Evidence map›Paper›PMID 34726694›Full record

Trial reportThe American journal of clinical nutrition2022

Low linoleic acid foods with added DHA given to Malawian children with severe acute malnutrition improve cognition: a randomized, triple-blinded, controlled clinical trial.

Kevin Stephenson, Meghan Callaghan-Gillespie, Kenneth Maleta, Minyanga Nkhoma, Matthews George, Hui Gyu Park, Reginald Lee, Iona Humphries-Cuff, R J Scott Lacombe, Donna R Wegner and 3 more

Erratum issued 2 registry-linked trialsOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of clinical nutrition, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03094247 nacompletednot on this map

Improved Polyunsaturated Ready-to-use Therapeutic Food for Improved Neurocognitive Outcomes in Severe Acute Malnutrition

TypeinterventionalSponsorWashington University School of MedicineRan2017 to 2021Enrolled2,897ConditionsSevere Acute MalnutritionArmsAmoxicillin, HO-RUTF, D-HO-RUTF, S-RUTF
NCT06781918 phase3not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Brain development, growth and health in children with severe acute malnutrition

TypeinterventionalSponsorNational Institute for Medical Research, TanzaniaRan2025 to 2026Enrolled800ConditionsSevere Acute Malnutrition in ChildhoodArmsReady to Use Therapeutic Food (RUTF), Psychosocial stimulation
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

Kevin StephensonDepartment of Medicine, Washington University, St. Louis, MO, USA.
Meghan Callaghan-GillespieDepartment of Pediatrics, Washington University, St. Louis, MO, USA.
Kenneth MaletaDepartment of Public Health, School of Public Health & Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi.ORCID 0000-0002-2536-3938
Minyanga NkhomaDepartment of Public Health, School of Public Health & Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi.
Matthews GeorgeDepartment of Public Health, School of Public Health & Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi.
Hui Gyu ParkDepartment of Pediatrics, University of Texas at Austin, Austin, TX, USA.
Reginald LeeDepartment of Pediatrics, Washington University, St. Louis, MO, USA.
Iona Humphries-CuffProject Peanut Butter, Lunzu, Malawi.
R J Scott LacombeDepartment of Pediatrics, University of Texas at Austin, Austin, TX, USA.
Donna R WegnerDepartment of Pediatrics, Washington University, St. Louis, MO, USA.
Richard L CanfieldDepartment of Pediatrics, University of Texas at Austin, Austin, TX, USA.
J Thomas BrennaDepartment of Pediatrics, University of Texas at Austin, Austin, TX, USA.
Mark J ManaryDepartment of Pediatrics, Washington University, St. Louis, MO, USA.
Washington University in St. Louis · USKamuzu Central Hospital · MWThe University of Texas at Austin · USAgricultural Research Service · USCornell University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is concern that the PUFA composition of ready-to-use therapeutic food (RUTF) for the treatment of severe acute malnutrition (SAM) is suboptimal for neurocognitive recovery.

objectivesWe tested the hypothesis that RUTF made with reduced amounts of linoleic acid, achieved using high-oleic (HO) peanuts without added DHA (HO-RUTF) or with added DHA (DHA-HO-RUTF), improves cognition when compared with standard RUTF (S-RUTF).

methodsA triple-blind, randomized, controlled clinical feeding trial was conducted among children with uncomplicated SAM in Malawi with 3 types of RUTF: DHA-HO-RUTF, HO-RUTF, and S-RUTF. The primary outcomes, measured in a subset of subjects, were the Malawi Developmental Assessment Tool (MDAT) global z-score and a modified Willatts problem-solving assessment (PSA) intention score for 3 standardized problems, measured 6 mo and immediately after completing RUTF therapy, respectively. MDAT domain z-scores, plasma fatty acid content, anthropometry, and eye tracking were secondary outcomes. Comparisons were made between the novel PUFA RUTFs and S-RUTF.

resultsAmong the 2565 SAM children enrolled, mean global MDAT z-scores were -0.69 ± 1.19 and -0.88 ± 1.27 for children receiving DHA-HO-RUTF and S-RUTF, respectively (difference 0.19, 95% CI: 0.01, 0.38). Children receiving DHA-HO-RUTF had higher gross motor and social domain z-scores than those receiving S-RUTF. The PSA problem 3 scores did not differ by dietary group (OR: 0.92, 95% CI: 0.67, 1.26 for DHA-HO-RUTF). After 4 wk of treatment, plasma phospholipid EPA and α-linolenic acid were greater in children consuming DHA-HO-RUTF or HO-RUTF when compared with S-RUTF (for all 4 comparisons P values < 0.001), but only plasma DHA was greater in DHA-HO-RUTF than S-RUTF (P < 0.001).

conclusionsTreatment of uncomplicated SAM with DHA-HO-RUTF resulted in an improved MDAT score, conferring a cognitive benefit 6 mo after completing diet therapy. This treatment should be explored in operational settings. This trial was registered at clinicaltrials.gov as NCT03094247.

Indexed as

MalnutritionSevere Acute MalnutritionChildCognitionFast FoodsHumansInfantLinoleic AcidMaleProstate-Specific AntigenLinoleic AcidProstate-Specific AntigencognitionDHAMDATPUFAready-to-use therapeutic foodsevere acute malnutrition

Identifiers

PMID34726694
PMCPMC9071416
OpenAlexW3210341501

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.