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Sato W, Furuta C, Akomo P, Bahwere P, Collins S, Sadler K, Banda C, Maganga E, Kathumba S, Murakami H. Amino acid-enriched plant-based RUTF treatment was not inferior to peanut-milk RUTF treatment in restoring plasma amino acid levels among patients with oedematous or non-oedematous malnutrition. Sci Rep 2021; 11:12582. [PMID: 34131186 PMCID: PMC8206220 DOI: 10.1038/s41598-021-91807-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/31/2021] [Indexed: 01/20/2023] Open
Abstract
Ready-to-use therapeutic food (RUTF) with adequate quality protein is used to treat children with oedematous and non-oedematous severe acute malnutrition (SAM). The plasma amino acid (AA) profile reflects the protein nutritional status; hence, its assessment during SAM treatment is useful in evaluating AA delivery from RUTFs. The objective was to evaluate the plasma AAs during the treatment of oedematous and non-oedematous SAM in community-based management of acute malnutrition (CMAM) using amino acid-enriched plant-based RUTFs with 10% milk (MSMS-RUTF) or without milk (FSMS-RUTF) compared to peanut milk RUTF (PM-RUTF). Plasma AA was measured in a non-blinded, 3-arm, parallel-group, simple randomized controlled trial conducted in Malawi. The RUTFs used for SAM were FSMS-RUTF, MSMS-RUTF or PM-RUTF. A non-inferiority hypothesis was tested to compare plasma AA levels from patients treated with FSMS-RUTF or MSMS-RUTF with those from patients treated with PM-RUTF at discharge. For both types of SAM, FSMS-RUTF and MSMS-RUTF treatments were non-inferior to the PM-RUTF treatment in restoration of the EAA and cystine except that for FSMS-RUTF, methionine and tryptophan partially satisfied the non-inferiority criteria in the oedematous group. Amino-acid-enriched milk-free plant-source-protein RUTF has the potential to restore all the EAA, but it is possible that enrichment with amino acids may require more methionine and tryptophan for oedematous children.
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Affiliation(s)
- Wataru Sato
- Ajinomoto Co. Inc., Research Institute for Bioscience Products & Fine Chemicals, Kawasaki, Japan
| | - Chie Furuta
- Ajinomoto Co. Inc., Institute of Food Science and Technologies, Suzukicho 1-1, Kawasaki-ku, Kawasaki, Kanagawa, 210-8681, Japan
| | | | - Paluku Bahwere
- Valid International, Oxford, UK
- Center for Epidemiology, Biostatistics, and Clinical Research, School of Public Health, Free University of Brussels, Brussels, Belgium
| | - Steve Collins
- Valid Nutrition, Cork, Ireland
- Valid International, Oxford, UK
| | | | | | | | | | - Hitoshi Murakami
- Ajinomoto Co. Inc., Institute of Food Science and Technologies, Suzukicho 1-1, Kawasaki-ku, Kawasaki, Kanagawa, 210-8681, Japan.
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Schwinger C, Chowdhury R, Sharma S, Bhandari N, Taneja S, Ueland PM, Strand TA. Association of Plasma Total Cysteine and Anthropometric Status in 6-30 Months Old Indian Children. Nutrients 2020; 12:nu12103146. [PMID: 33076294 PMCID: PMC7602373 DOI: 10.3390/nu12103146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/09/2020] [Accepted: 10/10/2020] [Indexed: 12/21/2022] Open
Abstract
High-quality protein has been associated with child growth; however, the role of the amino acid cysteine remains unclear. The aim was to measure the extent to which plasma total cysteine (tCys) concentration is associated with anthropometric status in children aged 6–30 months living in New Delhi, India. The study was a prospective cohort study including 2102 children. We calculated Z-scores for height-for-age (HAZ), weight-for-height (WHZ), or weight-for-age (WAZ) according to the WHO Child Growth Standards. We used multiple regression models to estimate the association between tCys and the anthropometric indices. A high proportion of the children were categorized as malnourished at enrolment; 41% were stunted (HAZ ≤ −2), 19% were wasted (WHZ ≤ −2) and 42% underweight (WAZ ≤ −2). Plasma total cysteine (tCys) was significantly associated with HAZ, WHZ and WAZ after adjusting for relevant confounders (p < 0.001). Low tCys (≤25th percentile) was associated with a decrease of 0.28 Z-scores for HAZ, 0.10 Z-scores for WHZ, and 0.21 Z-scores for WAZ compared to being >25th percentile. In young Indian children from low-to-middle socioeconomic neighborhoods, a low plasma total cysteine concentration was associated with an increased risk of poor anthropometric status.
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Affiliation(s)
- Catherine Schwinger
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Catherine Schwinger, Årstadveien 21, 5009 Bergen, Norway; (R.C.); (N.B.); (T.A.S.)
- Correspondence: ; Tel.: +47-5558-9733
| | - Ranadip Chowdhury
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Catherine Schwinger, Årstadveien 21, 5009 Bergen, Norway; (R.C.); (N.B.); (T.A.S.)
- Society for Applied Studies, New Delhi 110016, India;
| | - Shakun Sharma
- Department of Child Health, Institute of Medicine, Tribuhvan University, Kathmandu 44613, Nepal;
| | - Nita Bhandari
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Catherine Schwinger, Årstadveien 21, 5009 Bergen, Norway; (R.C.); (N.B.); (T.A.S.)
- Society for Applied Studies, New Delhi 110016, India;
| | - Sunita Taneja
- Society for Applied Studies, New Delhi 110016, India;
| | - Per M. Ueland
- Department of Clinical Science, University of Bergen,5020 Bergen, Norway;
| | - Tor A. Strand
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Catherine Schwinger, Årstadveien 21, 5009 Bergen, Norway; (R.C.); (N.B.); (T.A.S.)
- Department of Research, Innlandet Hospital Trust, 2618 Lillehammer, Norway
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