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RUTF and coeliac disease

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 3 replies. You can also reply via email – be sure to leave the subject unchanged.

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Iris Bollemeijer

Nutrition Advisor at IMC

Normal user

13 Feb 2015, 10:48

Does anybody have evidence that Plumpy'nut is save to use for children with coeliac disease?

We have a case of a 30 months old girl who is SAM and has celiac disease. Although I dont think that Plumpy'nut contains gluten I was unable to find evidence for this. Since maltodextrin is one of the ingredients of Plumpy'nut it could potentially contain gluten depending on whether the maltodextrin was derived from wheat, corn or rice.

Many thanks in advance,
Iris

André BRIEND

Frequent user

17 Feb 2015, 09:05

Maltodextrin used to manufacture Plumpy nut is the same as used in infant formulas and is prerpared from corn flour. It does not contain any gluten. I assume it is the same for other RUTF which have maltodextrin among their ingredients.

Mark Myatt

Consultant Epideomiologist

Frequent user

17 Feb 2015, 09:53

This is outside of my main areas of expertise but I did look into this (and peanut allergies &c.) when CTC (now CMAM) was contentious and opponents of the CTC model picked on anything they could find to cause trouble. I am not suggesting that your question is motivated by anything other than clinical concerns.

Wheat derived maltodextrin is unlikely to contain more than 20mg/kg of gluten and these levels are not considered high enough to be of concern in gluten intolerant individuals (these levels allow products to be labelled "gluten free"). In the EU (ECD 2000/13) maltodextrin from all cereals (including wheat) is exempt from labelling. We might still be concerned about wheat-derived maltodextrin in young and sick children. Maltodextrin used in therapeutic and infant feeding products tends not be be made from wheat (it is usually made from maize) and is gluten free. Using RUTF with this case is not contraindicated.

Dr. Bashir Ahmed

Field epidemiologist @MoH

Normal user

20 Nov 2017, 12:28

Dear all
Thanks for an important discussion. Now I'm confident to recommend RUTF to coeliac disease children.

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