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Title: Locally produced cereal/nut/legume-based biscuits versus peanut/milk-based spread for treatment of moderately to mildly wasted children in daily programmes on Nias Island, Indonesia: an issue of acceptance and compliance?
Author: Scherbaum V, Purwestri RC, Stuetz W, Inayati DA, Suryantan J, Bloem MA, Biesalski HK.
Journal: Asia Pac J Clin Nutr; 2015; 24(1):152-61. PubMed ID: 25740754.
Abstract:
BACKGROUND: Treatment effects of fortified ready-to-use foods for moderately to mildly wasted children are largely unknown. METHODS: Two nutritionally comparable forms of locally produced ready-to-use foods for daily feeding programmes of moderately to mildly wasted children (weight-for-height Z-score/WHZ>=-3 to <-1.5SD) were assessed on Nias, Indonesia. The frequencies of reaching target WHZ>=-1.5SD, compliance to the ready-touse food programme, and weight gain until recovery or programme closure among children treated with peanut/ milk-based spreads (n=29) were compared among children receiving cereal/nut/legume-based biscuits (n=44) and a second group treated with cereal/nut/legume-based biscuits whose mothers received intensive nutrition education (n=38). RESULTS: Children in the cereal/nut/legume-based biscuits groups were younger (31 and 33 vs 39 months, p=0.004) and more likely to be moderately wasted (45 and 39 vs 21% with WHZ<-2, p=0.114) at admission, but had a higher rate in recovery (84 and 79 vs 62%, p=0.086) and showed more frequently a high compliance (>80%) to the ready-to-use (86 and 84 vs 45%, p<0.001) than those children in the peanut/milk-based spreads programme. Multivariable logistic regression revealed high compliance followed by weight gain and a lower degree of wasting at admission as independent and significant predictors of reaching target WHZ>=-1.5SD (all p<0.01). Weight gain was positively associated with the consumption of the biscuits (vs peanut//milk-based spreads: r=0.188, p=0.051) and was highest in the cereal/nut/legume-based biscuits plus intensive education compared with the cereal/nut/legume-based biscuits and peanut/milk-based spreads groups. CONCLUSIONS: Locally produced ready-to-use foods as biscuits or spreads were similarly effective for rehabilitation of moderately to mildly wasted children. 背景：强化方便食品对轻中度虚弱儿童的治疗效果在很大程度上是未知的。方法：在印度尼西亚尼亚斯岛两种本地生产的方便食品的营养堪比形式对轻中度虚弱儿童（身高别体重Z-评分/WHZ，-3SD<=WHZ<-1.5SD）日常供餐方案中进行评估。在接受花生/牛奶为基础的涂抹酱治疗的儿童（n=29）、接受谷物/坚果/豆科植物为基础的饼干治疗的儿童（n=44）和第二组接受谷物/坚果/豆科植物为基础的饼干治疗并且其母亲接受营养强化教育（n=38）的儿童中，比较其达到目标WHZ>=-1.5SD 的频率、对方便食品计划的依从、直到康复或计划结束时的体重增加。结果：与花生/牛奶为基础的涂抹酱计划相比，接受谷物/坚果/豆科植物为基础的饼干组的儿童年龄更小（31 和33 比39 个月，p=0.04），在参加研究时虽然轻度虚弱者高些（WHZ<-2 分别为：45%和39%比21%，p=0.114），但恢复率更高（84%和79%比62%， p=0.086），对方便食品的高使用频率（86%和84%比45%，p<0.001）其依从性>80%。多因素logistic 回归分析显示：高依从性，重增加与饼干的消费呈正相关（与花生/牛奶为基础的涂抹酱相比，r=0.188，p=0.051），并且与接受谷物/坚果/豆科植物为基础的饼干和花生/牛奶为基础的涂抹酱组相比，接受谷物/坚果/豆科植物为基础的饼干加上营养教育组的体重增加最高。结论：本地生产的方便食品饼干或涂抹酱在轻中度虚弱儿童的恢复中效果相似。

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