title: 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.
abstract: The utility of dairy ingredients in the supplementary foods used in the treatment of childhood moderate acute malnutrition (MAM) remains unsettled.
  
  
  
  We evaluated the effectiveness of a peanut-based ready-to-use supplementary food (RUSF) with soy protein compared with a novel RUSF containing dairy ingredients in the form of whey permeate and whey protein concentrate in the treatment of children with MAM.
  
  
  
  We conducted a randomized, double-blind clinical effectiveness trial involving rural Malawian and Mozambican children 6-59 mo of age with MAM treated with either soy RUSF or a novel whey RUSF treatment of ~75 kcal · kg(-1) · d(-1) for up to 12 wk.
  
  
  
  The proportion of children that recovered from MAM was significantly higher in the group that received whey RUSF (960 of 1144; 83.9%) than in the group that received soy RUSF (874 of 1086; 80.5%; P < 0.04; risk difference 3.4%, 95% CI: 0.3%, 6.6%). Children who consumed whey RUSF also demonstrated better growth markers, with a higher mean midupper arm circumference (MUAC) at the time of discharge (P < 0.009), greater MUAC gain during the course of treatment (P < 0.003), higher mean weight-for-height z score at discharge (P < 0.008), and greater weight gain (P < 0.05). No significant differences were identified in length gain or time to recovery between the 2 groups.
  
  
  
  This study highlights the importance of milk protein in the treatment of MAM, because the use of a novel whey RUSF resulted in higher recovery rates and improved growth than did soy RUSF, although the whey RUSF supplement provided less total protein and energy than the soy RUSF. This study was registered at clinicaltrials.gov as NCT01790048.
authors: Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; Departments of Pediatrics and.
authors: Heather C
authors: HC
authors: Stobaugh
authors: Departments of Pediatrics and.
authors: Kelsey N
authors: 0000-0002-6057-452X
authors: KN
authors: Ryan
authors: Departments of Pediatrics and.
authors: Julie A
authors: JA
authors: Kennedy
authors: Departments of Pediatrics and.
authors: Jennifer B
authors: JB
authors: Grise
authors: Departments of Pediatrics and.
authors: Audrey H
authors: AH
authors: Crocker
authors: Departments of Community Health and.
authors: Chrissie
authors: 0000-0002-7545-0685
authors: C
authors: Thakwalakwa
authors: Medicine, Washington University in St. Louis, St. Louis, MO;
authors: Patricia E
authors: PE
authors: Litkowski
authors: Departments of Community Health and.
authors: Kenneth M
authors: 0000-0002-2536-3938
authors: KM
authors: Maleta
authors: Departments of Pediatrics and Departments of Community Health and Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX manary@kids.wustl.edu indi@alum.berkeley.edu.
authors: Mark J
authors: MJ
authors: Manary
authors: Departments of Pediatrics and Paediatrics and Child Health, University of Malawi, Blantyre, Malawi; and manary@kids.wustl.edu indi@alum.berkeley.edu.
authors: Indi
authors: 0000-0002-3364-6858
authors: I
authors: Trehan
mesh_terms: D010367:Arachis; D002675:Child, Preschool; D003611:Dairy Products; D004044:Dietary Proteins / Q000494:pharmacology / Q000627:therapeutic use*; D019587:Dietary Supplements; D004311:Double-Blind Method; D057140:Fast Foods; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000178:diet therapy*; D008894:Milk Proteins / Q000494:pharmacology / Q000627:therapeutic use; D009073:Mozambique; D030262:Soybean Proteins; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects; D000067796:Whey; D000067816:Whey Proteins / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D004044:Dietary Proteins; D008894:Milk Proteins; D030262:Soybean Proteins; D000067816:Whey Proteins
keywords: moderate acute malnutrition; ready-to-use supplementary food; wasting; whey permeate; whey protein