Acceptability and Efficacy of Locally Produced Ready-to-Use Therapeutic Food Nutreal in the Management of Severe Acute Malnutrition in Comparison With Defined Food: A Randomized Control Trial

Background:Severe acute malnutrition (SAM) is a salient health problem in India. Federation of Indian Chamber of Commerce and Industry (FICCI) Research and Analysis Centre, New Delhi, prepared nutreal equivalent to ready-to-use therapeutic food by World Health Organization (WHO) for the management of SAM and defined food like homemade diet. Objective:To compare acceptability and efficacy of nutreal over defined food for the management of SAM. Methods:One hundred twelve children aged less than 5 years with SAM were enrolled as per the standard of WHO. Children were randomized into 2 groups to receive nutreal (n = 56) and defined food (n = 56) in unlimited amounts for 42 consecutive days and extended by 2 weeks as per demand. Calorie and protein intake, weight, and mid-upper arm circumference (MUAC) were recorded daily. Results:Age range was 8 to 45 months. Ninety-three percent of children eagerly accepted nutreal but 7% does not. Whereas in the defined food group, 68% accepted eagerly, 30% did not accept eagerly, and 1.8% accepted poorly (P = .004). At enrollment, mean weight in the nutreal group was 6.44 1.60 kg and in the defined food group was 8.69 +/- 1.76 kg, with MUAC in the nutreal group being 11.12 +/- 0.47 cm and in the defined food group being 11.54 +/- 0.34 cm. Mean weight in the nutreal and defined food groups at eighth week of intervention was 7.97 +/- 1.8 kg and 9.71 +/- 1.8 kg (P < .001), respectively. Mid-upper arm circumference at eighth week was 12.10 +/- 0.29 cm in the nutreal group and 12.49 +/- 0.50 cm in the defined group (P < .001). Conclusion:Acceptability, mean weight gain, and MUAC in the nutreal group are greater than the defined food.