Summary
This systematic review and meta-analysis evaluated the effectiveness of ready-to-use therapeutic foods (RUTF) with low or no dairy content compared to standard RUTF (which contains at least 50% of its protein from dairy) in treating children aged six months and older with severe acute malnutrition (SAM). Analyzing data from six studies involving over 6,000 children, the review found that low- or no-dairy RUTFs led to slightly lower weight gain, lower recovery rates, and lower weight-for-age z-scores at discharge compared to standard RUTF. However, there were no significant differences in mortality, time to recovery, default rates, or nonresponse. Some alternative RUTFs showed improved iron and anemia outcomes, likely due to enhanced micronutrient content, and one study found better fat-free mass in children consuming standard RUTF. Overall, while lower-dairy RUTFs may be more cost-effective, they appear to be less effective in promoting optimal recovery and growth. The authors recommend further research into improving the nutritional quality of alternative formulations and assessing their long-term impacts on child health and development.
Authors
Isabel Potani, Carolyn Spiegel-Feld, Garyk Brixi, Jaden Bendabenda, Nandi Siegfried, Robert H J Bandsma, André Briend, and Allison I Daniel
Publisher
Advances in Nutrition
Source
Science Direct
Takeaway
- Effectiveness: RUTFs with less than 50% dairy protein are generally less effective than standard RUTFs in supporting weight gain, recovery, and weight-for-age outcomes in children with severe acute malnutrition.
- No Significant Difference in Mortality: There was no significant difference in mortality, default rates, or nonresponse between low-/no-dairy and standard RUTF groups.
- Micronutrient Advantage: Some low-dairy RUTF formulations improved iron status and reduced anemia, likely due to enhanced iron and vitamin C content.
- Need for Further Research: Additional studies are needed to explore cost-effective, nutritionally optimized RUTF alternatives that can maintain or improve clinical outcomes, especially in diverse child populations and over longer follow-up periods.