Supplementary feeding with either ready-to-use fortified spread or corn-soy blend in wasted adults starting antiretroviral therapy in Malawi: randomised, investigator blinded, controlled trial.

Abstract:

OBJECTIVE:To investigate the effect of two different food supplements on body mass index (BMI) in wasted Malawian adults with HIV who were starting antiretroviral therapy. DESIGN:Randomised, investigator blinded, controlled trial. SETTING:Large, public clinic associated with a referral hospital in Blantyre, Malawi. PARTICIPANTS:491 adults with BMI <18.5. INTERVENTIONS:Ready-to-use fortified spread (n=245) or corn-soy blend (n=246). MAIN OUTCOME MEASURES: PRIMARY OUTCOMES:changes in BMI and fat-free body mass after 3.5 months. SECONDARY OUTCOMES:survival, CD4 count, HIV viral load, quality of life, and adherence to antiretroviral therapy. RESULTS:The mean BMI at enrolment was 16.5. After 14 weeks, patients receiving fortified spread had a greater increase in BMI and fat-free body mass than those receiving corn-soy blend: 2.2 (SD 1.9) v 1.7 (SD 1.6) (difference 0.5, 95% confidence interval 0.2 to 0.8), and 2.9 (SD 3.2) v 2.2 (SD 3.0) kg (difference 0.7 kg, 0.2 to 1.2 kg), respectively. The mortality rate was 27% for those receiving fortified spread and 26% for those receiving corn-soy blend. No significant differences in the CD4 count, HIV viral load, assessment of quality of life, or adherence to antiretroviral therapy were noted between the two groups. CONCLUSION:Supplementary feeding with fortified spread resulted in a greater increase in BMI and lean body mass than feeding with corn-soy blend. TRIAL REGISTRATION:Current Controlled Trials ISRCTN67515515.

journal_name

BMJ

authors

Ndekha MJ,van Oosterhout JJ,Zijlstra EE,Manary M,Saloojee H,Manary MJ

doi

10.1136/bmj.b1867

subject

Has Abstract

pub_date

2009-05-22 00:00:00

pages

b1867

eissn

0959-8138

issn

1756-1833

journal_volume

338

pub_type

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