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replacement for Plumpy net

This question was posted the Management of wasting/acute malnutrition forum area and has 3 replies.

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Nini Tun

Medical coordinator, Medical Action Myanmar

Normal user

20 Nov 2015, 08:02

Dear colleges,

Greeting from Nini
Thanks for your kind answer for my previous question about CMAM guideline. Here again, I have another urgent question. We are having the shortage of plumpy nut in our nutrition program. We are trying to import but will be delayed for at least 3 months.

I am wondering how to make with locally available products to get the amount equal to Plumpy nut. Does anybody use any alternatives before?

Looking forwards to your reply
warm regards

Dr. Rajiv Tandon

Deputy Country Director, ACF - Action Against Hun

Normal user

23 Nov 2015, 06:55

A study was conducted by ACF-India (Action Against Hunger) in Baran district of Rajasthan with approval from district officials to test the acceptability of a novel, local, ready to use energy dense therapeutic food, with the technical support from Dr. Mark Manary from Washington University and supported by CIFF. The product was locally prepared in Rajasthan in order to ensure the acceptability and to reduce the cost of the product. The acceptability study examined the acceptability of the alternative formulation compared to the standard product through a two-arm, crossover design to test the acceptance of a local therapeutic food formulation compared to a standard therapeutic food in rural Rajasthan, India.

50 children with moderate wasting from Garda and Karwari Khurd village were enrolled in the two-week study. Therapeutic food were provided for 7 days, with local therapeutic food at one site and standard therapeutic food on the other site. After end of first week the food provide at both the sites was reversed. Later the acceptability was measured by calculating percentage of overall consumption, likeability, and adverse effects experienced by the participants.

The mean percent difference of consumption between the local therapeutic food and the
standard therapeutic food are -3.3 (95% CI -13.7-7.1) and 5.6 (95% CI -5.87-17.1) for the study sites. Also the mean difference of likeability scores between the local therapeutic food and standard therapeutic food is at 0.5 (95% CI 0.1-0.9) and -0.2 (95% CI -0.7-0.3) for the two sites. The local therapeutic food had a higher likeability than the standard therapeutic food at the chosen sites in Rajasthan. No significant differences were observed in both the products regarding adverse effects as minimal side effects were reported from both the local therapeutic food and the standard therapeutic food.

The preliminary results of the study demonstrate the acceptance of an alternative local
therapeutic food in India. The use of a country specific formula also has the potential to reduce the cost of the product and the use of locally accepted ingredients increase the acceptance for the product resulting in increase in the coverage of community based treatment, therefore improving outcomes for undernourished children.

Dr. Rajiv Tandon
Senior Advisor Health and Nutrition
Landline: +91 11 24115354, Cell phone : +91 9811103305.
Residence Address: C-55,Anand Niketan, New Delhi, India -110021 Skype address – dr.rajivtandon

Nini Tun

Medical coordinator, Medical Action Myanmar

Normal user

23 Nov 2015, 12:06

Thanks Dr Rajiv.

This is very interesting and helpful.

I want to know how to make Plumpy nut with locally available items such as milk , sugar, oil, multivitamins ( + formula) ?

Thanks and warm regards



Normal user

10 Aug 2016, 08:54

Dr. Rajiv,

The study sounds interesting, is there any way I could get the complete published version.


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