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The cost of ready‐to‐use therapeutic food ( RUTF ) used in community‐based management of acute malnutrition has been a major obstacle to the scale up of this important child survival strategy. The current standard recipe for  RUTF  [peanut‐based RUTF ( P ‐ RUTF  ) ] is made from peanut paste, milk powder, oil, sugar, and minerals and vitamins. Milk powder forms about 30% of the ingredients and may represent over half the cost of the final product. The quality of whey protein concentrates 34% ( WPC 34) is similar to that of dried skimmed milk ( DSM ) used in the standard recipe and can be 25–33% cheaper. This blinded, parallel group, randomised, controlled non‐inferiority clinical trial tested the effectiveness in treating severe acute malnutrition ( SAM ) of a new  RUTF  formulation  WPC ‐ RUTF  in which  WPC 34 was used to replace  DSM . Average weight gain (non‐inferiority margin Δ = −1.2 g kg −1  day −1 ) and recovery rate (Δ = −10%) were the primary outcomes, and length of stay ( LOS ) was the secondary outcome (Δ = +14 days). Both per‐protocol ( PP ) and intention‐to‐treat ( ITT ) analyses showed that  WPC ‐ RUTF  was not inferior to  P ‐ RUTF  for recovery rate [difference and its 95% confidence interval ( CI ) of 0.5% (95%  CI  –2.7, 3.7) in  PP  analysis and 0.6% (95%  CI  –5.2, 6.3) in  ITT  analysis] for average weight gain [0.2 (−0.5; 0.9) for both analyses] and  LOS  [−1.6 days (95%  CI , −4.6, 1.4 days) in  PP  analysis and −1.9 days (95%  CI , −4.6, 0.8 days) for  ITT  analysis]. In conclusion, whey protein‐based  RUTF  is an effective cheaper alternative to the standard milk‐based  RUTF  for the treatment of  SAM .

maternal and child nutrition

Effectiveness of milk whey protein‐based ready‐to‐use therapeutic food in treatment of severe acute malnutrition in  M alawian under‐5 children: a randomised, double‐blind, controlled non‐inferiority clinical trial