This statement references an article published in Maternal and Child Nutrition in 2015 describing the results of a cluster-randomized controlled equivalence trial that we undertook in Zambia between June 2009 and August 2010.2 This trial indeed shows that a non-milk-containing RUTF based on soya-maize and sorghum was not equivalent to the standard milk-peanut recipe in children aged 6–24 months. However the Manary et al. article does not mention a more recent article we published in The American Journal of Clinical Nutrition that reports the results of a large RCT looking at a refined version of that soya-maize-sorghum RUTF recipe that included some crystalline amino acids.3 This article demonstrates that the new soya-maize-sorghum RUTF recipe is not inferior to the standard milk-peanut recipe in terms of recovery from SAM, mortality, or default. The paper also demonstrates that the recipe is superior to the milk-containing product for the restoration of body iron stores and the treatment of anemia.3 Critically, the recipe will cost approximately 20% less than the current milk-peanut formula, potentially allowing for the treatment of almost 1 million more cases of SAM within existing budgets.
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