In 1999, Dr. Mark Manary, professor of pediatrics at Washington University School of Medicine in Missouri, spent 10 weeks in the impoverished Republic of Malawi in Southeast Africa to research the formulation requirements of a home-based food therapy supplement that could nourish children afflicted by severe acute malnutrition. Ideally, the product had to be something that was energy dense, resisted spoiling, didn’t need to be cooked and could be given in small amounts. His findings evolved into a Ready to Use Therapeutic Food (RUTF) called “Chiponde,” which became the cornerstone to Project Peanut Butter (PPB), a humanitarian organization focused on saving the lives of 2 million children by 2015 by preventing malnutrition.
 
“When a child’s body becomes swollen or quite thin from malnutrition, it’s essential to get treatment quickly, especially if the child is between six months and three years old, when critical development process are underway,” said Dr. Manary.
 
The Chiponde RUTF used by PPB consists of protein and zinc-rich peanuts, powdered milk, oil, sugar and a blend of vitamins and minerals. Interestingly, the Chiponde is produced within the local countries where it is served, using as many local ingredients as possible. According to PPB literature, in Malawi, peanuts and soy are sourced from about 6,000 local farmers, and the production facility is located within the country. PPB endeavors have also expanded into Sierra Leone and Mali.
 
PPB’s latest research program will investigate the potential benefits of using whey permeate and whey protein in ready-to-use food supplements. Specifically, the clinical study is designed to determine the ability of RUTF made with whey permeate and whey protein concentrate to promote the children’s recovery and healthy growth. The study will take place in Malawi and will focus on about 1,800 children with moderately acute malnutrition.

Århus, Denmark-based Arla Foods Ingredients is a co-founder of the initiative alongside the Danish Dairy Research Foundation and the U.S. Dairy Export Council, and will donate the whey permeate and protein required to carry out the study. “Food aid is often focused only on preventing starvation, but this approach can still leave children at risk from malnutrition and poor health,” Charlotte Sørensen, senior project manager at Arla Foods Ingredients. “The aim of the Malawi study is to investigate whether whey permeate, when used in conjunction with whey protein, can help children recover from the effects of malnutrition and grow up healthy.”
 
Earlier this year, PPB completed a preliminary study to determine the taste acceptability and physical tolerance of whey-containing RUTF compared to an existing RUTF formulation made with soya. Sixty moderately malnourished children, aged six to 51 months, participated in the trial, which found a similar level of liking for the two formulations and high tolerance. According to Arla, the results obtained with the whey-containing RUTF were particularly promising.

Dr. Manary said he was confident that the use of whey ingredients would enable RUTF to meet new World Health Organization (WHO) recommendations. “The WHO recommendations focus on protein quality, and, typically, the quality of whey protein is very high. We think that animal-sourced foods have some components that facilitate growth,” he said.
 
With the launch of its most recent clinical study, PPB is responding to a WHO call for more research into the efficacy of supplementary foods in treating and reducing the risk of moderately acute malnutrition in children under five years old. The children recruited for the study will be assessed for their rate of recovery during dietary supplementation with the soya or whey-based RUTF. Their health status will then be monitored for a year.

“We will not just be looking at linear growth and weight but also at if their immune system is recovering,” Dr. Manary explained. “When they have grown to a normal body size, they are still more vulnerable to infection. We want to see if whey RUTF has an influence.”

Whey permeate, a by-product of cheesemaking, is very high in lactose, which research suggests is good for immature digestive systems, promoting the absorption of minerals and stimulating the growth of beneficial bacteria in the gut, leading to a stronger digestive and immune system. Due to its high lactose content, whey permeate functions as a partial sugar replacer, also contributing important minerals, such as calcium, magnesium, phosphorus and zinc.

“Pure lactose is considered an expensive component in food aid products, but permeate is both a cheaper alternative and a source of important milk minerals, including calcium, phosphorus, potassium, magnesium and chloride—all important contributors to healthy growth and development,” said Ms. Sørensen. “Used in conjunction with whey protein, which is rich in the full range of amino acids required for healthy growth and development, we hope that whey permeate can offer a beneficial solution in the fight to eliminate malnutrition.”

* Photo provided by Project Peanut Butter