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Title: Local production and provision of ready-to-use therapeutic food (RUTF) spread for the treatment of severe childhood malnutrition

item Manary, Mark

Submitted to: Food and Nutrition Bulletin
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/1/2006
Publication Date: 9/1/2006
Citation: Manary, M.J. 2006. Local production and provision of ready-to-use therapeutic food (RUTF) spread for the treatment of severe childhood malnutrition. Food and Nutrition Bulletin. 27(3 Suppl):S83-S89.

Interpretive Summary: Peanut-butter-based ready-to-use therapeutic food is a new therapy that is used to treat severe malnutrition worldwide. The results of this therapy are much more successful that standard milk therapy. This food can be made in a simple manner in a single health care facility, or on a larger scale in factories. The paper describes in detail each production method, highlighting the essential elements.

Technical Abstract: Ready-to-use therapeutic food (RUTF) spread has been shown to be very effective in the rehabilitation of severely malnourished children and facilitates home-based therapy of these children. RUTF spread is an edible lipid-based paste that is energy dense, resists bacterial contamination, and requires no cooking. The primary production principles include grinding all ingredients to a particle size < 200 microns, producing the food without the introduction of water, and embedding the protein and carbohydrate components of the food into the lipid matrix. The most widely used RUTF spread is a mixture of milk powder, sugar, vegetable oil, peanut butter, vitamins, and minerals. RUTF spread can be produced in quantities sufficient to treat several hundred children using a planetary mixer in a clinic. Production of larger quantities of RUTF spread can be achieved in partnership with local food companies. Production sufficient to meet the needs of several thousand children can be achieved with a dedicated production facility using technology appropriate for use in the developing world. Care must be taken to avoid aflatoxin contamination, and quality control testing of the product is essential. RUTF spread can be safely and easily produced in small or large quantities in most settings worldwide. The local availability of the necessary ingredients limits its use in some settings, and further investigation of alternative ingredients is needed to overcome this limitation.