scholarly journals Useful Tools for Food Aid: Linear Programming and Protein Quality Tools

2018 ◽  
Vol 39 (2_suppl) ◽  
pp. S80-S86
Author(s):  
Meghan Callaghan-Gillespie ◽  
Melody Mui
Keyword(s):  
Linear Programming ◽  
Protein Quality ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Food Aid ◽  
Nutrient Quality ◽  
Home Based ◽  
Home Based Therapy ◽  
Quality Tools ◽  
Therapeutic Food

The development of a superior treatment option for severe acute malnutrition (SAM) which allowed for home-based therapy put in place constraints that are crucial for ensuring the feasibility and nutritional integrity of the treatment. Soon after the initial success of ready-to-use therapeutic food (RUTF), there were attempts to modify the formulation for cost and other areas of acceptability. While alternative formulations have been taken on in clinical trials, they have been inferior to the standard RUTF recipe. Linear programming (LP) technology, however, has streamlined the formulation process allowing the user to account for the crucial constraints required to maintain the feasibility and nutritional integrity of standard RUTF. With the aid of an LP tool and other functional tools for assessing nutrient quality, nutrition researchers can use innovative approaches in food development that could potentially revolutionize food aid products.

scholarly journals Comparison study on efficacy of UNICEF specified therapeutic food (F-75/F-100) with traditionally used home based food in management of severe acute malnutrition

2018 ◽  
Vol 5 (4) ◽  
pp. 1674
Author(s):  
Anand Shukla ◽  
Y. K. Rao
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Comparison Study ◽  
Medical College ◽  
Home Based ◽  
Appropriate Therapy ◽  
Moderate Malnutrition ◽  
Therapeutic Food

Background: The management of malnutrition depends on its severity. While mild to moderate malnutrition can be managed on ambulatory basis, severe malnutrition is preferably managed in hospital settings. This study was undertaken to find the magnitude of SAM in children (6 months to 60 months) and to compare the UNICEF specified therapeutic food (F-75/F-100) with traditionally used home based food in treatment of severe acute malnutrition.Methods: This prospective and observational study was conducted in the Department of Pediatrics of G.S.V.M. Medical College, L.L.R. and Associated Hospitals, Kanpur. Logarithmic transformation was achieved by SPSS 20.Results: The prevalence of SAM in children between 6 months to 60 months of age to be 18%. Clinical spectrum of SAM showed 95.24% of marasmus 3.57% of Kwashiorkor and 1.19% of marasmic kwashiorkor.    There was significant increase in weight of hospitalized patient receiving F75/F100 at 28 days of follow up. Weight gain was not statistically significant in patients treated at home.Conclusions: SAM should preferably be treated in hospital with appropriate therapy rather than home based management.

scholarly journals Costing of three feeding regimens for home-based management of children with uncomplicated severe acute malnutrition from a randomised trial in India

2018 ◽  
Vol 3 (2) ◽  
pp. e000702 ◽  
Author(s):  
Charu C Garg ◽  
Sarmila Mazumder ◽  
Sunita Taneja ◽  
Medha Shekhar ◽  
Sanjana Brahmawar Mohan ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Randomised Trial ◽  
National Income ◽  
Acute Malnutrition ◽  
Home Based ◽  
Life Years ◽  
Significant Difference ◽  
The Government ◽  
Treated Child ◽  
Therapeutic Food

Trial designThree feeding regimens—centrally produced ready-to-use therapeutic food, locally produced ready-to-use therapeutic food, and augmented, energy-dense, home-prepared food—were provided in a community setting for children with severe acute malnutrition (SAM) in the age group of 6–59 months in an individually randomised multicentre trial that enrolled 906 children. Foods, counselling, feeding support and treatment for mild illnesses were provided until recovery or 16 weeks.MethodsCosts were estimated for 371 children enrolled in Delhi in a semiurban location after active survey and identification, enrolment, diagnosis and treatment for mild illnesses, and finally treatment with one of the three regimens, both under the research and government setting. Direct costs were estimated for human resources using a price times quantity approach, based on their salaries and average time taken for each activity. The cost per week per child for food, medicines and other consumables was estimated based on the total expenditure over the period and children covered. Indirect costs for programme management including training, transport, non-consumables, infrastructure and equipment were estimated per week per child based on total expenditures for research study and making suitable adjustments for estimations under government setting.ResultsNo significant difference in costs was found across the three regimens per covered or per treated child. The average cost per treated child in the government setting was estimated at US$56 (<3500 rupees).ConclusionHome-based management of SAM with a locally produced ready-to-use therapeutic food is feasible, acceptable, affordable and very cost-effective in terms of the disability-adjusted life years saved and gross national income per capita of the country. The treatment of SAM at home needs serious attention and integration into the existing health system, along with actions to prevent SAM.Trial registration numberNCT01705769; Pre-results.

scholarly journals Serum iron and serum retinol level of severe acute malnourished children on therapeutic intervention with WHO/UNICEF recommended therapeutic food and home based therapeutic food

2021 ◽  
Vol 8 (2) ◽  
pp. 337
Author(s):  
Bharti Bhandari ◽  
Anita Mehta
Keyword(s):  
Serum Iron ◽  
Severe Acute Malnutrition ◽  
Vitamin A Deficiency ◽  
Controlled Trial ◽  
Acute Malnutrition ◽  
P Value ◽  
Serum Retinol ◽  
Home Based ◽  
Significant Difference ◽  
Therapeutic Food

Background: The prevalence of anaemia and vitamin A deficiency among children with severe acute malnutrition (SAM) and their correction during nutritional rehabilitation are not well documented. This study assessed serum iron and serum retinol levels, effect of ready-to-use therapeutic foods (RUTF) and home based treatment on levels of serum iron and serum retinol level in SAM children.Methods: This was a simple randomised controlled trial in 6-59 months old children with SAM. Two groups of 70 each were divided, one was given RUTF and other home based food comparable to RUTF. Serum retinol and serum iron were measured on day 1 and 6 weeks of therapy.Results: Home based food was found better in terms of increase in serum iron than RUTF while there was no difference in rise of serum retinol in both the groups. There was no significant difference between day 1 value of serum iron in both the groups as p value was 0.82 but the level of serum iron at 6 weeks has shown significant difference in both the groups as p value was 0.0014 so there was significant increase in serum iron in group B in comparison to group A; the serum retinol value in both the groups has not shown any significant improvement.Conclusions: It was concluded home based food is better in correcting iron deficiency in SAM children as it is cheap, easily available, palatable, and acceptable than RUTF.

scholarly journals Nutrient and Anti-nutrient Profile of a Local Formula from Sorghum, Peanut, Honey and Ghee (Metu2) for Treatment of Severe Acute Malnutrition

2018 ◽  
Vol 7 (2) ◽  
pp. 25
Author(s):  
Amegovu K. Andrew ◽  
Peter Yiga ◽  
Kuorwel K. Kuorwel ◽  
Timothy Chewere
Keyword(s):  
Vitamin A ◽  
Energy Content ◽  
Severe Acute Malnutrition ◽  
Essential Fatty Acids ◽  
High Energy ◽  
Acute Malnutrition ◽  
World Health ◽  
Home Based ◽  
North Eastern ◽  
Eastern Uganda

World over, we are still struggling with persistent acute malnutrition levels; an estimated 17 million preschool children suffer from SAM, roughly the same figures as reported in 2013, a trend depicting insufficient progress towards the 2025 World Health Assembly. One such affected area is Karamoja Region in North Eastern Uganda. Partly, the trend could be attributed to unsustainable interventions like RUTF. Formulas from locally available foods could provide not only an affordable but also a culturally acceptable and effective home based solution.   Locally available sorghum, peanut, honey and ghee in North Eastern Uganda, is such a potential local formula. The nutritional and anti-nutritional profile of this local formula(metu2) was compared to plumpy-nut. Standard official analytical methods were used. Proximate composition was comparable and within the WHO recommendations for therapeutic formulas. Local formula(metu2) had a comparatively high energy content, 528kcal/100g to 509kcal in plumpynut. Vitamin A and K contents were below the WHO recommendations in local formula while Na, Mg and essential fatty acids were comparable and within the contents needed for SAM recovery. Zn was comparatively higher in plumpy-nut but levels in both formulas were below the recommendations. Trypsin inhibitors, phytates and condensed tannins were higher in local formula while aflatoxins were within the limits but not for plumpynut. Though lacking in critical K, Zn and Vitamin A, local formula(metu2) was comparable to plumpy-nut and its efficacy to sustain recovery from SAM needs to be studied. 

Treatment of severe acute malnutrition with oat or standard ready-to-use therapeutic food: a triple-blind, randomised controlled clinical trial

Gut ◽  
2020 ◽  
Vol 69 (12) ◽  
pp. 2143-2149 ◽  
Author(s):  
David Taylor Hendrixson ◽  
Claire Godbout ◽  
Alyssa Los ◽  
Meghan Callaghan-Gillespie ◽  
Melody Mui ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Vegetable Oil ◽  
Severe Acute Malnutrition ◽  
Milk Powder ◽  
Acute Malnutrition ◽  
Growth Time ◽  
Controlled Clinical Trial ◽  
Hydrogenated Vegetable Oil ◽  
Therapeutic Food ◽  
Time To Graduation

ObjectiveWe hypothesised that an alternative RUTF (ready-to-use therapeutic food) made with oats (oat-RUTF) would be non-inferior to standard RUTF (s-RUTF).DesignThis was a randomised, triple-blind, controlled, clinical non-inferiority trial comparing oat-RUTF to s-RUTF in rural Sierra Leone. Children aged 6–59 months with severe acute malnutrition (SAM) were randomised to oat-RUTF or s-RUTF. s-RUTF was composed of milk powder, sugar, peanut paste and vegetable oil, with a hydrogenated vegetable oil additive. Oat-RUTF contained oats and no hydrogenated vegetable oil additives. The primary outcome was graduation, an increase in anthropometric measurements such that the child was not acutely malnourished. Secondary outcomes were rates of growth, time to graduation and presence of adverse events. Intention to treat analyses was used.ResultsOf the 1406 children were enrolled, graduation was attained in 404/721 (56%) children receiving oat-RUTF and 311/685 (45%) receiving s-RUTF (difference 10.6%, 95% CI 5.4% to 15.8%). Death, hospitalisation or remaining with SAM was seen in 87/721 (12%) receiving oat-RUTF and in 125/685 (18%) receiving s-RUTF (difference 6.2%, 95% CI 2.3 to 10.0, p=0.001). Time to graduation was less for children receiving oat RUTF; 3.9±1.8 versus 4.5±1.8 visits, respectively (p<0.001). Rates of weight in the oat-RUTF group were greater than in the s-RUTF group; 3.4±2.7 versus 2.5±2.3 g/kg/d, p<0.001.ConclusionOat-RUTF is superior to s-RUTF in the treatment of SAM in Sierra Leone. We speculate that might be because of beneficial bioactive components or the absence of hydrogenated vegetable oil in oat-RUTF.Trial registration numberNCT03407326.

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