Should India use Commercially Produced Ready to use Therapeutic Foods (RUTF) for Severe Acute Malnutrition (SAM)

In India, 48% of children under five years of age are stunted and 43% are underweight: almost 8 million children suffer from Severe Acute Malnutrition.

Dr Prasad and colleagues are of the view that “the current thinking – that a centrally produced and processed Ready to use Therapeutic Foods should supplant the locally prepared indigenous foods in treating SAM – ignores the multiple causes of malnutrition and destroys the diversity of potential solutions based on locally available foods”.

They argued that though the effectiveness of Plumpy Nut (produced by Nutriset in France and being imported in several States for SAM treatment in India), has been demonstrated in other countries, the studies demonstrating effectiveness were carried out in disaster settings where other community-based treatments for SAM have not existed.

However, the guidelines for community and home-based treatment of SAM formulated by a large group of experts and supported by the Indian Academy of Paediatrics recommend the use of home-based foods (modified from the family pot). It specifically warns that commercially available international RUTF may not be suitable, acceptable, cost effective and sustainable.

Many locally produced/producible foods that are culturally acceptable and relatively low cost have been used for SAM in India for many decades by reliable academic and medical institutions as well as by non-governmental groups. Though there are few formal studies documenting their efficacy, there are some along with plenty of anecdotal evidence of success.

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