Miracle food made in Bangladesh

Scientists at the icddr,b have developed a special food rich in protein and micronutrients that can help recover children suffering from Severe Acute Malnutrition (SAM).

The ready-to-use therapeutic food (RUTF) is made of locally available ingredients -- rice, lentil, chickpea, milk powder, sugar and soybean oil. Its quality is similar to that of the standard RUTF -- Plumpy'Nut -- produced commercially by a French company, says the icddr,b.

“This RUTF is critically important for Bangladesh, as six lakh children under the age of five are suffering from severe acute malnutrition,” Prof Tahmeed Ahmed, director at the Centre for Nutrition and Food Security at the icddr,b, said yesterday at an international symposium organised by it.

SAM is a condition that can cause death or intellectually maim those who survive. The children suffering from it remain highly underweight and stunted either for lack of breastfeeding, supplementary food or diarrhoea.

Globally, close to 20 million children below five years suffer from SAM, and around one million of them die every year, according to the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). 

Most Asian countries don't have locally made RUTF, and some of them, including Afghanistan, Indonesia and Nepal, import Plumpy'Nut on a limited scale for children suffering from SAM.

With an aim to develop a RUTF that would be cheap and available, the icddr,b, initiated a research four years ago. A team of scientists led by Tahmeed first sorted out food items that are locally available and cheap.

They finally prepared two types of RUTF -- one is rice and lentil-based and the other is chickpea-based. Both the food items were separately mixed with lentil, powder milk, sugar and soybean oil. The rice and lentil-based one was named Sharnali-1 and the chickpea-based one Sharnali-2.

Each 100 grams of the two items contain food value of more than 500 kilocalories. 

As part of the study, Sharnali-1 and 2, and Plumpy'Nut were fed separately to 327 children suffering from SAM in three facilities -- Dhaka Hospital of icddr,b, a health facility of an NGO in Mirpur and Terre Des Hommes in Kurigram.

The children were also breastfed or provided with supplementary food.

“Their average weight gain was 9.3 grams against per kg a day.” A child under five years should gain a weight of minimum 7.5 gram against each kg a day, said Tahmeed.

There was no significant difference in weight gain among the children who were provided with the three types of RUTF, he said.

Tahmeed said it was proved that the Bangladeshi RUTF was as good as Plumpy'Nut.

“What is needed now is effectiveness trial of the Bangladeshi RUTF in a real life situation.”

It is necessary to undertake a pilot project at community level. Health workers need to be trained to identify children suffering from SAM and determine doses for them, he said.

Tahmeed warned that if a normal child is given this special food, he might suffer from indigestion, as it contains concentrated protein and micronutrients.

“If the pilot project proves successful, this RUTF can be provided to children suffering from SAM in other parts of Bangladesh and even in other countries,” he added.

Icddr,b Executive Director Prof John D Clemens said the Bangladeshi RUTF could greatly help address the issue of child malnutrition not only in Bangladesh, but also in South Asia.

“The product, however, will need to be transitioned into programmes,” he said at the inaugural ceremony of the two-day symposium on childhood acute malnutrition at the icddr,b conference hall in the capital.

Allyson Bear, acting director of the Office of Population, Health, Nutrition and Education of USAID Bangladesh, stressed the need for special efforts to check SAM in Bangladesh, as it remains a serious problem despite the country's significant progress in child and maternal health.

Edouard Beigbeder, country representative of Unicef; Sarah Cooke, country representative of DFID; Dr Alamgir Ahmed, director at the Institute of Public Health and Nutrition; and Habib-e-Millat, lawmaker of the ruling Awami League, also spoke.