This news release describes a study published in PLOS Medicine, showing that among moderate acute malnourished infants lipid-based nutrient supplement (LNS)–a kind of fortified peanut butter–produced more gain in muscle and organ weight over 12 weeks than a corn-soy blend (CSB) porridge. Acute malnutrition affects over 50 million children across the world. It is characterized by bodily wasting following experience of a recent period of starvation.
According to the researchers, until now there has been concern that because LNS has a very high fat content any weight gain it produced would be composed primarily of fat. The distinction of this study is its demonstration that LNS not only resulted in more weight gain, but that weight gain was in muscles and organs (lean mass) rather than fat.
Children with the most severe level of acute malnutrition are at risk of death. Increasing the effectiveness of interventions with children before their malnutrition becomes severe could save millions of lives. However, readers would take away a better understanding of this critical issue if more space in this news release had been devoted to explaining the study itself, and less to citing various researchers and partners about how important the project was.
No comparison is made in the news release between the cost of the current corn-soy blend (CSB) nutrient supplement and the alternative lipid-based supplement. This is strange considering that the original study devotes some space to addressing the issue of cost-effectiveness. The researchers conclude that although LNS is about twice as expensive as CSB, the possibility that it could require a shorter treatment regimen, is easier to prepare, and has a longer shelf life could make it more cost-effective in the long run. They call for detailed cost-effectiveness studies to inform policy decisions, a point that goes unmentioned in the release.
The primary outcome in this study was weight gain that was not primarily fat; it is important to note that this study did not address survival or neurodevelopment, which are the presumed benefits of greater fat-free weight gain. The news release tells us that children who received LNS gained more weight than children on the corn-soy porridge, and that weight was primarily lean mass. It doesn’t tell us how much more weight they gained, nor does it describe the difference in progression to severe acute malnutrition. Studies with large samples like this one can give results that are statistically significant even when differences are small. Specific information about the size and clinical importance of the difference should have been included.
Many people’s first question upon reading about a peanut buttery kind of nutrient supplement might be whether it produced any allergic reaction or other side effects in infants. In fact, it didn’t, but the news release doesn’t tell us that.
Readers are told there were two arms of the study, the treatment lasted for 12 weeks, and children’s lean mass was assessed afterward. It would have been better if the news release mentioned that children were randomly assigned to treatment. Nevertheless, the basics for understanding how the study was conducted are provided.
No mongering here. It would be pretty much impossible to engage in disease mongering about acute malnutrition.
The major funding sources for the study are listed, but financial relationships between two of the authors and Nutriset, a producer of LNS products, were not included in the release. According to the published study they are Nutriset patent holders.
The study is all about comparing widely used alternatives about which there have been long standing questions of relative benefit.
The news release assumes availability of both types of supplements, though no specific information is provided about how much each is currently used for treatment of moderate acute malnutrition in infants.
This piece gives the impression that across the globe most current interventions for infants with moderate acute malnutrition use CSB as a nutritional supplement. The original study itself presents a somewhat different picture, noting that there is currently no consensus on which of the two food supplements is better, and citing a World Health Organization recommendation that more research needs to be done.
The news release claims in the first paragraph that “corn-soy porridge should be replaced with a lipid-based nutrient supplement (LNS)” [emphasis ours]. The researchers in the original study are careful to qualify their recommendation with the need for a cost-effectiveness analysis as well as more study about the role of soy and milk in food supplements. We’d like to have seen correspondingly moderate claims in the news release.