Re: [pronut-hiv] Supplementation for moderately malnourished HIV-infected children (3)

["Geoffrey Douglas" <geoff@hetn.org>]

[Zeina Makhoul of Washington who writes:
Does anyone know what is the best approach to supplement moderately
malnourished (weight for age z score between -2 and -3) HIV-infected
children with PlumpyNut or Supplementary Plumpy? I read papers where they
did it per kg body weight but the children were severely malnourished. Are
there age-specific guidelines for moderate malnutrition where RUTF is used
as a supplement instead of therapeutic food? Or are there any guidelines for
treatment of moderate malnutrition?]


I am frankly appalled that anyone would even think of promoting or using
PlumpyNut (30% full fat milk powder, 28% icing sugar, 15% cottonseed oil,
25% salt free peanut butter and 1.6% multivitamins and minerals in chemical
isolate form) as a suitable food for children. It may have a place (for 2 –
4 weeks) in managing starvation in refugee camps, but it is not what hungry
children need (high fat, high sugar, high protein). If anyone recommended it
as a children's food in the West, they would be shot.

There is no way that you can make a child nutrient replete with PlumpyNut
and, as an African citizen, I am not just saddened, I am angry at the way
the powers-that-be play with my continent, imposing solutions that would
never be accepted in the West and making people increasingly dependent,
whilst millions die. It saddens me even more that where local people have
developed appropriate and empowering interventions, they are often ignored
or even castigated by International Agencies who have their own agendas.

Children everywhere, malnourished or not, need a diet that is based on whole
grains. It should be low in fat and sugar. It should contain all the
vitamins and minerals that would ideally be sourced from fruit and
vegetables in a form that is bioavailable. Such a product (e'Pap) has been
available in Africa for years, and has been used successfully with
malnourished children.

Geoff Douglas

CEO – Health Empowerment Through Nutrition

www.hetn.org


------ Zeina Makhoul wrote:
>
> Hello,
>
> Does anyone know:
>
> What is the best approach to supplement moderately malnourished (weight
> for age z score between -2 and -3) HIV-infected children with PlumpyNut or
> Supplementary Plumpy?  I read papers where they did it per kg body weight
> but the children were severely malnourished. Are there age-specific
> guidelines for moderate malnutrition where RUTF is used as a supplement
> instead of therapeutic food? Or are there any guidelines for treatment of
> moderate malnutrition?
>
> Thanks!!
>
> Zeina Makhoul
> Postdoctoral Research Fellow
> Fred Hutchinson Cancer Research Center
> Seattle, Washington
>
>
>
>