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Maternal and Child Nutrition
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The relationship between energy provided and growth during severe wasting treatment

Authors: Isabel Potani; Zachary Tausanovitch; Christian Ritz; André Briend; Issa Niamanto Coulibaly; Césaire T. Ouédraogo; Geoffrey Manda; +1 Authors

The relationship between energy provided and growth during severe wasting treatment

Abstract

AbstractTreatment of severe acute malnutrition aims at producing quick catch‐up growth in children to decrease their short‐term mortality risk. The extent to which catch‐up growth is influenced by the amount of energy provided is unclear. This study assessed whether energy provided at admission is associated with catch‐up ponderal growth among children with mid‐upper arm circumference (MUAC) < 115 mm at admission. We conducted a secondary data analysis an operational cohort in Mali. The children were treated with a simplified protocol providing 1000 kcal/day of therapeutic food until MUAC ≥ 115 mm was achieved for two consecutive weeks and 500 kcal/day thereafter until discharge with MUAC ≥ 125 mm for two consecutive weeks. Linear mixed‐effects regression models were fitted to assess the relationship between energy provided at admission (kcal/kg/day) with weight gain velocity (g/kg/day) (primary outcome), change in MUAC ‐for‐age z‐score and change in weight‐for‐age z‐score. Unadjusted models and models adjusted for sex, age, seasonality and MUAC at admission were fitted. Both models included the study site as a random effect. A 10 kcal/kg/day increase in energy provided at admission was associated with increments in all outcomes; for weight gain velocity, the mean (95% CI) increment was 0.340 [0.326, 0.354] g/kg/day and 0.466 [0.446, 0.485] g/kg/day in the unadjusted and adjusted analysis, respectively. A positive relationship exists between energy provided at admission and catch‐up ponderal growth in children with MUAC < 115 mm treated using a simplified protocol. Determining the ideal weight gain rate remains essential for assessing the benefits and risks of increased energy intake during treatment.

Keywords

Male, 3123, RC620-627, wasting, 610, severe acute malnutrition, Weight Gain, Mali, Pediatrics, RJ1-570, Cohort Studies, Energy Intake/physiology, children, Humans, Child, Preschool, Nutritional diseases. Deficiency diseases, Weight Gain/physiology, Severe Acute Malnutrition/therapy, Wasting Syndrome, Severe Acute Malnutrition, Infant, ready‐to‐use therapeutic food, Gynecology and obstetrics, undernutrition, Child, Preschool, catch‐up growth, catch-up growth, RG1-991, Arm, Original Article, Female, Human medicine, Energy Intake, ready-to-use therapeutic food, Wasting Syndrome/epidemiology

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
Green
gold