Search Results (9)

Background: Malnutrition has extensive consequences, affecting multiple levels of functioning, including motor skill impairments. However, current interventions have mainly focused on dietary treatment, often neglecting motor impairments and relying solely on clinical and anthropometric indicators to assess treatment response. This study aims to bridge this gap by examining the combined effect of ready-to-use supplementary food (RUSF) and high-intensity motor learning (HiML) on motor skill-related physical fitness in children with moderate thinness (MT). Methods: A cluster randomized controlled trial was conducted among children 5–7 years old with MT in Jimma Town. Three schools were randomized to three intervention arms, including a total of 69 children: RUSF (n = 23), RUSF + HiML (n = 25), and no intervention (n = 21). The HiML training was applied for 12 weeks, and RUSF was distributed daily for 12 weeks. HiML was given daily (1 h/day, 5 days/week). The primary outcome was motor skill-related physical fitness assessed at baseline and endline using the performance and fitness test battery (PERF-FIT). The changes from baseline to endline measurements were calculated as differences, and the mean difference in these changes/differences (DID) was then computed as the outcome measure. AN(C)OVA was used to directly investigate differences between groups. Statistical significance was declared at p-value ≤ 0.05. Results: There was a significantly greater and comparable improvement in both the RUSF and RUSF + HiML groups compared to the control group for the ‘stepping’ item (p < 0.001), the ‘side jump’ item (p < 0.001), the ‘standing long jump’ (p < 0.001) and the ‘jumping and hopping’ total (p = 0.005). The RUSF + HiML group showed significantly greater improvements in the ‘bounce and catch’ (p = 0.001) and ‘throw and catch’ (p < 0.001) items compared to the RUSF group, which, in turn, demonstrated greater improvement than the control group in both items (p < 0.01). Conclusions: A 12-week combination of RUSF + HiML was proven to be safe in children with MT and caused clear improvements in motor skill-related physical fitness. When the children received RUSF with HiML training, similar gains in stepping, side jump, standing long jump, and jumping and hopping were observed, except for the ball skills where the HiML training group performed better. Full article

Background: In Ethiopia, moderate thinness (MT) is a persistent issue among children. Yet, evidence on the effects of dietary supplementation and motor skills training in these children is limited. Objective: This study aimed to assess the effect of Ready-to-Use Supplementary Food (RUSF), whether or not combined with high-intensity motor learning (HiML), on weight, height, body composition, and muscle strength in children 5–7 years old with MT living in Jimma Town, Ethiopia. Methods: A cluster-randomized controlled trial was carried out among 69 children (aged 5–7) with MT assigned to receive RUSF (n = 23), RUSF + HiML (n = 25), or no intervention (control group, n = 21). A multivariable Generalized Estimating Equations model was used and the level of significance was set at alpha < 0.05. Results:At baseline, there were no significant differences in the outcome measurements between the RUSF, RUSF + HiML, and control groups. However, after 12 weeks of intervention, there were significant mean differences in differences (DIDs) between the RUSF group and the control arm, with DIDs of 1.50 kg for weight (p < 0.001), 20.63 newton (N) for elbow flexor (p < 0.001), 11.00 N for quadriceps (p = 0.023), 18.95 N for gastrocnemius sup flexor of the leg (p < 0.001), and 1.03 kg for fat-free mass (p = 0.022). Similarly, the mean difference in differences was higher in the RUSF + HiML group by 1.62 kg for weight (p < 0.001), 2.80 kg for grip strength (p < 0.001), 15.93 for elbow flexor (p < 0.001), 16.73 for quadriceps (p < 0.001), 9.75 for gastrocnemius sup flexor of the leg (p = 0.005), and 2.20 kg for fat-free mass (p < 0.001) compared the control arm. Conclusion: RUSF alone was effective, but combining it with HiML had a synergistic effect. Compared to the control group, the RUSF and RUSF + HiML interventions improved the body composition, height, weight, and muscle strength of the studied moderately thin children. The findings of this study suggest the potential that treating moderately thin children with RUSF and combining it with HiML has for reducing the negative effects of malnutrition in Ethiopia. Future research should explore these interventions in a larger community-based study. This trial has been registered at the Pan African Clinical Trials Registry (PACTR) under trial number PACTR202305718679999. Full article

In Africa, the number of children under 5 years old who suffer from stunting and wasting are, respectively, 61.4 and 12.1 million, and to manage situations like these, emergency food products like RUTF and RUSF (ready-to-use therapeutic/supplementary food) are very useful. The aim of this study was to develop an RUSF biscuit using the low-cost food resources usually present in Sub-Saharan Africa (Burundi and the DRCongo in our case study); we conducted chemical characterization, nutritional evaluation, and a stability trial simulating the usual storage conditions in a rural context to demonstrate that RUSF can be functional also using low-cost ingredients and a simple method of production. The obtained recipes showed good potential in supplying protein integration—17.81% (BUR) and 16.77% (CON) (% as food) were the protein contents—and the protein digestibility values were very high (BUR: 91.72%; CON: 92.01%). Moreover, 30% of the daily requirement was achieved with less than 50 g of both recipes in all the considered ages. Finally, a good shelf-life was demonstrated during the 35-day testing period at 30 °C, considering moisture, texture, and lipid oxidation evolution. Recipes like these, with appropriate changes, could be very useful in all contexts where child malnutrition is a serious problem. Full article

Dietary supplementation with a gut microbiota-directed complementary food (MDCF-2) significantly improved weight gain and repaired gut microbiota, as reported in a recent randomized controlled trial on Bangladeshi children with moderate acute malnutrition (MAM). Environmental enteric dysfunction (EED) is a small bowel disorder, and recent evidence shows that it is linked to growth failure in children. Therefore, we intended to investigate whether supplementation with MDCF-2 has any role in modifying gut health by changing the levels of biomarkers of EED and gut inflammation in children with MAM. We randomly assigned 124 children aged 12–18 months to one of two intervention diets, either MDCF-2 or ready-to-use supplementary food (RUSF). Approximately 50 g of the diet was administered in two feeding sessions daily for 12 weeks. Stool and plasma biomarkers were assessed to evaluate intestinal health. Results showed that the average change in citrulline concentration (µmol/L) significantly increased among children who consumed MDCF-2 compared to those who consumed RUSF (mean difference-in-differences: 123.10; 95% CI: 3.60, 242.61; p = 0.044). The research findings demonstrated that MDCF-2 might have a beneficial effect on improving the gastrointestinal health of malnourished children. Full article

The effective management of the 33 million children with moderate acute malnutrition (MAM) is key to reducing childhood morbidity and mortality. In this review, we aim to evaluate the effectiveness of specially formulated foods (SFFs) compared to non-food-based approaches to manage MAM in children >6 months old. We conducted a search on ten databases until 23 August 2021 and included five studies, covering 3387 participants. Meta-analysis of four studies comparing SFFs to counselling or standard of care showed that SFFs likely increase recovery rate, reduce non-response, and may improve weight-for-height z-score, weight-for-age z-score and time to recovery, but have little or no effect on MUAC gain. One study on a multicomponent intervention (SFFs, antibiotics and counselling provided to high-risk MAM) compared to counselling only was reported narratively. The intervention may increase weight gain after 24 weeks but may have little or no effect on weight gain after 12 weeks and on non-response and mortality after 12 and 24 weeks of enrollment. The effect of this intervention on recovery was uncertain. In conclusion, SFFs may be beneficial for children with moderate wasting in humanitarian contexts. Programmatic recommendations should consider context and cost-effectiveness. Full article

Hangzhou Bay is a large, high-turbidity shallow bay located on the southern side of the Changjiang Estuary, China. The process and dynamic mechanisms of water and sediment transport in the bay are not yet clear. An improved three-dimensional sediment numerical model that combined various dynamic factors was established to simulate and analyze these mechanisms. The residual current cannot properly represent the net water and sediment transport, and the residual unit width water flux (RUWF) and residual unit width sediment flux (RUSF) were used to explain the water and sediment transport. The results of numerical simulations indicate that in summer, the surface RUWF from the Changjiang Estuary near Nanhui Cape flows westward along the coast, in which the major part flows southward to the Zhenhai area, and the small part flows further westward along the north coast and then turns to the south coast and eastward, forming the water transport pattern of north-landward and south-seaward, which is stronger in the spring tide than in the neap tide. The bottom RUWF near Zhenhai flows northward to Nanhui Cape in the neap tide, which is larger in the neap tide than in the spring tide. In the middle and western parts of the bay, the RUWF has the same pattern as the surface water transport and is stronger in the spring tide than in the neap tide. The pattern of RUSF is roughly similar to the water flux transport. During the spring tide, the water and sediment transport fluxes near Nanhui Cape are from the Changjiang Estuary into Hangzhou Bay, but from Hangzhou Bay into the Changjiang Estuary during the neap tide. In the winter, the distributions of RUWF, RUSF, and suspended sediment concentration (SSC) are similar to those in the summer. In addition, the distance of surface water transport westward along the north coast is shorter than that in the summer, the magnitude of the bottom RUWF is smaller than that in the summer due to the weaker salinity gradient, and the bottom RUSF near Nanhui Cape is weaker than that in the summer during the neap tide. The net transect water flux (NTWF) and the net transect sediment flux (NTSF) near Nanhui Cape are from the Changjiang Estuary into Hangzhou Bay during the spring tide; during the neap tide, the NTWF is still from the Changjiang Estuary into Hangzhou Bay, but the NTSF is from Hangzhou Bay into the Changjiang Estuary because the SSC is much higher in the bottom layer than in the surface layer. The dynamic reason for the temporal and spatial variation in RUWF and RUSF is that the barotropic pressure gradient force is larger than the baroclinic pressure gradient force during the spring tide and is the opposite during the neap tide. Full article

Undernourishment is a threat to human health. The prevalence of undernourishment remains alarming, especially among children under five years old in many countries, including Indonesia. Nowadays, the handling of undernourishment has shifted to treatment outside the hospital, utilizing local nutrient-rich foods. At the national level, the utilization of local food resources is a part of the promotion of dietary diversification and the bioeconomy. Ready-to-use supplementary food (RUSF) refers to supplementary foods aimed at improving the nutrition of moderate acute malnutrition (MAM) children under five years old. RUSF biscuit recipes were made using local food resources available in Banten province, Indonesia. To optimize the nutritional profile of the developed RUSF, taro/talas banten were mixed with ground-nut/peanut (Arachis hypogaea L.) and mungbean (Vigna radiata) as protein and lipid sources and red rice (Oryza longistaminata) and maize (Zea mays) as carbohydrate sources, and enriched by the local banana Nangka (Musa textilia). Two formulations were selected for the pilot testing, namely the taro-peanut and taro-peanut/mungbean RUSF biscuits, made from taro Banten, cereal, peanut and/or mungbean, and local banana. The RUSF biscuit showed promising results, presenting a high level of acceptance and a macronutrient composition that meets the standards for MAM children. However, the RUSF biscuits should be fortified with micronutrient premix to fulfill the dietary requirement for the MAM children. The results of this study provide further development opportunities. Full article

Childhood malnutrition is a major public health concern, as it is associated with significant short- and long-term morbidity and mortality. The objective of this review was to comprehensively review the evidence for the management of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) according to the current World Health Organization (WHO) protocol using facility- and community-based approaches, as well as the effectiveness of ready-to-use therapeutic food (RUTF), ready-to-use supplementary food (RUSF), prophylactic antibiotic use, and vitamin A supplementation. We searched relevant electronic databases until 11 February 2019, and performed a meta-analysis. This review summarizes findings from a total of 42 studies (48 papers), including 35,017 children. Limited data show some benefit of integrated community-based screening, identification, and management of SAM and MAM on improving recovery rate. Facility-based screening and management of uncomplicated SAM has no effect on recovery and mortality, while the effect of therapeutic milk F100 for SAM is comparable to RUTF for weight gain and mortality. Local food and whey RUSF are comparable to standard RUSF for recovery rate and weight gain in MAM, while standard RUSF has additional benefits to CSB. Prophylactic antibiotic administration in uncomplicated SAM improves recovery rate and probably improves weight gain and reduces mortality. Limited data suggest that high-dose vitamin A supplementation is comparable with low-dose vitamin A supplementation for weight gain and mortality among children with SAM. Full article

Micronutrient deficiencies during pregnancy are common in Africa and can cause adverse outcomes. The objective was to measure micronutrient status and change in moderately malnourished pregnant Malawian women randomized to one of three nutritional interventions. Serum vitamin B₁₂, 25-hydroxyvitamin D, folate, retinol, ferritin, zinc, albumin and C-reactive protein were measured in pregnant women with MUAC ≥20.6 cm and ≤23.0 cm at enrollment (n = 343) and after 10 weeks (n = 229) of receiving: (1) ready-to-use supplementary food (RUSF); (2) fortified corn-soy blend (CSB+) with multiple-micronutrient supplement (CSB+UNIMMAP); or (3) CSB+ with iron and folic acid (CSB+IFA). Each provided 100–300% Recommended Dietary Allowance of most micronutrients and 900 kcal/day. Birth length was measured in 272 infants. Enrollment measurements indicated deficiencies in vitamin B₁₂ (20.9%) and zinc (22.3%), low values of ferritin (25.1%) and albumin (33.7%), and elevated CRP (46.0%). Vitamin B₁₂ is known to decrease in the third trimester; the RUSF group had the smallest decrease from enrollment to week 10 (3%), compared to 20% decrease in the CSB+IFA group and 8% decrease in the CSB+UNIMMAP group (p = 0.001). Mean serum 25-hydroxyvitamin D increased most in the RUSF group (+6.4 ng/mL), compared to CSB+IFA (+1.7 ng/mL) and CSB+UNIMMAP (+2.7 ng/mL) (p < 0.001). Micronutrient deficiencies and inflammation are common among moderately malnourished pregnant women and had little improvement despite supplementation above the RDA, with the exception of vitamins B₁₂ and D. Full article