Effect of Finger Millet-Based Supplementation on Anthropometry and Body Composition Among Moderately Acute Malnourished Under -5 Children in Telangana, India: A Randomized, Community -Based Trial

BackgroundModerate acute malnutrition (MAM) remains a major health challenge in India despite ongoing efforts of government nutrition programs. Finger millet (Ragi), a nutrient-dense, climate-resilient crop rich in calcium, fiber, and bioactive compounds, offers potential advantages over conventional cereal-based ready-to-use therapeutic foods (RUTF). This trial evaluated the effects of finger millet-based supplement on anthropometry, body composition, dietary adequacy among MAM children aged 18-59 months. Material & methodsIn this open-label, randomized community-based trial, 221 MAM children were allocated to receive either a finger millet-with-dates supplement (FMD) or the standard wheat/rice-based Balamrutham plus with dates (BMD) for 8 weeks in Anganwadi centers in Hyderabad, India. Anthropometry, body composition (InBody S10), dietary intake (three-day recall), biomarkers, and compliance were assessed at baseline and endpoint, with follow-ups at days 100 and 160. Growth trends were evaluated using repeated-measures ANOVA. Results136 children completed the intervention (FMD: 71; BMD: 65); compliance exceeded 80%. By day 40, both groups showed significant gains in weight (6.3-6.4%), height (2.4%), and MUAC (3.5-6.2%), which continued through day 160. The FMD group showed greater improvements in mineral mass, bone mineral content, and skeletal muscle mass, whereas the BMD group demonstrated higher increases in protein mass and fat-free mass. Dietary recall revealed markedly low micronutrient adequacy among MAM children. No major adverse events were reported. ConclusionFinger millet-based supplementation achieved comparable or superior improvements to cereal-based RUTF, supporting its integration into ICDS and POSHAN 2.0 as a sustainable approach to MAM management.