RUTF for Treating Child Malnutrition in Developing Countries

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FORT THOMAS, Kentucky — Hunger is not a matter of insufficiency but rather inequality. Poverty is the leading cause of hunger. However, in a vicious cycle, hunger also perpetuates poverty, inhibiting individuals from leading productive lives. Those worst affected are children under the age of 5. Adequate nutrition is essential for healthy growth, proper organ formation and function, a resilient immune system and neurological and cognitive development. Proper nutrition has increasingly been recognized as a basic pillar for social and economic development. Approximately 45% of deaths among children under 5 can be attributed to undernutrition, which is commonly prevalent in the regions of Asia and Africa. The situation is dire but the solutions are out there. One of the most promising innovations for treating child malnutrition in developing countries is ready-to-use therapeutic food (RUTF).

The Global Hunger Issue

In 2015, the United Nations adopted 17 Sustainable Development Goals (SDGs) and laid out a 15-year plan for achieving them. SDG 2 is particularly ambitious: zero hunger by 2030. Though this may seem optimistic, global food production is actually more than 1.5 times the amount necessary to feed everyone on the planet. This is enough to feed 10 billion people, which is the population peak expected by 2050.

In spite of this, the world is not on track to meet SDG 2. In fact, the number of individuals impacted by hunger globally has been growing slowly since 2014. An estimated 8.9% of the world’s population suffers from hunger. If recent trends continue, this figure will be close to 10% by 2030 rather than zero, without factoring in the impact of the COVID-19 pandemic. Furthermore, where there is hunger, there is usually malnutrition.

Malnutrition Defined

The World Health Organization defines malnutrition as “deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients.” The most extreme and urgent form of undernutrition is severe acute malnutrition. Severe acute malnutrition is often highly visible, apparent in the sunken faces and frail, skeletal bodies of afflicted children. Edema, or fluid retention, can also be a side effect, resulting in swelling in the face and extremities.

Severe acute malnutrition globally affects an estimated 16 million children under the age of 5, making them nine times more likely to die in comparison to well-nourished children. These deaths arise directly from the malnutrition itself or sicknesses like diarrhea or pneumonia that malnourished children are too weak to survive.

While long-term, sustainable eradication of hunger is the ultimate goal, in the short-term, children with severe acute malnutrition need immediate life-saving interventions to survive. This relief comes in the form of ready-to-use therapeutic food.

How RUTF Intervention Helps

Ready-to-use therapeutic food is an energy-dense, micronutrient-enriched paste that treats children suffering from severe acute malnutrition. It does not require any cooking or preparation and has an extremely long shelf life.

Before RUTFs became popular, malnourished children had to be treated in hospitals or facilities that provided therapeutic milk and medical care. Now, RUTF offers a means for treating child malnutrition without children having to go elsewhere. This community-based management can treat more children and allows for earlier treatment, meaning better survival rates. Furthermore, RUTF grants autonomy to communities who can heal themselves more cost-effectively than through in-patient treatment.

Varieties of RUTF

The original RUTF is Plumpy’Nut, a peanut-based paste that comes in a foil pouch. French pediatrician, André Briend, invented Plumpy’Nut in 1996. It remains one of the most popular brands to date. However, numerous formulations of RUTF have since been developed in the quest to maximize nutrition and accessibility. RUTF formulations have a high micronutrient and macronutrient content, long shelf life, good palatability and consistency suitable for children. Furthermore, RUTFs should ideally consist of ingredients that are readily available in developing countries.

Major RUTF Producers

  • Nutriset: Nutriset is the producer of Plumpy’Nut as well as newer products, including Plumpy’Sup and Plumpy’Doz corn-based supplements used to prevent relapse into severe acute malnutrition post-RUTF treatment.
  • Valid Nutrition: This manufacturer focuses on developing food products that incorporate locally available ingredients and produces milk-peanut formula RUTFs.
  • Mana Nutrition: Mana’s RUTF is composed of peanut paste, milk, vitamins and minerals. Some of the world’s largest international aid organizations, including USAID and UNICEF, distribute this brand.
  • GC Rieber: This manufacturer producers a unique RUTF called BP-100, which comes in the form of a compressed biscuit/bar and can be consumed as is or crushed into boiled drinking water and eaten as porridge.

The Future of RUTF

RUTF is a proven instrument in treating child malnutrition with numerous manufacturers churning out these life-saving formulations. However, the key bottleneck preventing RUTF from being scaled up is funding not manufacturing. UNICEF is the world’s largest buyer of RUTF (roughly 80%) and is constantly working to streamline its supply chain and promote local RUTF production.

RUTF is not a substitute for equitable access to nutrition and healthcare which can prevent malnutrition from occurring in the first place. However, it is a timely, life-saving tool for treating child malnutrition that has reached the most severe state. Supporting organizations that manufacture and distribute RUTF means directly supporting malnourished children who are most in need.

Margot Seidel
Photo: Flickr

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