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Why RUSF should not be given to children with Severe Acute Malnutrition?

This question was posted the Management of wasting/acute malnutrition forum area and has 9 replies.

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ATANASIO CINQUENTA

Public Health Nutritionist

Normal user

13 Nov 2023, 10:10

Greetings,

My name is Atanasio Cinquenta, a young researcher and Public Health Nutritionist working for a United Nations agency in Mozambique, southern Africa. I work with specific nutrition programmes and one of the activity is supporting the local Ministry of Health with nutritional supplements for the treatment of malnutrition according to CMAM recommendations. The question is: why can't RUSF be given to children with severe acute malnutrition if RUSF and RUTF have almost the same ingredients as well as the same kcal (usually 500 kcal/sachet)? I tried to read in the CMAM protocol, but i don't find any response. 

Thanks

Alexis Kilompfu

Nutritionniste

Normal user

14 Nov 2023, 11:18

Hello dear colleagues

Even if RUSF (ASPE) or RUTF (ATPE) can have the same nutrient values, energy and/or the same composition. ASPEs are prescribed differently from RUTFs.

RUSF are prescribed 1 sachet, i.e. 500kcal/day regardless of the child's weight while the prescription of RUTF depends on the child's weight, i.e. 150 - 200 kcal/kg/d and/or according to the national protocol .

In the simplified PCMA approach, only 2 sachets of RUTF are used, or 1,000 kcal/day for all cases.

Alexis Kilompfu

Nutritionniste

Normal user

14 Nov 2023, 11:18

Hello dear colleagues

Even if RUSF (ASPE) or RUTF (ATPE) can have the same nutrient values, energy and/or the same composition. ASPEs are prescribed differently from RUTFs.

RUSF are prescribed 1 sachet, i.e. 500kcal/day regardless of the child's weight while the prescription of RUTF depends on the child's weight, i.e. 150 - 200 kcal/kg/d and/or according to the national protocol .

In the simplified PCMA approach, only 2 sachets of RUTF are used, or 1,000 kcal/day for all cases.

Vidar Kvamme

GC RIEBER COMPACT AS

Normal user

14 Nov 2023, 13:18

Dear Atanasio ! Main different for RUTF and RUSF is the protein quality, where RUTF have minimum 50% of protein coming from milk, while RUSF specification only claim minimum 3,6g of milk protein pr 100g product, so it is around the double amount of milk protein in RUTF. Also the fatty acids omega-3 and omega-6 levels are different as well as some of the minerals.

Kind regards

Vidar Kvamme, R&D Manager GC RIEBER COMPACT. (Manufacturer of RUTF and RUSF.)

Ahmed Mohamed Osman

Senior health and Nutrition officer

Normal user

14 Nov 2023, 13:31

"Hello, my name is Ahmed and I work with Concern Worldwide Somalia.

Concern Worldwide is an international humanitarian organization that has been working in Somalia since 1986. They have been responding to emergencies such as drought, flooding, conflict, and food shortages health and nutrition direct implementation to support children and PLWs elders and wider popiulations, while also building resilience in the region.

based on my research regarding this question of "why RUSF is not given to SAM hildren" here are some points to contribute from my end, although I'm not an expert According to the World Health Organization (WHO), Ready-to-Use Therapeutic Food (RUTF) is a recommended option for the dietary management of children aged from 6 to 59 months with severe acute malnutrition (SAM) without medical complications. However, Ready-to-Use Supplementary Food (RUSF) is not recommended for children with SAM.

Due to the high dense of nutrient in the RUSF the SAM child may develop diarrhea which wosen the condition of the child.

RUSF is designed to provide additional nutrients to children who are moderately malnourished, but not severely malnourished. RUTF, on the other hand, is specifically formulated to provide the high-energy content and adequate amounts of vitamins, minerals, and other nutrients needed by children with SAM. It is important to note that RUTF should only be used under the supervision of a healthcare professional.

RUTF requires extra supervision by a certified nutritionist and must be treated in close observation, while RUSF can be distributed even auxiliary with biweekly and monthly distribution and less dense than the RUTF. RUTF can be based on the child’s body weight, while RUSF is distributed one sachet per day to supplement other household foods that the child gets as complementarity. RUTF is enriched with many micro-nutrients that the body missed and required child to cover from the deficiencies, while MAM require additional support with a minimum amount of micro-nutrient compared to the SAM condition.

I

Ahmed Mohamed Osman

Senior health and Nutrition officer

Normal user

14 Nov 2023, 13:31

"Hello, my name is Ahmed and I work with Concern Worldwide Somalia.

Concern Worldwide is an international humanitarian organization that has been working in Somalia since 1986. They have been responding to emergencies such as drought, flooding, conflict, and food shortages health and nutrition direct implementation to support children and PLWs elders and wider popiulations, while also building resilience in the region.

based on my research regarding this question of "why RUSF is not given to SAM hildren" here are some points to contribute from my end, although I'm not an expert According to the World Health Organization (WHO), Ready-to-Use Therapeutic Food (RUTF) is a recommended option for the dietary management of children aged from 6 to 59 months with severe acute malnutrition (SAM) without medical complications. However, Ready-to-Use Supplementary Food (RUSF) is not recommended for children with SAM.

Due to the high dense of nutrient in the RUSF the SAM child may develop diarrhea which wosen the condition of the child.

RUSF is designed to provide additional nutrients to children who are moderately malnourished, but not severely malnourished. RUTF, on the other hand, is specifically formulated to provide the high-energy content and adequate amounts of vitamins, minerals, and other nutrients needed by children with SAM. It is important to note that RUTF should only be used under the supervision of a healthcare professional.

RUTF requires extra supervision by a certified nutritionist and must be treated in close observation, while RUSF can be distributed even auxiliary with biweekly and monthly distribution and less dense than the RUTF. RUTF can be based on the child’s body weight, while RUSF is distributed one sachet per day to supplement other household foods that the child gets as complementarity. RUTF is enriched with many micro-nutrients that the body missed and required child to cover from the deficiencies, while MAM require additional support with a minimum amount of micro-nutrient compared to the SAM condition.

Kemal T J Tunne

Emergency Nutrition Coordinator

Normal user

14 Nov 2023, 14:14

Ready-to-use supplementary food (RUSF) and ready-to-use therapeutic food (RUTF) are both nutrient-dense, fortified foods used to treat malnutrition in children and adults. However, there are some key differences between the two products that make RUTF the preferred treatment for severe acute malnutrition (SAM).

Nutrient density

RUTF has a higher nutrient density than RUSF, meaning that it contains more nutrients per calorie. This is important for children with SAM, who have increased nutritional needs due to their condition. For example, RUTF contains more protein and micronutrients, such as zinc, vitamin A, and folic acid, which are essential for recovery from SAM.

Digestibility

RUTF is also more digestible than RUSF, meaning that the body can absorb the nutrients in RUTF more easily. This is important for children with SAM, who often have impaired gastrointestinal function. For example, RUTF is made with a blend of oils that are easier to digest than the oils used in RUSF.

Palatability

RUTF is generally more palatable than RUSF, meaning that children with SAM are more likely to eat it. This is important because children with SAM often have a poor appetite. For example, RUTF is typically sweeter and more flavorful than RUSF.

Packaging

RUTF comes in individual sachets, which makes it easier to transport and store. This is important for use in emergency settings, where access to resources may be limited. For example, RUTF sachets can be distributed directly to families in need.

Cost

RUTF is more expensive than RUSF. However, the cost of RUTF is justified by its superior nutritional value and effectiveness in treating SAM. For example, studies have shown that children with SAM who are treated with RUTF are more likely to recover than children who are treated with RUSF.

Conclusion

While RUSF and RUTF have similar ingredients, RUTF is the preferred treatment for SAM because it is more nutrient-dense, digestible, palatable, portable, and cost-effective.

Kemal T J Tunne

Emergency Nutrition Coordinator

Normal user

14 Nov 2023, 14:15

Ready-to-use supplementary food (RUSF) and ready-to-use therapeutic food (RUTF) are both nutrient-dense, fortified foods used to treat malnutrition in children and adults. However, there are some key differences between the two products that make RUTF the preferred treatment for severe acute malnutrition (SAM).

Nutrient density

RUTF has a higher nutrient density than RUSF, meaning that it contains more nutrients per calorie. This is important for children with SAM, who have increased nutritional needs due to their condition. For example, RUTF contains more protein and micronutrients, such as zinc, vitamin A, and folic acid, which are essential for recovery from SAM.

Digestibility

RUTF is also more digestible than RUSF, meaning that the body can absorb the nutrients in RUTF more easily. This is important for children with SAM, who often have impaired gastrointestinal function. For example, RUTF is made with a blend of oils that are easier to digest than the oils used in RUSF.

Palatability

RUTF is generally more palatable than RUSF, meaning that children with SAM are more likely to eat it. This is important because children with SAM often have a poor appetite. For example, RUTF is typically sweeter and more flavorful than RUSF.

Packaging

RUTF comes in individual sachets, which makes it easier to transport and store. This is important for use in emergency settings, where access to resources may be limited. For example, RUTF sachets can be distributed directly to families in need.

Cost

RUTF is more expensive than RUSF. However, the cost of RUTF is justified by its superior nutritional value and effectiveness in treating SAM. For example, studies have shown that children with SAM who are treated with RUTF are more likely to recover than children who are treated with RUSF.

Conclusion

While RUSF and RUTF have similar ingredients, RUTF is the preferred treatment for SAM because it is more nutrient-dense, digestible, palatable, portable, and cost-effective.

Kemal T J Tunne

Emergency Nutrition Coordinator

Normal user

14 Nov 2023, 14:16

Ready-to-use supplementary food (RUSF) and ready-to-use therapeutic food (RUTF) are both nutrient-dense, fortified foods used to treat malnutrition in children and adults. However, there are some key differences between the two products that make RUTF the preferred treatment for severe acute malnutrition (SAM).

Nutrient density

RUTF has a higher nutrient density than RUSF, meaning that it contains more nutrients per calorie. This is important for children with SAM, who have increased nutritional needs due to their condition. For example, RUTF contains more protein and micronutrients, such as zinc, vitamin A, and folic acid, which are essential for recovery from SAM.

Digestibility

RUTF is also more digestible than RUSF, meaning that the body can absorb the nutrients in RUTF more easily. This is important for children with SAM, who often have impaired gastrointestinal function. For example, RUTF is made with a blend of oils that are easier to digest than the oils used in RUSF.

Palatability

RUTF is generally more palatable than RUSF, meaning that children with SAM are more likely to eat it. This is important because children with SAM often have a poor appetite. For example, RUTF is typically sweeter and more flavorful than RUSF.

Packaging

RUTF comes in individual sachets, which makes it easier to transport and store. This is important for use in emergency settings, where access to resources may be limited. For example, RUTF sachets can be distributed directly to families in need.

Cost

RUTF is more expensive than RUSF. However, the cost of RUTF is justified by its superior nutritional value and effectiveness in treating SAM. For example, studies have shown that children with SAM who are treated with RUTF are more likely to recover than children who are treated with RUSF.

Conclusion

While RUSF and RUTF have similar ingredients, RUTF is the preferred treatment for SAM because it is more nutrient-dense, digestible, palatable, portable, and cost-effective.

Kemal T J Tunne

Emergency Nutrition Coordinator

Normal user

14 Nov 2023, 14:17

Ready-to-use supplementary food (RUSF) and ready-to-use therapeutic food (RUTF) are both nutrient-dense, fortified foods used to treat malnutrition in children and adults. However, there are some key differences between the two products that make RUTF the preferred treatment for severe acute malnutrition (SAM).

Nutrient density

RUTF has a higher nutrient density than RUSF, meaning that it contains more nutrients per calorie. This is important for children with SAM, who have increased nutritional needs due to their condition. For example, RUTF contains more protein and micronutrients, such as zinc, vitamin A, and folic acid, which are essential for recovery from SAM.

Digestibility

RUTF is also more digestible than RUSF, meaning that the body can absorb the nutrients in RUTF more easily. This is important for children with SAM, who often have impaired gastrointestinal function. For example, RUTF is made with a blend of oils that are easier to digest than the oils used in RUSF.

Palatability

RUTF is generally more palatable than RUSF, meaning that children with SAM are more likely to eat it. This is important because children with SAM often have a poor appetite. For example, RUTF is typically sweeter and more flavorful than RUSF.

Packaging

RUTF comes in individual sachets, which makes it easier to transport and store. This is important for use in emergency settings, where access to resources may be limited. For example, RUTF sachets can be distributed directly to families in need.

Cost

RUTF is more expensive than RUSF. However, the cost of RUTF is justified by its superior nutritional value and effectiveness in treating SAM. For example, studies have shown that children with SAM who are treated with RUTF are more likely to recover than children who are treated with RUSF.

Conclusion

While RUSF and RUTF have similar ingredients, RUTF is the preferred treatment for SAM because it is more nutrient-dense, digestible, palatable, portable, and cost-effective.

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