Menu ENN Search

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 staff subsequently adopted dangerous treatment approaches (i.e., dextrose-saline drips) which resulted in higher mortality rates (>70%) amongst kwashiorkor patients. This led to a network wide debate on the comparative feasibility, appropriateness, and effectiveness of therapeutic milk versus local food products in the treatment of severe malnutrition.

Evidence based consensus indicated that in general, F100 is currently the most nutritious, efficient and cost effective approach to therapeutic feeding in terms of mortality, weight gain, and intestinal recovery, and is therefore appropriate for use in acute relief situations.

While the value of local foods in the 'acute' stage of severe malnutrition remains unclear, recent research has shown encouraging results using local food products in the rehabilitation phase, particularly in 'non emergency'
settings where "ideal" imported diets may be unavailable.

Thus, the reality is, that in the absence of funding to buy 'optimal' foods, there is a need to provide alternative food options to make the best possible use of whatever is available for all levels of dietary management.

To this end, Benjamin Torun (INCAP) and George Fuchs (Centre for Health & Population Research) are setting up a database of locally available and culturally acceptable foods, which have been successfully used to treat patients in different parts of the world.
The information will be available through the NGOnut.

Contributions are welcome !

Note from Prof. Golden

This is an area of active research. In the treatment of severe malnutrition attention needs to be given to all the essential nutrients (there are about 40 of them) and not just energy and protein. In the interim, for those who need to use local produce, my advice is to have a very varied diet with as many different foods being used as possible, rather than simple mixtures of cereal and pulse given monotonously, and to have oil as a major ingredient of every meal to increase the energy density.

In a number of places 'country' salts are traditionally made by burning plants, dissolving and filtering the ash and then evaporating the liquor. These might be a valuable and sustainable source of minerals for such diets - if these are made in your area could you please post a labelled sample to me for analysis.

Prof. Michael H.N.Golden
Dept of Medicine and Therapeutics
Univ of Aberdeen, Foresterhill,
AB9 2ZD. Scotland. U.K.

More like this

FEX: 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....

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: 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...

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: 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: ACC/SCN Working Group on Nutrition in Emergencies

Excerpts from Working Group Report The ACC/SCN held its 27th Session at the World Bank in Washington DC last April. About 60 participants from NGOs, bilateral and UN agency...

en-net: Getting RUTF on the WHO list of Essential medicines - Call to sign a letter of support - repost

Dear all,

As you may be aware, Action Contre la Faim (ACF) has recently conducted a study on whether RUTF should be added on the Essential Medicines list (EML) of WHO...

FEX: Dietary Treatment of Severe Malnutrition in Adults

Summary of a Published Paper Somalia - Standing in the mud near the edge of the Sabelle River a boy watches the arrival of the villagers from a neighbouring Bulomano which,...

en-net: Zinc supplementation to SAM and/or MAM with acute diarrhoea?

Can we give zinc supplementation to the severely and/or moderately acute malnourished children with acute diarrhoea? The Unicef and WHO document "Diarrhoea treatment guideline...

en-net: Your opinion sought on draft guidance to regulate marketing of Ready to Use Supplemental Foods

Ready to use supplemental foods (RUSFs) are receiving increasing attention by agencies working to alleviate problems of malnutrition. In late 2010, members of the NGO/Civil...

en-net: What should be the nutritional support to adult patients with Ebola Virus Disease (EVD) in treatment centres in West Africa?

Dear experts, I would appreciate your help in this. I drafted the following text but you might have ideas and other suggestions. Please help me on this one... This question...

FEX: Alternative RUTF formulations (Special Supplement 2)

By Steve Collins & Jeya Henry Developing CTC programmes that use Ready to Use Therapeutic Food (RUTF) made locally, from locally available produce, and used to treat...

en-net: Treatment of Preg/Lact women with F100/RUTF?

Could I please have some advice on the recommended treatment for severely malnourished P/L women. I am currently working with our Zimbabwe team and have read in the national...

FEX: Putting nutrition products in their place: ACF position paper

Summary of position paper1 Action Against Hunger | ACF International has recently produced a position paper on the role of products in the treatment and prevention of global...

FEX: Letter on micronutrient deficiency management, by Donald McLaren

Dear Editor I was amazed, and greatly disappointed, to read the report of the workshop on Community Based Approaches to Managing Severe Malnutrition, and the piece on this...

FEX: Issue 31 Editorial

A mother attending a MSF programme in Niger One of the longest raging debates in nutrition continues in the letters section of this issue of Field Exchange. Put simply, does...

en-net: inpatient SAM management

in Jordan, the CMAM program is integrated into primary healthcare...thus, only children with urgent complications are referred for secondary healthcare...

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...

FEX: Community-based Approaches to Managing Severe Malnutrition

One nutrition worker's solution to childcare at a busy feeding distribution! A three day meeting was held in Dublin hosted by Concern and Valid International between 8-10th of...

FEX: Support for PLWHAs in Malawi

By Mary Corbett Mary Corbett is a food security and nutrition consultant who visited the region on behalf of ENN in early 2005. This article is based on interviews with a...


Reference this page

Prof. Michael H.N.Golden (1998). Therapeutic Feeding: Imported Versus Local Foods. Field Exchange 4, June 1998. p29.



Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.