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Treatment of Severe Malnutrition with a Therapeutic Spread

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Comparison of growth of Escherichia coli liquid F100 diet and in the paste under development (log scale)

Milk based diets are used in the treatment of severely malnourished children. However, these diets need to be given under supervision particularly as there is always a risk of bacterial contamination if used in an uncontrolled environment. This can really limit the effectiveness of treatment of severe malnutrition when, if for any reason, it is not possible to keep children in for a long time at the therapeutic feeding centre.

A new therapeutic food may get around this problem. The idea is to copy the F100 diet used in phase 2 of therapeutic feeding programmes but to present it in a different physical form. F100 has a very high fat content which in the traditional powdered form is made up of thousands of droplets protected by a layer of sugar. The protection of the droplets is needed because they have a high surface to volume ratio which would result in the fat being rapidly oxidised, and therefore becoming rancid, if exposed to air. In this new therapeutic food, the opposite approach is used; fat is spread around the other components of the food so that its surface contact with oxygen is dramatically reduced. In the process a "ready to eat" paste is obtained which eliminates the need for dilution with water and the problem of bacterial contamination. The paste contains no water and bacteria will not grow in it (see Figure). The product is made by replacing some of the DSM in the F100 with groundnut butter.

Field tests are now in progress to see how acceptable the modified F100 formula is and to measure weight gain on the new diet. If results are encouraging, the product could be used in situations where controlled preparation of milk based therapeutic feeding products is not possible.

For further information contact: Dr Andre Briend, INSERM U 290, Hospital St Lazare, 107 rue de Faubourg St Denis, 75,475 Paris, Cedex 10, France. Tel No. (+33 1) 48005004. Fax No. (+33 1) 47702835.

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Treatment of Severe Malnutrition with a Therapeutic Spread. Field Exchange 2, August 1997. p14. www.ennonline.net/fex/2/treatment

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