There are no guidelines for the optimal protein quality of ready-to-supplementary food (RUSF) for moderate acute malnutrition (MAM). This randomized, controlled, double-blinded, clinical effectiveness trial evaluated two RUSFs in the treatment of MAM. Both foods contained greater than 7% dairy protein, but the protein-optimized RUSF had a calculated digestible indispensable amino acid score (DIAAS) of 95%, whereas the control RUSF had a calculated DIAAS of 63%. There were 1,737 rural Malawian children 6-59 months of age treated with 75 kcal/kg/day of either control or protein quality-optimized RUSF for up to 12 weeks. There was no difference in the proportion of children who recovered from MAM between the group that received protein-optimized RUSF (759/860, 88%) and the group that received control RUSF (766/877, 87%, difference 1%, 95% CI, -2.1 to 4.1, p = 0.61). There were no differences in time to recovery or average weight gain; nor were adverse effects reported. Both RUSFs showed indistinguishable clinical outcomes, with recovery rates higher than typically seen in treatment for MAM. The DIAAS of these two RUSFs was measured using a pig model. Unexpectedly, the protein quality of the optimized RUSF was inferior to the control RUSF: DIAAS = 82% for the protein quality optimized RUSF and 96% for control RUSF. The controlled conditions of this trial suggest that in supplementary food products for MAM, protein quality is not an independent predictor of clinical effectiveness.

中文翻译：

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即用型补充食品中的蛋白质质量适合适度浪费。

对于中度急性营养不良 (MAM) 的即食补充食品 (RUSF) 的最佳蛋白质质量，目前尚无指南。这项随机、对照、双盲临床有效性试验评估了两种 RUSF 治疗 MAM 的效果。两种食品都含有超过 7% 的乳蛋白，但蛋白质优化的 RUSF 的计算可消化必需氨基酸评分 (DIAAS) 为 95%，而对照 RUSF 的计算 DIAAS 为 63%。1,737 名 6-59 个月大的马拉维农村儿童接受了 75 kcal/kg/天的对照或蛋白质质量优化的 RUSF 治疗，治疗时间长达 12 周。接受蛋白质优化 RUSF 的组 (759/860, 88%) 和接受对照 RUSF 的组 (766/877, 87%, 差异 1%, 95) 从 MAM 恢复的儿童比例没有差异% CI，-2.1 至 4.1，p = 0.61）。恢复时间或平均体重增加没有差异；也没有不良反应的报道。两种 RUSF 均表现出无法区分的临床结果，恢复率高于 MAM 治疗中的典型恢复率。这两个 RUSF 的 DIAAS 是使用猪模型测量的。出乎意料的是，优化的 RUSF 的蛋白质质量低于对照 RUSF：蛋白质质量优化的 RUSF 的 DIAAS = 82%，对照 RUSF 的 DIAAS = 96%。该试验的受控条件表明，在 MAM 补充食品中，蛋白质质量并不是临床有效性的独立预测因素。