Treatment of childhood undernutrition: development of and access to improved foods (TREATFOOD)

Project summary

The objectives were 1) To develop improved corn-soy-blend-based (CSB) and lipid-based nutrient supplements (LNS) for treatment of moderate acute malnutrition, and 2) identify the best product based on effectiveness and acceptability, 3) to disseminate this results, and 4) to build capacity in research and treatment of acute malnutrition, all to ensure that more children are treated effectively.

Development of the products were done with partners from WFP and WHO, as well as leading food aid product manufactures (Compact, Norway and Fipros, Denmark), whereas the main trial was done in collaboration between UCPH, MSF and ALIMA. In addition, the partners, in collaboration with other researchers and international organisations, trained PhD-students, and trained doctors, paediatricians, and nutritionists in treatment of acute malnutrition, and also disseminated research findings to a broader audience.

Outputs

Project completion report:
Based on the main trial, we have been the first to show that treatment of moderate acute malnutrition, irrespective of supplement, lead to quite high accretion of lean mass - muscle and organ tissue. We have also been able to show, that the current practice of excluding short children from treatment - due to concern that these children may accumulate excessive fat - is not justified. These latter finding, published in American Journal of Clinical Nutrition in 2016, but disseminated through our partners through various channels, has already resulted in policy changes in Niger, and other countries are likely to follow.

In addition, the Treatfood trial have documented that LNS products are more effective than CSB, especially if based on soy isolate rather than dehulled soy, in increasing lean mass accretion as well as recovery rate, and that it is highly acceptable and results in less leftover. The additional benefits of adding expensive milk protein could not be clearly demonstrated, and needs further study. Thus, policy makers have hard data to inform their policies, and decide what products to use.

As part of the trial and the research at research capacity sites Ethiopia, Kenya or Uganda, 13 researchers, 7 from Africa and 6 from Denmark, have done PhD-work. As mentioned, we conducted 4 PhD-courses, including 2 on treatment of severe acute malnutrition. Other international experts were invited as guest lecturers, and paediatricians and nutritionist from a large number of countries, mainly from Africa, participated.

As mentioned above, we contributed to dissemination of research findings to paeditricians and nutritionists globally through our role as academic partner in CMAM Forum, with ACF, UNICEF and WHO. CMAM Forum had the same objectives as ours, and almost 2500 members in 106 countries. Our role was to make resource updates, and technical and research summaries. CMAM Forum is now being continued as part of The State of SAM Website (www.severemalnutrition.org), which is part of the No Wasted Lives initiative, an interagency effort between UNICEF, Action Against Hunger (ACF), and other organizations.