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PIA2501 Leslie & Tran Presentation

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on 10 April 2013

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Transcript of PIA2501 Leslie & Tran Presentation


Nutrient: Provitamin A

Results: Children 6-35 months, orange sweet potato contributed more than 50% of their total vitamin A intake Leslie Brady, Tran Doan Ready-to-Use Therapeutic Foods (Short Term) vs.
Biofortification (Long Term) Child Malnutrition in the Developing World Ready-to-Use Therapeutic
Foods Supplemental vitamins Malnutrition Plumpy'Nut Malnutrition Interventions United Nations Millennium Development Goals
Goal 1: Eradicate Extreme Poverty and Hunger Short Term High Impact Intervention Ready-to-Use Therapeutic Foods Need for Dietary Diversification PIA2501: Issues in Development Policy and Administration
Professor Paul Nelson
September 19, 2012 "Plumpy’Nut® was developed in 1996 by Nutriset. It was the first ready-to-use food intended specifically for the treatment of severe acute malnutrition.

"Eureka Moment": French Pediatrician Andre Briend and a jar of Nutella

Controversy: Who should control means of production?
Intellectual Property Debate:
benevolent or profit-driven?
Stifle paste-based RUTF research?
Grant license to which countries?
New York Times article "The Peanut Solution" Biofortification Addressing Malnutrition: Long Term Intervention
=
Sustainable World Health Organization CONS
High institutional costs
Little opportunity for caregiver to learn about good child-feeding practices and malnutrition prevention
Requires nearby clinic or community health workers
Requires efficient transport and distribution networks
Risk of dependency
Address children in the "golden interval." What about the older children?
Produced by Western country (reduces developing nations' competition in open market?)
Need more evidence of effectiveness Pros: Cons: Future Direction Malnutrition Definition

Malnutrition Disease Burden

Common Interventions






Future Direction

Conclusion Overview Ready-to-Use Therapeutic
Foods Supplemental vitamins Malnutrition Interventions Pros:
Sustainable
Far-reaching
locally available
cost-effective

Cons:
time-consuming
poor-man's food
PROS
Low water activity
Can be kept unrefrigerated for several months
Eaten uncooked
Resist bacterial contamination
Potential to be made from local crops
Easily reproducible − World Health Organization
on vitamin A deficiency Leslie Brady, Tran Doan Ready-to-Use Therapeutic Foods (Short Term) vs.
Biofortification (Long Term) Throughout Sub-Saharan Africa
Amaranthus caudatus
Amaranthus creuntus

Objective:
Re-engineer the microstructure of underutilized African leafy vegetables with the goal of optimizing nutrient bioavailability and palatability Biofortification
Selective Breeding
Genetic Engineering Malnutrition Plumpy'Nut Short Term High Impact Intervention
=
Not Sustainable Underutilized African Leafy Vegetable (ALV): Amaranth PIA2501: Issues in Development Policy and Administration
Professor Paul Nelson
September 19, 2012 Budget

Local RUTF Production

Biofortification Conclusion Biofortification Uganda Case Study: Vitamin A-Rich Orange-Fleshed Sweet Potatoes Addressing Malnutrition: Long Term Intervention
=
Sustainable Future Direction How is biofortification sustainable?

Biofortified crops will be made freely available to any national agriculture research program.

The recurrent costs associated with monitoring and maintaining the crops will be far lower than the initial costs of development. Overview PROS
High in provitamin A & other nutrients
Sustainable
Far-reaching
Locally available
Cost-effective

CONS
Time & Resource-consuming
Poor-man's food What is Biofortification?

Biofortification is the process of breeding food crops that are rich in bioavailable micronutrients, such as Vitamin A, zinc, and iron. The process begins by loading higher levels of minerals and vitamins in the seeds of the plants during growth.

www.harvestplus.org

The HarvestPlus Challenge Program was officially began in 2004 when it became the first recipient of funding for biofortification research by the Bill & Melinda Gates Foundation. By Mary Beth Wilson, Ph.D. Candidate
P.R. Phil LeDuc
Carnegie Mellon University
in collaboration with
Phipps Conservatory
Funded by Bill & Melinda Gates Foundation Deficient nutrition during infant and early childhood development is a continuing crisis that impacts the developing world, as it contributes to increased immediate mortality, stunted growth and downstream chronic disease.

Although a great deal of interventional efforts have concentrated on breastfeeding practices, nutrient supplementation, and ready-to-use therapeutic foods, they need to be coupled with long-term, sustainable complementary feeding practices that utilize native and traditional foodstuffs to diversify diets and improve the nutritional status of infants and young children.

Issue 28% of children and 23% of women are estimated to be vitamin A deficient

Crop: Orange Sweet Potatoes Special Acknowledgements:

Mary Beth Wilson
Laura Wilson
Professor Paul Nelson www.harvestplus.org "Plumpy’Nut® was developed in 1996 by Nutriset. It was the first ready-to-use food intended specifically for the treatment of severe acute malnutrition.

"Eureka Moment": French Pediatrician Andre Briend and a jar of Nutella

Intended to be administer at home, by families instead of doctors. 90-95% subjects made a full recovery!!

Controversy: Who should control means of production?
Intellectual Property Debate:
-Benevolent or Profit-Driven?
-Strifle RUTF paste-based research?
Patent registered in 38 countries (much of Africa)
Grant license mostly to developing countries (11 countries overall)
New York Times article "The Peanut Solution" www.nutriset.fr Infamous 60 Minutes Video
PROS
Low water activity
Long shelf life
Do not need refrigeration
Eaten uncooked, right from the packet
Resist bacterial contamination
Potential to be made from local crops
Easily reproducible
Tasty "To successfully combat vitamin A deficiency, short-term interventions and proper infant feeding must be backed up by long-term sustainable solutions.” "Cultivating the garden, both literally and figuratively, is the next phase necessary to achieve long-term results.” Biofortification
Selective Breeding
Genetic Engineering Undernutrition:
Combined protein + energy
(and fatty acids) deficiencies

Growth faltering:
Deceleration in growth over time:
widening gap from medium

Protein-Energy Malnutrition:
Deficiency in protein and energy

Micronutrient deficiency:
Deficiency in particular micronutrients
(Vitamin A, Iron, Iodine, and Zinc) Seasons of Hunger

"Hunger is responsible for weakening immune systems and opening the door for killer epidemic disease; it is estimated that the total burden of disease in poor countries could be reduced by nearly one-third if child malnutrition was eradicated. Ending malnutrition would save the lives of several million young children every year who are killed by epidemic diseases." THE FACTORY Partners in Health makes its own peanut-based supplement in Haiti Definitions

"Malnutrition essentially means bad nourishment'.

Clinically, malnutrition is characterized by inadequate or excess intake of protein, energy, and micronutrients such as vitamins, and the frequent infections and disorders that result. Disease Burden THE SCALE Loramie Joseph is weighed at a Save the Children center Ready-to-Use Therapeutic Foods

Biofortification Gatchell, Valerie, Vivienne Forsythe, and Paul-Rees Thomas. "The Sustainability of Community-based Therapeutic Care (CTC) in non-acute emergency contexts."

Nutriset. "Plumpy'nut and the CMAM approach: how Nutriset's R&D has helped change the way to transform severe acute malnutrition." Plumpy'Soy Plumpy'Nut CONS
Expensive ($60/child for 2 month treatment)
High institutional costs
Little opportunity for caregiver to learn about good child-feeding practices and malnutrition prevention
Requires nearby clinic or community health workers
Requires efficient transport and distribution networks
Risk of dependency
Address children in the "golden interval." What about the older children?
Produced by Western country (reduces developing nations' competition in open market?)
Need more evidence of effectiveness Food and Nutrition Bulletin, vol. 27, no. 3, 2006, The United Nations University.
Mark J. Manary
Local production and provision of ready-to-use therapeutic food (RUTF) spread for the treatment of severe childhood malnutrition

"The recent success of home-based therapy has been seen in conjunction with the availability of a novel food, a spread form of ready-to-use therapeutic food (RUTF).

RUTF is a generic term including different types of foods, such as spreads or compressed products, suitable for feeding severely malnourished children.

Among RUTFs, spreads are prepared with a simple technology that has already been successfully transferred to developing countries with minimal industrial infrastructure.

The RUTF spread is made of powdered ingredients (milk powder, sugar, vegetable oil, peanut butter, vitamins, and minerals) embedded in a lipid-rich paste, resulting in an energy-dense food that resists microbial contamination and requires no cooking."
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