title: Acceptability and Efficacy of Locally Produced Ready-to-Use Therapeutic Food Nutreal in the Management of Severe Acute Malnutrition in Comparison With Defined Food: A Randomized Control Trial.
abstract: BACKGROUND
  Severe acute malnutrition (SAM) is a salient health problem in India. Federation of Indian Chamber of Commerce and Industry (FICCI) Research and Analysis Centre, New Delhi, prepared nutreal equivalent to ready-to-use therapeutic food by World Health Organization (WHO) for the management of SAM and defined food like homemade diet.
  
  
  OBJECTIVE
  To compare acceptability and efficacy of nutreal over defined food for the management of SAM.
  
  
  METHODS
  One hundred twelve children aged less than 5 years with SAM were enrolled as per the standard of WHO. Children were randomized into 2 groups to receive nutreal (n = 56) and defined food (n = 56) in unlimited amounts for 42 consecutive days and extended by 2 weeks as per demand. Calorie and protein intake, weight, and mid-upper arm circumference (MUAC) were recorded daily.
  
  
  RESULTS
  Age range was 8 to 45 months. Ninety-three percent of children eagerly accepted nutreal but 7% does not. Whereas in the defined food group, 68% accepted eagerly, 30% did not accept eagerly, and 1.8% accepted poorly ( P = .004). At enrollment, mean weight in the nutreal group was 6.44 ± 1.60 kg and in the defined food group was 8.69 ± 1.76 kg, with MUAC in the nutreal group being 11.12 ± 0.47 cm and in the defined food group being 11.54 ± 0.34 cm. Mean weight in the nutreal and defined food groups at eighth week of intervention was 7.97 ± 1.8 kg and 9.71 ± 1.8 kg ( P < .001), respectively. Mid-upper arm circumference at eighth week was 12.10 ± 0.29 cm in the nutreal group and 12.49 ± 0.50 cm in the defined group ( P < .001).
  
  
  CONCLUSIONS
  Acceptability, mean weight gain, and MUAC in the nutreal group are greater than the defined food.
authors.affiliation: 1 Department of Pediatric Gastroenterology, Postgraduate Institute Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Babu Ram
authors.initials: BR
authors.lastname: Thapa
authors.affiliation: 1 Department of Pediatric Gastroenterology, Postgraduate Institute Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Pooja
authors.initials: P
authors.lastname: Goyal
authors.affiliation: 1 Department of Pediatric Gastroenterology, Postgraduate Institute Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Jagadeesh
authors.initials: J
authors.lastname: Menon
authors.affiliation: 2 Department of Pediatric Gastroenterology, Federation of Indian Chamber of Commerce and Industry Research and Analysis Centre (FICCI), New Delhi, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Sharma
keywords: RUTF; SAM; defined food; nutreal