.jpg) Plumpy'Nut, a ready-to-use therapeutic food (RUTF) | |||||||
| Nutritional value per 92 g[1] | |||||||
|---|---|---|---|---|---|---|---|
| Energy | 2,100 kJ (500 kcal) | ||||||
45 g | |||||||
30.3 g | |||||||
12.8 g | |||||||
| |||||||
| Other constituents | Quantity | ||||||
| Ingredients | peanut paste, vegetable oil, powdered milk, powdered sugar, vitamins, minerals | ||||||
| †Percentages estimated usingUS recommendations for adults.[2] Source: Nutriset, France | |||||||
Plumpy'Nut is apeanut-based paste, packaged in a plastic wrapper, for treatment ofsevere acute malnutrition. Plumpy'Nut is manufactured byNutriset, a French company.[3][4] Feeding with the 92-gram (3+1⁄4 oz) packets of this paste reduces the need for hospitalization. It can be administered at home, allowing more people to be treated.[3]
Plumpy'Nut may be referred to in scientific literature as aReady-to-Use Therapeutic Food (RUTF) alongside other RUTFs such as BP100.[5]
Nutriset has been criticized byMédecins Sans Frontières for enforcing its Plumpy'Nutpatents.[6] However, as of 2018[update], Plumpy'Nut patents have expired in theUS,UK and theEuropean Union.
Plumpy'Nut is used as a treatment for emergency malnutrition cases. It supports rapid weight gain derived from broad nutrient intake which can alleviate impending illness or death in a starving child.[7] The product is easy for children to eat because it dispenses readily from a durable, tear-open package. The fortified peanut butter–like paste containsfats,dietary fiber,carbohydrates,proteins (as essentialmacronutrients), vitamins and minerals (as essentialmicronutrients). Peanut butter itself is a rich source ofvitamin E (45% of theDaily Value, DV, in a 100-gram amount) andB vitamins (particularlyniacin at 67% DV).[8]
Plumpy'Nut has a two-year shelf life and requires no water, preparation, or refrigeration.[3] Its ease of use has made mass treatment of malnutrition infamine situations more efficient than in the past.[4][9] Severe acute malnutrition has traditionally been treated with therapeutic milk and required hospitalization.[10] Unlike milk, Plumpy'Nut can be administered at home and without medical supervision.[3] It also providescalories andessential nutrients that restore and maintain body weight and health in severely malnourished children more effectively thanF100.[7]
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TheUnited Nations has recognized this utility, stating in 2007 that "new evidence suggests ... that large numbers of children with severe acute malnutrition can be treated in their communities without being admitted to a health facility or a therapeutic feeding centre,"[11] as was implemented in 2007 byUNICEF and theEuropean Commission's Humanitarian Aid Department inNiger to address a malnutrition emergency.[12] Plumpy'Nut conforms to the UN definition of aReady-to-Use Therapeutic Food (RUTF).[3][11]
Plumpy'Nut is not intended for routine nutrition, or for malnutrition in non-famine situations.[13]Peanut allergies have not been found to be a problem in usage due to a lack of allergic reactions in the target populations.[14]
The ingredients in Plumpy'Nut include "peanut-based paste, with sugar,vegetable oil and skimmedmilk powder, enriched withvitamins andminerals".[3] Plumpy'Nut is said to be "surprisingly tasty".[4]
While the majority of Plumpy'Nut was made in France as of 2010, this therapeutic food is easily produced[4] and can be made locally in peanut-growing areas by mixing peanut paste with a slurry of other ingredients provisioned by Nutriset.[15]
A number of partner companies make Plumpy'Nut, including two U.S. nonprofits,Edesia Nutrition inRhode Island and Mana inGeorgia.[16] There are six factories in African countries (Niger,Burkina Faso,Ethiopia,Sudan,Madagascar,Kenya), one inHaiti and another one inIndia.[15][17]
Plumpy'Nut is distributed from the manufacturer to geographic areas of need through a complexsupply chain. Forward (downstream) information flow, such as projections of need,order processing, andpayment processing, and backward (upstream) information flow, includingstock monitoring,quality assurance, and performance data occur through information exchange vulnerable to errors or tardiness associated with supply chainfragmentation.[18][19]Factors affecting potential for loss of efficiency in the supply chain are information flow on orders, basis of need, forecasts, flow upstream from field officers and country offices to parties controlling regional distribution and manufacturing by Nutriset, downstream flow of information on delivery times and order status.[18][19]
A complete two-month regimen for a child costs US$60c. 2010.[4]
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Inspired by the popularNutella spread,[4] Plumpy'Nut was invented in 1996 byAndré Briend, aFrench paediatric nutritionist, andMichel Lescanne, a food-processing engineer.[3] Nutella is a spread composed of sugar, modifiedpalm oil,hazelnuts, cocoa, skimmed milk powder,whey powder,lecithin, andvanillin. In contrast, Plumpy'Nut is a combination ofpeanut paste, vegetable oil and milk powder, without including chocolate, but containing sugar, vitamins and dietary minerals.
Nutriset holds or held patents in many countries (includingUS patent 6346284 , published in 2002) for the production of nut-based, nutritional foods as pastes, which they have defended to prevent non-licensees in the United States from producing similar products.[9] In places where Nutriset does not hold a patent, manufacturers of similar pastes have been stopped from exporting their products to places where Plumpy'Nut is patented.[20] In at least 27 African nations, any non-profit (includingNGOs) can make the paste and not pay a license fee.[21]
In 2010, two US non-profit organizations unsuccessfully sued the French company in an attempt to legally produce Plumpy'Nut in the US without paying the royalty fee.[9] Mike Mellace, president of one of the organizations claimed that "some children are dying because Nutriset prevents other companies from producing a food which could save their lives."[22] Invalidation of the Nutriset patent may have a positive impact on populations affected by famine, and studies by humanitarian organizations support the idea that having a single, dominant supplier in Nutriset is undesirable.[23] Critics of Nutriset argue the US patent is "obvious in light of prior recipes" and "that the patent has essentially conferred monopoly power on Nutriset and thus violated theSherman Act".[24] By definition, apatent grants a temporary monopoly, and Nutriset won the case. Some have suggested a similarity between pharmaceutical company compulsory licensing agreements, in place under theWTOTRIPS Agreement, and Plumpy'Nut.[24]
Following a threat of legal action against a Norwegian company that was exporting a similar product to Kenya, Nutriset was criticized byMédecins Sans Frontières,[23] which stated in an open letter that "Nutriset has been asked repeatedly by us and others for simple, reasonable licensing terms ... Instead it appears that [Nutriset has] decided to adopt a policy of aggressive protection of [its] patents that could be considered an abuse in relation to humanitarian products."[25] A UNICEF study, commissioned at Duke University and the University of North Carolina, recommended a diversified supplier base of RUTF products to better serve global needs.[26] In response to the criticism, Nutriset has allowed companies and NGOs in some African countries to make the paste and not pay license fees.[21]
The Plumpy'Nut patents in the USA expired in 2017 (US patent 6346284 ), and in the UK and the European Union in 2018 (EP patent 1032280 ).
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