Project Details

Rice bran-based supplemental foods for the treatment and prevention of malnutrition in Indonesia

Elizabeth Ryan, PhD

Summary

BACKGROUND: Acute malnutrition (AM), both severe (SAM) and moderate (MAM), carries a high risk for mortality, and affects an estimated 49.5 million children under five globally. Acute malnutrition remains a leading cause of death in early childhood. Malnutrition in early life is also associated with increased risk of other detrimental conditions including cognitive impairment and non-communicable disease later in life. GAP: The pathogenesis of AM is complex, including a lack of nutrient-dense foods, but also involves the burden of infectious diseases that impact the composition of the human microbiome. The absence or altered distribution of healthy, mature, anaerobic microbiota can lead to malabsorption of dietary macro- and micronutrients and impaired development of intestinal-mucosal immunity. In Indonesia, SAM continues to be a major public health problem, affecting >2 million children under 5 years of age. The coverage of facility-based care for children with SAM in Indonesia remains unacceptably low, with only approximately 20,000 children (1%) receiving adequate SAM treatment in a year. HYPOTHESIS: This study hypothesis is that SAM patients who received treatment with a rice-bran based RUTF have a more mature microbiome that improves nutrient absorption when comparing recovered SAM patients treated with RUTFs without rice bran. Children treated with RUTF including rice bran will have a higher increase in lean body mass. METHODS: In a randomized controlled trial, 600 children, 6 – 59 months of age, will receive treatment with either 1) PlumpyNut® (control); 2) Locally produced RUTF or 3) Locally produced RUTF + 5% rice bran. Treatment with RUTF will be supplied for 8 weeks, with children being followed-up for an additional 8 weeks. RESULTS: Pending. IMPACT: To treat SAM, there is a need for local production of Ready to Use Therapeutic Foods (RUTF) to support the local food systems and reduce cost of treatment, thereby allowing more children being treated. The absence of locally produced RUTFs hampers current efforts to treat children with SAM. Novel formulations for RUTFs that are based on local ingredients and reduce food waste (e.g. with rice bran) may increase long-term sustainability of production. Website Link: https://labs.vetmedbiosci.colostate.edu/ryan/