Foods for the Treatment of Malnutrition

Summary of Conference Presentation

At the Dublin conference on Emergency Supplementary Feeding (February 18 to 21, 1997), reported on in the last issue of Field Exchange, Prof. Mike Golden of Aberdeen University gave a succinct overview of his work in developing suitable foods for the treatment of malnutrition. His main point was that "low recovery rates that are often reported in therapeutic and supplementary feeding programmes may be attributable to fundamental physiological changes and nutrient deficiencies that occur in malnutrition but are not adequately addressed by diets currently in use". His research has shown that the most appropriate diets for treating malnutrition should do two things:

Three feeding products have now been developed as a result of this work:

F75 (Phase 1 milk) is designed for use in the initial phase of the recovery process from severe malnutrition when metabolism is abnormal. The milk is modified to reduce the risk of diarrhoea. It has a lower osmolarity, sodium, fat and protein content and a higher carbohydrate content than F100. ACF is currently assessing this product in field.

F100 (Phase 2 milk) is a high energy milk with added minerals and vitamins. It is intended for the treatment of severely malnourished children once their condition has been stabilised (in phase 2 of therapeutic feeding) and is designed to maximise weight gain and reduce mortality rates. Evaluations of this product in ACF feeding centres have shown mortality and weight gain rates that are comparable to those achieved in the more controlled environment of a metabolic ward.

SP450 is a porridge fortified with vitamins and minerals. It can be used in phase 2 of therapeutic feeding and in supplementary feeding programmes. It is suitable for all ages. The product has been assessed in a number of ACF supplementary feeding programmes. Initial findings are summarised in the table below.

Diet Recovered Defaulted Death Weight gain per kg per day
Porridge 51% 39% 1% 1 gr/kg/day
SP450 81.9% 9% &nbsp 5 gr/kg/day

 

Issues and Challenges:

For further information contact: Professor Mike Golden, Department of Medicine and Therapeutics, University of Aberdeen, Forresterhill, AB9 2ZD. Tel. No. +44 1 224 681818 e-mail: m.golden@abdn.ac.uk

In 1989 Professor Mike Golden developed and tested a prototype feed for severely malnourished children in a metabolic ward in Jamaica. After some adjustments to the formula and acceptance by a number of UN agencies and NGOs a company called Nutriset took the formula and started to produce it in pre-packaged sachets which they called 'therapeutic milk'. Action Contra la Faim started to use the product immediately and reported that it was a great success. A large number of other agencies followed suit. Specifications for the feed are now published and in the public domain so that any manufacturer with the ability and adequate quality control procedures can produce it. The company Compact in Denmark has also started to manufacture the same formula so that it is now available commercially from at least two sources. F100 (the preferred name for the complete formula), 'therapeutic milk' and the Nutriset and Compact products are all the same basic formula.

More like this

FEX: Treatment of Severe Malnutrition with a Therapeutic Spread

On going Research Milk based diets are used in the treatment of severely malnourished children. However, these diets need to be given under supervision particularly as there...

FEX: Therapeutic Feeding: Imported Versus Local Foods

Steve Collins recently drew attention to a situation in Haiti where the only food being used (i.e.,F100) in the treatment of severe malnutrition became unavailable. Health...

FEX: Clinical Trial of BP100 vs F100 Milk for Rehabilitation of Severe Malnutrition

Child eating BP100 in Freetown TFC. By Carlos Navarro-Colorado and Stéphanie Laquière Carlos Navarro-Colorado is a medical doctor, with a MSc Epidemiology. He has ten years...

FEX: Ready to use therapeutic food for treatment of marasmus

Summary of published letter Severely malnourished child eats crude porridge mix before the development of specialised therapeutic foods. Chad '85 The second edition of field...

FEX: Failure to respond to treatment in supplementary feeding programmes

By Prof Mike Golden and Yvonne Grellety As highlighted in the recent large-scale retrospective review of emergency supplementary feeding programmes conducted by the ENN and SC...

FEX: Letter on local v imported therapeutic milk, by Rebecca Norton and Jean-Pierre Papart (with responses by Mike Golden, Ann Ashworth, Mary Lung'aho and David Sanders)

Recently, ENN was party to an exchange of questions and discussion between field staff and 'experts' relating to decisions on the use of readymade therapeutic products versus...

FEX: Diet and renal function in malnutrition

Summary of presentation1 Supplementary suckling (SS) has revolutionised management of young, malnourished infants Water balance in young, malnourished infants Water is an...

FEX: Locally produced RUTF in a hospital setting in Uganda

By Tina Krumbein, Veronika Scherbaum, and Hans Konrad Biesalski Tina Krumbein is a graduate nutritionist. This article forms part of her diploma thesis submitted to the...

en-net: Treatment of SAM children in the absence of RUTFs

In an area where there is targeted feeding programme for moderately undernourished children and PLW with supercereal plus and supercereal and oil respectively but no RUTF for...

FEX: WHO/UNICEF/WFP/UNHCR informal consultation on moderate malnutrition management in U5’s

Summary of meetinga The World Health Organisation (WHO) convened a meeting in Geneva (September 30th - October 3rd, 2008) with the overall aim of answering the question, 'What...

Resource: UNICEF urges end to instant milk donations for disaster-hit areas, Indonesia

UNICEF urges end to instant milk donations for disaster-hit areas Available from:...

FEX: Letter on cup feeding infants, by Mike Golden

Field exchange addressed the following question to Prof Mike Golden of Aberdeen University Dear Mike, In a meeting a couple of weeks ago on 'infant feeding in emergencies'...

FEX: Debate on the Management of Severe Malnutrition

by Marie McGrath, Fiona O'Reilly and Jeremy Shoham (ENN). Over the past six months, ENN has been a party to debate regarding technical aspects of the management of severe...

en-net: Plumpynut use in patients with hepatitis

I a a health advisor for MSF OCA, I have received a question from the field regarding the sfaety of treating malnutrition in patients with hepatitis using plumpynut or BP100,...

en-net: Use of half strength infant formula instead of F75 Formula

Hi All I am currently working as a Dietitian Advisor to the Samoan NHS. A current practice in the Paediatric ward for infants ranging from about 6 months to 2 years,...

FEX: Comparison of the Efficacy of a Solid Ready-to-Use Food and a Liquid, Milk- Based Diet in Treating Severe Malnutrition

Kwashiorkor case, before and after management using RUTF (oedema resolved). Nutritional Rehabilitation Centre (Dispensaire Saint Martin), Senegal 2001 Summary of published...

FEX: A pragmatic approach to treating severe malnutrition in emergencies: is F75 always beneficial?

By Saskia van der Kam Saskia is the headquarters nutritionist in MSF Holland. This article describes MSF's experience of implementing a therapeutic feeding programme for...

en-net: What home made food for children is equal to plumpy nut?

what home made food for baby is equal to plumpy nut? Can they make it in their homes ???? Tell me detail which ingredients may be included and quantity. I think you are...

FEX: A Role for the Knemometer in Emergencies

Summary of research study During emergencies, there is usually more concern about the effect of malnutrition in children, on weight loss rather than on linear growth, i.e....

en-net: Treatment of SAM in older people through outpatient

Treating older people (>=60 year old) with uncomplicated SAM with RUTF at home as out patients: which doses should we use? Some recommend 100kcal/kg/day. Should it be...

Close

Reference this page

Foods for the Treatment of Malnutrition. Field Exchange 2, August 1997. p13. www.ennonline.net/fex/2/foods