%0 Journal Article
%T Impact of Daily versus Weekly Supply of Locally Produced Ready-to-Use Food on Growth of Moderately Wasted Children on Nias Island, Indonesia
%A Ratna Chrismiari Purwestri
%A Veronika Scherbaum
%A Dyah Ayu Inayati
%A Nia Novita Wirawan
%A Julia Suryantan
%A Maurice Alexander Bloem
%A Rosnani Verba Pangaribuan
%A Wolfgang Stuetz
%A Volker Hoffmann
%A Matin Qaim
%A Hans Konrad Biesalski
%A Anne Camilla Bellows
%J ISRN Nutrition
%D 2013
%R 10.5402/2013/412145
%X This study reports the outcomes of daily (semi-urban areas) and weekly (remote rural regions) programs for moderately wasted children supplemented with locally produced ready-to-use foods in the form of fortified cereal/nut/legume-based biscuits on Nias Island, Indonesia (RUF-Nias biscuit). Thirty-four children in daily and twenty children in weekly programs aged ¡Ý6 to <60 months with weight-for-height -score (WHZ) ¡Ý £¿3 to < £¿2 SD were recruited (October 2007¨CJune 2008) on Nias and admitted into existing nutrition centers in the Church World Service project area. Individual discharge criterion was WHZ ¡Ý £¿1.5 SD. Weight gain of the children in daily and weekly programs was and £¿g/kg/day, respectively. A higher proportion of children in daily than weekly programs reached target WHZ (76% vs. 35%, ). Weight gain at program discharge/closure was highly predicted ( , ) by compliance to RUF biscuits: high vs. low compliance resulted in a 1.33 (95% CI 0.16 to 1.53)£¿g/kg/day higher weight gain. Compliance and admission in daily programs were significant factors in reducing the risk of not reaching the discharge criterion. However, mothers complained more frequently about time constraints in the daily relative to weekly programs. 1. Introduction Globally, about 36 million children are suffering from moderate acute malnutrition (MAM) [1]. These children are usually supplemented with uncooked food supplements such as corn soy blend, often substituted with sugar and oil [2]. In 2008, a WHO/UNICEF/WFP/UNHCR meeting focused on management of MAM children and highlighted the importance of dietary management by providing both nutritional counseling and locally adapted food supplements [3, 4]. To date, fortified peanut/milk paste ready-to-use therapeutic foods (RUTFs), which are mainly commercially produced at international or national levels, have been tested with promising weight gain for severely, moderately, and mildly wasted children in the community-based settings [5¨C9]. More recently, alternative ready-to-use foods (RUFs) in the form of fortified cereal/nut/legume-based biscuits were designed at the University of Hohenheim, Germany, for severe acute malnutrition (SAM) among children. Out of nine RUF recipes, two were locally selected, produced at village level, and tested for the children suffering from moderate forms of wasting on Nias Island, Indonesia, within daily (in semi-urban areas) and weekly supervision and distribution programs (in rural remote regions) [10]. This study reports comparison between daily and weekly program outcomes of moderately wasted
%U http://www.hindawi.com/journals/isrn.nutrition/2013/412145/