TREATFOOD

COMPLETED PROJECT

Period: 2013 - 2014.

Child examined by Doctor

Treatfood was a 2x2x3 factorial randomized trial among 6-24 months old children with moderate acute malnutrition (MAM) in Burkina Faso.

 

 

Background

While children with MAM were at risk of deteriorating to severe acute malnutrition and death, there was no consensus on what foods to give. In fact, there was no WHO recommendation to treat children with MAM, partly due to concerns that children might accumulate too much fat tissue. Instead, WHO recommended more research on food supplements for children with MAM.

Objectives

To assess the effects of food matrix, soy quality and milk content in food supplements on fat-free mass, weight, total and knee-heel length, nutritional recovery, hemoglobin and iron status, and child development among children with MAM.

Methods

The study was a 2×2×3 factorial randomized trial. The children were all given a daily food supplement providing 500 kcal/d for three months.

The three experimental factors were matrix (LNS vs CSB), soy quality (isolate vs dehulled), and milk (20% and 50% versus 0% of total protein). This combination of factors resulted in 12 different supplements.

The trial was double-blinded with respect to soy quality and milk content, but not matrix. Children were followed-up every 2 weeks.

The primary outcome was increase in fat-free mass measured using the deuterium dilution technique. Other outcomes included increase in fat-mass, weight, total and knee-heel length, MUAC, triceps skinfold, and nutritional recovery, child development.

 

 

 

 

The data has resulted in 4 PhD degrees, and 18 papers (see publications). Several papers are in preparation.

In the main paper, we showed that children with MAM during 3 months of supplementation – irrespective of type and composition - predominantly gained fat-free mass.

LNS resulted in higher fat-free mass accretion, but there were no effects of soy quality and milk (Fabiansen C, Plos Med, 2017).

In a couple of other papers we showed that even short children responded well to supplementation both in terms of growth (Fabiansen C, AJCN, 2016) and accretion of fat-free mass (Fabiansen C, Pediatrics, 2018).

 

 

  1. Cichon B, Fabiansen C, Yaméogo CW, Rytter MJH, Ritz C, Briend A, et al. Children with moderate acute malnutrition have inflammation not explained by maternal reports of illness and clinical symptoms: a cross-sectional study in Burkina Faso. BMC Nutrition. 2016;2: 57. doi:10.1186/s40795-016-0096-0
  2. Cichon B, Fabiansen C, Iuel-Brockdorf A-S, Yaméogo CW, Ritz C, Christensen VB, et al. Impact of food supplements on hemoglobin, iron status, and inflammation in children with moderate acute malnutrition: a 2 × 2 × 3 factorial randomized trial in Burkina Faso. The American Journal of Clinical Nutrition. 2018;107: 278–286. doi:10.1093/ajcn/nqx050
  3. Cichon B, Ritz C, Fabiansen C, Christensen VB, Filteau S, Friis H, et al. Assessment of Regression Models for Adjustment of Iron Status Biomarkers for Inflammation in Children with Moderate Acute Malnutrition in Burkina Faso. J Nutr. 2017;147: 125–132. doi:10.3945/jn.116.240028
  4. Fabiansen C, Cichon B, Yaméogo CW, Iuel-Brockdorf A-S, Phelan KPQ, Wells JC, et al. Association between admission criteria and body composition among young children with moderate acute malnutrition, a cross-sectional study from Burkina Faso. Sci Rep. 2020;10: 13266. doi:10.1038/s41598-020-69987-9
  5. Fabiansen C, Phelan KPQ, Cichon B, Yaméogo CW, Iuel-Brockdorff A-S, Kurpad A, et al. Short Malnourished Children and Fat Accumulation With Food Supplementation. Pediatrics. 2018;142. doi:10.1542/peds.2018-0679
  6. Fabiansen C, Phelan KP, Cichon B, Ritz C, Briend A, Michaelsen KF, et al. Short children with a low midupper arm circumference respond to food supplementation: an observational study from Burkina Faso. Am J Clin Nutr. 2016;103: 415–421. doi:10.3945/ajcn.115.124644
  7. Fabiansen C, Yaméogo CW, Devi S, Friis H, Kurpad A, Wells JC. Deuterium dilution technique for body composition assessment: resolving methodological issues in children with moderate acute malnutrition. Isotopes Environ Health Stud. 2017;53: 344–355. doi:10.1080/10256016.2017.1295043
  8. Fabiansen C, Yaméogo CW, Iuel-Brockdorf A-S, Cichon B, Rytter MJH, Kurpad A, et al. Effectiveness of food supplements in increasing fat-free tissue accretion in children with moderate acute malnutrition: A randomised 2 × 2 × 3 factorial trial in Burkina Faso. PLoS Med. 2017;14: e1002387. doi:10.1371/journal.pmed.1002387
  9. Iuel-Brockdorf A-S, Dræbel TA, Fabiansen C, Cichon B, Christensen VB, Yameogo C, et al. Acceptability of new formulations of corn-soy blends and lipid-based nutrient supplements in Province du Passoré, Burkina Faso. Appetite. 2015;91: 278–286. doi:10.1016/j.appet.2015.04.058
  10. Iuel-Brockdorf A-S, Draebel TA, Ritz C, Fabiansen C, Cichon B, Brix Christensen V, et al. Evaluation of the acceptability of improved supplementary foods for the treatment of moderate acute malnutrition in Burkina Faso using a mixed method approach. Appetite. 2016;99: 34–45. doi:10.1016/j.appet.2015.12.030
  11. Iuel-Brockdorf A-S, Ouedraogo A, Ritz C, Draebel TA, Ashorn P, Filteau S, et al. Feeding behaviors during home-based treatment of moderate acute malnutrition using corn-soy blends or lipid-based nutrient supplements. Matern Child Nutr. 2017;13. doi:10.1111/mcn.12399
  12. Kjaer TW, Grenov B, Yaméogo CW, Fabiansen C, Iuel-Brockdorff A-S, Cichon B, et al. Correlates of serum IGF-1 in young children with moderate acute malnutrition: a cross-sectional study in Burkina Faso. The American Journal of Clinical Nutrition. 2021 [cited 19 May 2021]. doi:10.1093/ajcn/nqab120
  13. Olsen MF, Iuel-Brockdorff A-S, Yaméogo CW, Cichon B, Fabiansen C, Filteau S, et al. Early development in children with moderate acute malnutrition: A cross-sectional study in Burkina Faso. Matern Child Nutr. 2020;16: e12928. doi:10.1111/mcn.12928
  14. Olsen MF, Iuel-Brockdorff A-S, Yaméogo CW, Cichon B, Fabiansen C, Filteau S, et al. Impact of food supplements on early child development in children with moderate acute malnutrition: A randomised 2 x 2 x 3 factorial trial in Burkina Faso. PLOS Medicine. 2020;17: e1003442. doi:10.1371/journal.pmed.1003442
  15. Rytter MJH, Cichon B, Fabiansen C, Yameogo CW, Windinmi SZ, Michaelsen KF, et al. Thymus size in children with moderate malnutrition: a cohort study from Burkina Faso. Pediatr Res. 2021;89: 1732–1741. doi:10.1038/s41390-020-1057-5
  16. Yaméogo CW, Cichon B, Fabiansen C, Rytter MJH, Faurholt-Jepsen D, Stark KD, et al. Correlates of whole-blood polyunsaturated fatty acids among young children with moderate acute malnutrition. Nutr J. 2017;16. doi:10.1186/s12937-017-0264-3
  17. Yaméogo CW, Cichon B, Fabiansen C, Iuel-Brockdorf A-S, Shepherd S, Filteau S, et al. Correlates of Physical Activity among Young Children with Moderate Acute Malnutrition. J Pediatr. 2017;181: 235–241. doi:10.1016/j.jpeds.2016.10.073
  18. Friis H, Cichon B, Fabiansen C, Iuel-Brockdorff A-S, Yaméogo CW, Ritz C, et al. Serum cobalamin in children with moderate acute malnutrition in Burkina Faso: Secondary analysis of a randomized trial. PLoS Med. 2022;19: e1003943. doi:10.1371/journal.pmed.1003943

 

 

 

 

 

 

 

Treatfood started as a collaboration between Médicins Sans Frontièrs (MSF, Denmark) and our research group, and was conducted in Burkina Faso in collaboration with the non-governmental organization Alliance for International Medical Action (ALIMA, Senegal).

 

 

 

 

 

 

 

 

Funded by

  • Danish International Development Agency
  • Médecins Sans Frontières (Denmark, Norway)
  • Arvid Nilsson's Foundation
  • Merete and Mogens Brix Christensen
  • The World Food Program/USAID
  • ALIMA and the European Union's humanitarian aid funds, in partnership with Action Contre la Faim.