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Randomized Controlled Trial
. 2012 Jan;95(1):212-9.
doi: 10.3945/ajcn.111.022525. Epub 2011 Dec 14.

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  1 , Indi Trehan, Gus J Meuli, Richard J Wang, Chrissie Thakwalakwa, Kenneth Maleta, Mark J Manary
Affiliations
Randomized Controlled Trial

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 et al. Am J Clin Nutr. 2012 Jan.

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, investigator-blinded, 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: -1.82%; 95% CI: -4.95%, 1.30%) and soy/whey RUSF (807 of 918, 87.9%; risk difference: -1.99%; 95% CI: -5.10%, 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.

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Figures

FIGURE 1.
FIGURE 1.
Flow of participants throughout the study. *CSB++, corn-soy blend “plus-plus.” †RUSF, ready-to-use supplementary food. ‡MAM, moderate acute malnutrition. **SAM, severe acute malnutrition.
FIGURE 2.
FIGURE 2.
Recovery of children with moderate acute malnutrition treated with 1 of 3 supplementary foods. Log-rank test for trend, P ≈ 0.13. *CSB++, corn-soy blend “plus-plus”; †RUSF, ready-to-use supplementary food.
See this image and copyright information in PMC

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