Effect of nutritional supplementation with lipid-based therapeutic food on body composition of non-severely malnourished African children aged 6–59 months hospitalized with severe pneumonia
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2025
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Oxford University Press
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Pneumonia remains an important cause of morbidity and mortality among children in low- and middle-income countries. Poor outcomes are associated with undernutrition. Nutritional supplementation may be beneficial. We examined the effect of supplementation with lipid-based ready-to-use therapeutic food (RUTF) on the body composition of children with severe pneumonia. Non-severely malnourished children (6–59 months) with severe pneumonia enrolled into the Children’s Oxygen Administration Strategies and Nutrition trial in Uganda and Kenya and randomized to receive a diet supplemented with RUTF (500 Kcal/day) for 56 days versus usual diet alone (control) were included. We assessed arm anthropometry and bioimpedance analysis at admission and days 28, 90, and 180 of follow-up. We used mixed effects linear regression to compare body composition between groups. We included 737 participants (369 in intervention; 368 in control group). The median age was 16 months (IQR; 9, 26), and 58.1% were male. Overall, baseline mean arm fat area (AFA), arm muscle area and arm muscle circumference were 5.8 ± 1.8 cm2, 11.6 ± 2.3 cm2, and 12.3 ± 1.2 cm2, respectively. The mean fat mass and fat-free mass calculated in 116 participants were 5.5 ± 1.5 kg and 5.5 ± 1.5 kg, respectively. There were modest increases in most body composition parameters. RUTF significantly increased AFA at days 28 and 90 but not at day 180 (P-value ¼ .03, .02, and .99, respectively). RUTF did not change other body composition parameters. Despite initial increases in AFA, RUTF did not change the body composition of children with severe pneumonia.
KEYWORDS: bio-impedance analysis; body composition; children; fat-free-mass fat-mass; malnutrition; pneumonia; ready-to-use therapeutic food
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Nalwanga, D., Musiime, V., Kiguli, S., Olupot-Olupot, P., Alaroker, F., Opoka, R., Tagoola, A., Mnjala, H., Mogaka, C., Nabawanuka, E., Giallongo, E., Karamagi, C., Briend, A., & Maitland, K. (2025). Effect of nutritional supplementation with lipid-based therapeutic food on body composition of non-severely malnourished African children aged 6–59 months hospitalized with severe pneumonia. Journal of Tropical Pediatrics, 71(2). https://doi.org/10.1093/tropej/fmaf010