12 Findings from an antiretroviral therapy programme in rural Malawi that provided corn-soy blend as a supplementary food in 2003 and fortified spread in 2004 indicate that patients receiving fortified spread had greater weight gain (1.5 v 0.8 kg/month; P=0.04) (Kaliwo G. Use of RUTF in Thyolo district. CTC workshop, 25 June 2004, Lilongwe, Malawi).
In our trial, both preparations of milk provided 1890 kJ of energy and 20 g of dairy protein, and yet micronutrient fortified group showed improved weight and height gain.
Systematic reviews have estimated that multiple-micronutrient supplementation by using either tablets or fortified drinks increases birth weight by 20 50 g and reduces LBW by 10 20% (4– 6).
As stated in a systematic review [ 59], preterm infants fed fortified HM have improved weight gain, linear growth, and head circumference growth without experiencing major adverse effects (i.e., necrotising enterocolitis).
Severely malnourished Malawian children with HIV who received fortified spread had greater weight-for-height improvement than those receiving corn-soy blend.
Lipid based nutrient supplements have previously been associated with higher weight gains than fortified blended foods.
The milk formula was well tolerated and associated with better weight gain compared with fortified breast milk (18.1 vs. 15.2 g kg 1 day–1; p = 0.0015).
Fat-free mass contributed to 2.9 kg (51.8%) of the 5.6 kg weight gain in the fortified spread group and 2.2 kg (51.2%) of the 4.3 kg weight gain in the corn-soy blend group.
The chromatographic profiles of extracts obtained after digestion in vitro of control and enriched bread showed that the major indigestible protein fractions in control and fortified bread were fractions with molecular weights 61-35, 30-22, 20-16.5, and 6.5 kDa).
Furthermore, this effect on height was sustained over a 24-months observation period and the children in the fortified spread cohort continued to display improved weight gain after the supplementation phase ended [24].
