Week 6: Practical

Week 6: Practical Production and Sensory Evaluation of Ready-to-Use Therapeutic Foods (RUTF) Introduction Developing interventions to treat severe-acute malnutrition (SAM) and moderate- acute malnutrition (MAM) is a vital part of community-based care programmes. This often involves the manufacture of ready-to-eat therapeutic foods (RUTF). To date, the most successful RUTFs have contained peanuts, vegetable oil, sugar and skimmed milk powder, providing an ideal balance of protein and energy for recovery from acute malnutrition. At present, most peanut-based RUTFs such as PlumpyNutTM are made centrally in highly controlled conditions that ensure excellent product quality and shelf life, yet the export of these products does little to stimulate the local economy of the affected population and, much more importantly, is not always available in the quantities required at an affordable cost. Efforts are therefore underway to derive a successful RUTF formula that can be produced from locally available food produce in areas where malnutrition is prevalent. An ideal RUTF formulation must have the following attributes: ? Good nutritional quality (i.e. protein, energy and micronutrient content) ? Long shelf life ? Highly palatable with a good taste ? A consistency and texture suitable for feeding to children ? Require no additional processing prior to feeding, including cooking ? Amino acid complementation for maximum protein quality and digestibility ? Low anti-nutrient content and low risk of contamination with toxins ? Product stability (long shelf life without refrigeration) ? Ingredients should be easily available in developing countries Aims of the practical session ? In six teams of n=5, you will design and produce small samples of therapeutic foods that are not peanut-based. There will be two inclass sessions to discuss and finalise the ingredients you are going to use during the practical. ! ! ? You will evaluate the sensory properties of these foods and consider how these might affect their palatability, acceptability and safety. ? Using Nutritics software, you will derive the nutrition information of the formulated RUTF. ? In doing the practical and the associated tasks, you will gain an understanding of the importance of concepts underpinning the design of these foods, such as energy density, micronutrient quality, consistency, palatability, and microbiological risk. Your group will design a detailed proposal setting out a plan to tackle acute malnutrition in children in a less developed or transitional country. You are free to be as creative as you like in designing your intervention, but please note that it must be corroborated by evidence from the literature of its efficacy in achieving significant improvements in nutritional status and health outcomes. Any proposed intervention must be designed to achieve long-term and sustainable improvements to the health of the target population. Country of target : Bolivia Ingredients: Puffed Quinoa:54g Syrup,Agave nectar:80g Apricots,dried:31g Almond butter:113g 100g per serving Sensory data: sweet 4.5,bitter 1,sour 1,salty 1,smooth 1,pasty 2.5,mouthfeel 1,palatable 3 Stage one: Identifying and assessing the target population 1. Identify and describe the target population (must be infants and children in less developed or transitional country) 2. Assess the nutritional status of this population 3. Identify the most urgent nutritional requirements to reduce risk of morbidity and mortality in the target population. 500 words 25 marks Stage two: Applying the use of the RUTF developed during the practical 4. Using Nutritics, calculate the energy and nutrient composition of your group’s alternative RUTF and compare these values with other commonly used RUTFs for infants and children. 5. Briefly discuss why is it so difficult to find a palatable recipe with the desired energy and nutrient composition that does not contain peanuts? 6. Why is it so important to ensure adequate intake of micronutrients in order to facilitate recovery from so-called 'protein-energy malnutrition'? 7. Your answer should include a discussion of the principles and benefits of community-based management of malnutrition (CMAM). 500 words 25 marks Stage three: Evaluation and monitoring 8. Can you foresee any potential obstacles or risks to effective implementation of the intervention? How might these risks be managed and minimised? 9. What indicators do you intend to use to evaluate the impact and effectiveness of your intervention? 10.How do you plan to achieve observable and sustainable improvements in this population’s health over the long-term Group draft proposals should be submitted in week 8 for inclass formative feedback from peers and the module leader. Marking Criteria for coursework Level Description Excellent 70% or above Firm evidence of knowledge in all areas assessed. Demonstrates an excellent grasp of a wide range of sources and a high level of understanding of the subject area. Excellent awareness of relevant practical issues. Provides a well-argued and referenced answer, with evidence of outstanding ability to analyse ideas critically and to think in a creative and original manner. Very good 60-69% Knowledge is demonstrated across a broad range of topics with evaluative analysis of a good order. Demonstrates a good grasp of a range of sources and utilises them in a scholarly fashion that indicates understanding of current relevant practical issues. Provides a clear, well-organised answer with some evidence of original thinking. Good 50-59% Satisfactory evidence of sound knowledge and understanding and fluent expression of ideas. Demonstrates knowledge of a few sources and utilises them satisfactorily. Provides an adequate answer but has some theoretical and/or methodological weaknesses and/or does not show a complete grasp of relevant current issues. Satisfactory 40-49% The level of knowledge and understanding achieved is limited. Basic knowledge and skills have been acquired, but the quality of the performance is just adequate to pass. Limited grasp of sources; not well organised answer; limited understanding of theory and/or methods. FAIL 0-39% Core knowledge and skills have not been acquired and basic understanding has not been achieved. Demonstrates an inadequate grasp of sources or inappropriate use of sources. Fails to provide a coherent answer; shows inadequate understanding of theory and/or methods. Developing interventions to treat severe-acute malnutrition (SAM) and moderate- acute malnutrition (MAM) is a vital part of community-based care programmes. This often involves the manufacture of ready-to-eat therapeutic foods (RUTF). To date, the most successful RUTFs have contained peanuts, vegetable oil, sugar and skimmed milk powder, providing an ideal balance of protein and energy for recovery from acute malnutrition. At present, most peanut-based RUTFs such as PlumpyNutTM are made centrally in highly controlled conditions that ensure excellent product quality and shelf life, yet the export of these products does little to stimulate the local economy of the affected population and, much more importantly, is not always available in the quantities required at an affordable cost. Efforts are therefore underway to derive a successful RUTF formula that can be produced from locally available food produce in areas where malnutrition is prevalent. An ideal RUTF formulation must have the following attributes: ? Good nutritional quality (i.e. protein, energy and micronutrient content) ? Long shelf life ? Highly palatable with a good taste ? A consistency and texture suitable for feeding to children ? Require no additional processing prior to feeding, including cooking ? Amino acid complementation for maximum protein quality and digestibility ? Low anti-nutrient content and low risk of contamination with toxins ? Product stability (long shelf life without refrigeration) ? Ingredients should be easily available in developing countries Aims of the practical session ? In six teams of n=5, you will design and produce small samples of therapeutic foods that are not peanut-based. There will be two inclass sessions to discuss and finalise the ingredients you are going to use during the practical. ? You will evaluate the sensory properties of these foods and consider how these might affect their palatability, acceptability and safety. ? Using Nutritics software, you will derive the nutrition information of the formulated RUTF. ? In doing the practical and the associated tasks, you will gain an understanding of the importance of concepts underpinning the design of these foods, such as energy density, micronutrient quality, consistency, palatability, and microbiological risk.