Effectiveness of Dietary Management for Moderate Wasting among Children > 6 Months of Age—A Systematic Review and Meta-Analysis Exploring Different Types, Quantities, and Durations

Author:

Cichon Bernardette1,Das Jai K.23,Salam Rehana A.4ORCID,Padhani Zahra A.2ORCID,Stobaugh Heather C.56,Mughal Muzna1,Pajak Patrizia1,Rutishauser-Perera Alexandra1,Bhutta Zulfiqar A.237ORCID,Black Robert E.8ORCID

Affiliation:

1. Action Against Hunger UK, Operations Department, London SE10 0ER, UK

2. Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan

3. Division of Women and Child Health, Aga Khan University, Karachi 74800, Pakistan

4. The Daffodil Centre, The University of Sydney, Sydney 2006, Australia

5. Action Against Hunger USA, Technical Services and Innovation Department, Washington, DC 20463, USA

6. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA

7. Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada

8. Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA

Abstract

Currently, no World Health Organization guidelines exist for the management of approximately 31.8 million moderately wasted children globally. The objective of this review was to synthesise evidence on the optimal type, quantity, and duration of dietary treatment for moderate wasting. Ten electronic databases were searched until the 23rd of August 2021. Experimental studies comparing interventions for the dietary management of moderate wasting were included. Meta-analyses were conducted and results were presented as risk ratios or mean differences with 95% confidence intervals. Seventeen studies comparing specially formulated foods were included involving 23,005 participants. Findings suggest little or no difference in recovery between Fortified Blended Foods (FBFs) with improved micronutrient and/or milk content (enhanced FBFs) and lipid-based nutrient supplements (LNS), whereas children treated with non-enhanced FBFs (locally produced FBFs or standard corn–soy blend) may have lower recovery rates than those treated with LNS. There was no difference in recovery when ready-to-use therapeutic and ready-to-use supplementary food were compared. Other outcomes mostly aligned with results for recovery. In conclusion, LNSs improve recovery compared to non-enhanced FBFs, but are comparable to enhanced FBFs. Programmatic choice of supplement should consider factors such as cost, cost-effectiveness, and acceptability. Further research is required to determine optimal dosing and duration of supplementation.

Funder

World Health Organization

Publisher

MDPI AG

Subject

Food Science,Nutrition and Dietetics

Reference59 articles.

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4. World Health Organization, World Food Programme, United Nations System Standing Committee on Nutrition, and United Nations Children’s Fund (2007). Community-Based Management of Severe Acute Malnutrition: A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children’s Fund, World Health Organization.

5. World Health Organization (2021). WHO Guideline on the Dairy Protein Content in Ready-to-Use Therapeutic Foods for Treatment of Uncomplicated Severe Acute Malnutrition, World Health Organization.

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