Current evidence on the effectiveness of Ready-to-Use Supplementary Foods in children with moderate acute malnutrition: a systematic review and meta-analysis.

Moderate acute malnutrition (MAM) is defined by a weight-for-height Z-score (WHZ) between -3 and -2 of the WHO reference or by a mid-upper arm circumference (MUAC) of ≥11⋅5 and <12⋅5 cm. This study aimed to synthesise the evidence for the effectiveness of Ready-to-Use Supplementary Food (RUSF) compared to other dietary interventions or no intervention on functioning at different levels of the International Classification of Functioning, Disability, and Health (ICF) among children with MAM between 2 and12 years old. Three databases (PubMed, Scopus, and Web of Science) were systematically searched (last update: 20 November 2022). Pooled estimates of effect were calculated using random-effects meta-analyses. The level of evidence was estimated with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method. Seven studies were included. RUSF had a significant small-sized better effect (pooled mean: 0⋅38; 95 % CI = [0⋅10, 0⋅67], P = 0⋅01, I² = 97 %) on different anthropometric measurements compared to other dietary interventions among MAM children (n 6476). Comparing RUSF with corn-soy blend Plus Plus (CSB++) showed that RUSF had a small-sized but significantly better effect on the children's anthropometric measures compared to children who received CSB++ (pooled mean: 0⋅16; 95 % CI = [0⋅05, 0⋅27], P = 0⋅01; I2 = 35 %). MAM children treated with RUSF had a better recovery rate compared to those treated with CSB++ (pooled risk difference: 0⋅11; 95 % CI = [0⋅06, 0⋅11], P < 0⋅001; I2 = 0 %). The RUSF intervention seems promising in improving MAM children's nutritional outcomes and recovery rate compared to other dietary interventions.

Nutritional and sensory quality of composite extruded complementary food.

Complementary foods in Ethiopia have nutritional and sensory limitations which can be attributed to cereal-dominated ingredients and lack of appropriate processing techniques. This study aimed to optimize the nutritional and sensory quality of complementary food product through compositing and extrusion of various local ingredients. A constrained D-optimal mixture experiment with 13 runs was designed. Accordingly, 55-65 g/100 g oats, 11-23 g/100 g soybean and 6-11 g/100 g linseed, and a premix of 9.9 g/100 g sugar, 0.6 g/100 g table salt, three g/100 g moringa and 1.5 g/100 g fenugreek were blended and extruded using a co-rotating twin screw extruder with set parameters. Statistical model evaluation and optimization were done using Minitab version 16 software package. There is a statistically significant (p < 0.05) association between the blend of oats and soybean, oats and linseed, soybean and linseed, and the protein, fat, carbohydrate, fiber, ash, ß-carotene content as well as aroma, taste, and consistency. On the contrary, there is a no statistically significant (p < 0.05) association between the blends and moisture, energy, and zinc content together with appearance and overall acceptability. The optimal blending ratio was 55.0 g/100 g oats, 21.0 g/100 g soybean, and 9.0 g/100 g linseed plus 15.0 g/100 g premix. Evidence-based selection of locally grown plant-based ingredients, an optimal mixture of these ingredients and optimal processing, can result in a complementary food product with an improved dietary quality for children in low-income settings.