WBSCM Material Description and Number

EMERGENCY FD, RUTF SPRD POUCH-150/92 G  110170

General Information

Ready-to-Use Therapeutic Foods (RUTF) are high-energy, lipid-based spreads used in any cultural setting for the treatment of severe acute malnutrition (SAM)¹. They are designed to be used in Phase 2 for the rehabilitation of severely malnourished populations and are designed to provide the same nutritional profile as F100 therapeutic milk. RUTF may be the sole source of food, except water and/or breast milk, during the period of use. RUTF must meet the specifications of the United Nations Children’s Fund (UNICEF) Supply Catalog for therapeutic spreads (http://www.supply.unicef.dk/catalogue/). RUTF spreads are packaged in 92-gram sachets and subsequently in cases of 150 sachets. They have a shelf life of two years when stored at 80 degrees Fahrenheit and are designed to be used in any climactic setting. For full product specifications refer to the USDA Commodity Requirements Document and/or the Commercial Item Description for Ready-to-Use Therapeutic Foods.

Programming Guidance

RUTF is expected to be used as part of a medical malnutrition intervention program for targeted populations, including children 6 to 59 months of age with SAM who are free from severe medical complications and who have appetite. This intervention is to be delivered in accordance with United Nations (UN) guidelines for the outpatient care and management of SAM, with national guidelines for the management of SAM, and with guidelines described in Community-based Therapeutic Care (CTC): A field manual (Valid International 2006). Inpatient settings may provide F100 or SP450 as an alternative to RUTF, but RUTF is the treatment of choice for community-based management of SAM. RUTF is provided according to the weight of the child at approximately 200 kilocalories per kilogram of body weight per day.

According to the Food Aid Quality Review report, RUTF may be provided in the second phase of emergencies to screened children and adults with SAM. RUTF may be provided in development settings or chronic emergencies to screened children and adults with HIV or Tuberculosis (TB) as well as SAM.  

Nutrition/Preparation

RUTF provides appropriate energy, protein, fat, vitamins and minerals to treat SAM in children six to fifty-nine months. The product delivers 520 to 550 kilocalories per 100 grams of product. This includes 10 to 12 percent protein of which at least half must be from dairy sources, in addition to protein concentrates, vegetable proteins or protein isolates. RUTF may contain 45 to 60 percent fat in the form of canola or soybean oil. Additional components may include nuts, legumes, grains, and sweeteners. The micronutrient mix contains 24 vitamins and minerals; for more details, see the table below. RUTF requires no preparation and may be consumed directly from the packaging in addition to clean drinking water.

Nutritional Content

The values in the table below were compiled from the USDA Commercial Item Description for Ready-to-Use Therapeutic Food (RUTF) (https://www.ams.usda.gov/sites/default/files/media/CID%20Therapeutic%20Food,%20Ready-To-Use.pdf).

USDA Commodity Requirements Document

http://www.fsa.usda.gov/Internet/FSA_File/rutf2.pdf

Shelf Life/Best if Used By Date (BUBD)

• Shelf life - 24 months after packaging
• BUBD - not available

Sources

Annan, R., P. Webb, R. Brown. 2014 CMAM Forum Technical Brief: September 2014-Management of Moderate Acute Malnutrition (MAM): Current Knowledge and Practice. Retrieved on September 30, 2016 from: http://www.cmamforum.org/Pool/Resources/MAM-management-CMAM-Forum-Technical-Brief-Sept-2014.pdf

United States Department of Agriculture, Agricultural Marketing Service. 2012. Commercial Item Description: Ready-to-Use Therapeutic Food.  Retrieved September 30, 2016 from: https://www.ams.usda.gov/sites/default/files/media/CID%20Therapeutic%20Food,%20Ready-To-Use.pdf

United States Department of Agriculture, Farm Services Agency. 2012. USDA Commodity Requirements. Ready-to-use Therapeutic Food for Use in Export Programs.  Retrieved September 30, 2016 from: http://www.fsa.usda.gov/Internet/FSA_File/rutf2.pdf

UNICEF. Position Paper: Ready-to-Use Therapeutic Food for Children with Severe Acute Malnutrition. 2013. Retrieved September 30, 2016 from: http://www.unicef.org/media/files/Position_Paper_Ready-to-use_therapeutic_food_for_children_with_severe_acute_malnutrition__June_2013.pdf  

United Nations Supply Catalogue. Retrieved May 31, 2016 from: https://supply.unicef.org/unicef_b2c/app/displayApp/(layout=7.0-12_1_66_67_115&carea=%24ROOT)/.do?rf=y

Valid International and Concern Worldwide. 2006. Community-Based Therapeutic Care: A Field Manual. Retrieved September 30, 2016 from: http://www.fantaproject.org/sites/default/files/resources/CTC-Field-Manu...

Webb, P., B. Rogers, I. Rosenberg, N. Schlossman, C. Wanke, J. Bagriansky, K. Sadler, Q. Johnson, J. Tilahun, A. Reese Masterson, A. Narayan.  2011.  Delivering Improved Nutrition: Recommendations for Changes to U.S. Food Aid Products and Programming.  Retrieved September 30, 2016 from: http://pdf.usaid.gov/pdf_docs/PNADZ842.pdf

World Health Organization (WHO). 2012. Severe Acute Malnutrition. Retrieved on September 30, 2016 from: http://www.who.int/nutrition/topics/severe_malnutrition/en/index.html

World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition, and the United Nations Children’s Fund. 2007.  Community-Based Management of Severe Acute Malnutrition. 2007.  Accessed September 30, 2016: http://www.who.int/nutrition/topics/Statement_community_based_man_sev_acute_mal_eng.pdf

¹ According to the World Health Organization, Severe Acute Malnutrition (SAM) is defined by a very low weight for height (below -3 z-scores of the median WHO growth standards) by visible severe wasting, or by the presence of nutritional oedema. http://www.who.int/nutrition/topics/severe_malnutrition/en/index.html