Title |
Ready-to-use therapeutic food with elevated n-3 polyunsaturated fatty acid content, with or without fish oil, to treat severe acute malnutrition: a randomized controlled trial
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Published in |
BMC Medicine, April 2015
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DOI | 10.1186/s12916-015-0315-6 |
Pubmed ID | |
Authors |
Kelsey DJ Jones, Rehema Ali, Maureen A Khasira, Dennis Odera, Annette L West, Grielof Koster, Peter Akomo, Alison WA Talbert, Victoria M Goss, Moses Ngari, Johnstone Thitiri, Said Ndoro, Miguel A Garcia Knight, Kenneth Omollo, Anne Ndungu, Musa M Mulongo, Paluku Bahwere, Greg Fegan, John O Warner, Anthony D Postle, Steve Collins, Philip C Calder, James A Berkley |
Abstract |
Ready-to-use therapeutic foods (RUTF) are lipid-based pastes widely used in the treatment of acute malnutrition. Current specifications for RUTF permit a high n-6 polyunsaturated fatty acid (PUFA) content and low n-3 PUFA, with no stipulated requirements for preformed long-chain n-3 PUFA. The objective of this study was to develop an RUTF with elevated short-chain n-3 PUFA and measure its impact, with and without fish oil supplementation, on children's PUFA status during treatment of severe acute malnutrition. This randomized controlled trial in children with severe acute malnutrition in rural Kenya included 60 children aged 6 to 50 months who were randomized to receive i) RUTF with standard composition; ii) RUTF with elevated short chain n-3 PUFA; or iii) RUTF with elevated short chain n-3 PUFA plus fish oil capsules. Participants were followed-up for 3 months. The primary outcome was erythrocyte PUFA composition. Erythrocyte docosahexaenoic acid (DHA) content declined from baseline in the two arms not receiving fish oil. Erythrocyte long-chain n-3 PUFA content following treatment was significantly higher for participants in the arm receiving fish oil than for those in the arms receiving RUTF with elevated short chain n-3 PUFA or standard RUTF alone: 3 months after enrolment, DHA content was 6.3% (interquartile range 6.0-7.3), 4.5% (3.9-4.9), and 3.9% (2.4-5.7) of total erythrocyte fatty acids (P <0.001), respectively, while eicosapentaenoic acid (EPA) content was 2.0% (1.5-2.6), 0.7% (0.6-0.8), and 0.4% (0.3-0.5) (P <0.001). RUTF with elevated short chain n-3 PUFA and fish oil capsules were acceptable to participants and carers, and there were no significant differences in safety outcomes. PUFA requirements of children with SAM are not met by current formulations of RUTF, or by an RUTF with elevated short-chain n-3 PUFA without additional preformed long-chain n-3 PUFA. Clinical and growth implications of revised formulations need to be addressed in large clinical trials. Clinicaltrials.gov NCT01593969 . Registered 4 May 2012. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United Kingdom | 5 | 38% |
Japan | 1 | 8% |
Kenya | 1 | 8% |
Unknown | 6 | 46% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 7 | 54% |
Practitioners (doctors, other healthcare professionals) | 4 | 31% |
Scientists | 2 | 15% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Kenya | 2 | 1% |
Unknown | 191 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 31 | 16% |
Student > Master | 27 | 14% |
Student > Bachelor | 21 | 11% |
Student > Ph. D. Student | 17 | 9% |
Other | 12 | 6% |
Other | 39 | 20% |
Unknown | 46 | 24% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 45 | 23% |
Nursing and Health Professions | 33 | 17% |
Agricultural and Biological Sciences | 19 | 10% |
Social Sciences | 8 | 4% |
Economics, Econometrics and Finance | 4 | 2% |
Other | 30 | 16% |
Unknown | 54 | 28% |