Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: a randomized, double-blind clinical trial

Am J Clin Nutr. 2016 Mar;103(3):926-33. doi: 10.3945/ajcn.115.124636. Epub 2016 Feb 10.


Background: The utility of dairy ingredients in the supplementary foods used in the treatment of childhood moderate acute malnutrition (MAM) remains unsettled.

Objective: We evaluated the effectiveness of a peanut-based ready-to-use supplementary food (RUSF) with soy protein compared with a novel RUSF containing dairy ingredients in the form of whey permeate and whey protein concentrate in the treatment of children with MAM.

Design: We conducted a randomized, double-blind clinical effectiveness trial involving rural Malawian and Mozambican children 6-59 mo of age with MAM treated with either soy RUSF or a novel whey RUSF treatment of ~75 kcal · kg(-1) · d(-1) for up to 12 wk.

Results: The proportion of children that recovered from MAM was significantly higher in the group that received whey RUSF (960 of 1144; 83.9%) than in the group that received soy RUSF (874 of 1086; 80.5%; P < 0.04; risk difference 3.4%, 95% CI: 0.3%, 6.6%). Children who consumed whey RUSF also demonstrated better growth markers, with a higher mean midupper arm circumference (MUAC) at the time of discharge (P < 0.009), greater MUAC gain during the course of treatment (P < 0.003), higher mean weight-for-height z score at discharge (P < 0.008), and greater weight gain (P < 0.05). No significant differences were identified in length gain or time to recovery between the 2 groups.

Conclusion: This study highlights the importance of milk protein in the treatment of MAM, because the use of a novel whey RUSF resulted in higher recovery rates and improved growth than did soy RUSF, although the whey RUSF supplement provided less total protein and energy than the soy RUSF. This study was registered at as NCT01790048.

Keywords: moderate acute malnutrition; ready-to-use supplementary food; wasting; whey permeate; whey protein.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arachis
  • Child, Preschool
  • Dairy Products*
  • Dietary Proteins / pharmacology
  • Dietary Proteins / therapeutic use*
  • Dietary Supplements
  • Double-Blind Method
  • Fast Foods
  • Female
  • Food, Fortified
  • Humans
  • Infant
  • Male
  • Malnutrition / diet therapy*
  • Milk Proteins / pharmacology
  • Milk Proteins / therapeutic use
  • Mozambique
  • Soybean Proteins*
  • Treatment Outcome
  • Weight Gain / drug effects
  • Whey
  • Whey Proteins / pharmacology
  • Whey Proteins / therapeutic use*


  • Dietary Proteins
  • Milk Proteins
  • Soybean Proteins
  • Whey Proteins

Associated data