Z score >2. Both supplements reduced reported rates of malaria, diarrhea and other illnesses compared to controls.
Children Under 2 , Formula Comparisons