Curbing malnutrition: what works in Africa doesn’t quite in India


Packaged fortified food, which showed remarkable results in treating children with Severe Acute Malnutrition (SAM) in Africa, has proved much less effective in a trial conducted in India.

This has prompted concerned paediatricians and nutritionists to write a letter to the prime minister cautioning against ‘quick fixes’ of buying commercial products instead of focusing on sustainable measures such as care support for mothers, clean drinking water and food security.

The letter also criticised the overstating of the ‘SAM crisis’ (children with SAM constitute about 3% of under-five children) when the proportion of children affected by it has been going down steadily from 6.4% to 4.6% to 3.3% by 2011. Even for the trial, of one lakh children screened, just 1.1% had SAM. The experts also warned that a hasty introduction of packaged food ostensibly for eliminating severe malnutrition could be exploited by the food industry.

The study was meant to compare the efficacy of two kinds of ready-to-use therapeutic foods (RUTF) – packaged, fortified, energy-dense food – with home-prepared food which was energy-dense and enriched with micronutrients, in treating severe malnutrition at home instead of in a hospital.

It was found that the children fed locally prepared packaged food showed the greatest improvement. But even among these children, only 17% were cured of SAM, while 30% slipped back into it and over 53% continued to have moderate acute malnutrition four months after the monitored daily intake of the special food was stopped.

Studies in Africa had shown that most children with SAM recovered within two months of starting RUTF. However, in the Indian trial, recovery rates were low at the end of two months.

Written by Rema Nagarajan. This story was sourced from the Healthworld from the Economic Times website.


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