alternative recipes for rutf - unicef

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Alternative Recipes for RUTF Alison Fleet and Jan Debyser UNICEF Nutrition Supply Forum November 5 th and 6 th 2019

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Page 1: Alternative Recipes for RUTF - UNICEF

Alternative Recipes

for RUTFAlison Fleet and Jan Debyser

UNICEF Nutrition Supply Forum November 5th and 6th 2019

Alternative Recipes for RUTF

1 Why is UNICEF exploring alternative recipes of RUTF

2 What kinds of formulations exist

3 Results of the UNICEF RUTF tender for alternative recipes

4 Results of the evaluation

5 Competitiveness of offers

6 Technical screening and assessment of offers

7 Local ingredient inclusion

8 Technical Expert meeting

9 What is considered a new formulation

10 Acceptability trials for RUTF- requirements

11 Next steps

Background

- 2015 UNICEF proposal for RUTF guideline accepted at the CCNFSDU- Member state emphasis on locally adapted guideline RUTF that

is affordable and culturally acceptable- The section on Ingredients and raw materials now includes cereals

legumes and seeds ndash not just peanuts

Studies on alternative products

- Meanwhile the literature on RUTF started to feature alternative recipes of RUTF with different combinations aiming to reduce cost include more local ingredients or more suitable products to otherwise untreated populations

UNICEF RUTF Tender December 2018- Included alternative RUTF formulations- Competitive framework to assess quality and price of the 3 categories

of RUTF alternatives

Renovation

Innovative

Novel

bull Legumes

bull Cereals

bull Seeds

bull Egg

bull Insect

bull Fish

bull Added amino acid to meet protein requirements

bull Increased micronutrients

Alt

ern

ativ

e In

gre

die

nts

Var

iati

on

s

Tender results Financial offers for alternative version of RUTF

Renovation Novel

Offshore Local Offshore Local

Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Total

Financial offers

27 27 9 9 3 4 0 1 80

bull 80 financial offers from 15 manufacturers for 35 different product formulations

bull Mixture of offers for off-shore supply only combined off-shore amp local and local only Most offers are for Year 1 and Year 2 some are only for Year 2

bull No offers were received for the Innovation category

Tender condition that products with alternative ingredientsrecipes are offered at a lower price than the standard peanutmilk version offered by the same manufacturer

bull All offers for Year 1 (Year 2 when no offer for Year 1) are cheaper than offers for standard product (S0000240) of the same year

bull With the exception of one offer which is more expensive and will therefore not be considered

bull One supplier only offered for the alternative RUTF and not for the standard version

bull When only considering valid and comparable (base) offers price reduction ranges from 016 - 427 US$ 04 - 101 with below medians

Tender results for alternative version of RUTF support to tender price objectives

Renovation Novel

Off-shore Local Off-shore Local

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

US$ 206 48 US$ 193 40 US$ 165 40 US$ 278 58

Technical Screening of Alternative RUTFs

1 Completed Interagency product

Questionnaires

2 Product specification

3 Product sample submitted

3 Product sample organoleptic testing against specification

4 Short listing of products

UNICEF organoleptic requirements as per specification

Texture Smooth homogeneous thick paste easy to squeeze out of sachet It should be a uniform paste with no lumps or grittiness having a small particle size (size lt 200 microns) to minimise phase separation granularity and oil leaking out of the sachet The paste should not elicit chewing when consumed by the target population

Flavour and odour

RUTF paste should have a pleasing sweet fresh flavour RUTF paste should be free from foreign odours and flavours such as (but not limited to) burnt scorched rancid malted sour or stale

Colour RUTF paste should have cream to light or orangey brown colour The RUTF paste should not have a dull grey tinge or other abnormal cast It should show no evidence of excessive heating (materially darkened or scorched)

From RUTF Renovation Specification

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 2: Alternative Recipes for RUTF - UNICEF

Alternative Recipes for RUTF

1 Why is UNICEF exploring alternative recipes of RUTF

2 What kinds of formulations exist

3 Results of the UNICEF RUTF tender for alternative recipes

4 Results of the evaluation

5 Competitiveness of offers

6 Technical screening and assessment of offers

7 Local ingredient inclusion

8 Technical Expert meeting

9 What is considered a new formulation

10 Acceptability trials for RUTF- requirements

11 Next steps

Background

- 2015 UNICEF proposal for RUTF guideline accepted at the CCNFSDU- Member state emphasis on locally adapted guideline RUTF that

is affordable and culturally acceptable- The section on Ingredients and raw materials now includes cereals

legumes and seeds ndash not just peanuts

Studies on alternative products

- Meanwhile the literature on RUTF started to feature alternative recipes of RUTF with different combinations aiming to reduce cost include more local ingredients or more suitable products to otherwise untreated populations

UNICEF RUTF Tender December 2018- Included alternative RUTF formulations- Competitive framework to assess quality and price of the 3 categories

of RUTF alternatives

Renovation

Innovative

Novel

bull Legumes

bull Cereals

bull Seeds

bull Egg

bull Insect

bull Fish

bull Added amino acid to meet protein requirements

bull Increased micronutrients

Alt

ern

ativ

e In

gre

die

nts

Var

iati

on

s

Tender results Financial offers for alternative version of RUTF

Renovation Novel

Offshore Local Offshore Local

Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Total

Financial offers

27 27 9 9 3 4 0 1 80

bull 80 financial offers from 15 manufacturers for 35 different product formulations

bull Mixture of offers for off-shore supply only combined off-shore amp local and local only Most offers are for Year 1 and Year 2 some are only for Year 2

bull No offers were received for the Innovation category

Tender condition that products with alternative ingredientsrecipes are offered at a lower price than the standard peanutmilk version offered by the same manufacturer

bull All offers for Year 1 (Year 2 when no offer for Year 1) are cheaper than offers for standard product (S0000240) of the same year

bull With the exception of one offer which is more expensive and will therefore not be considered

bull One supplier only offered for the alternative RUTF and not for the standard version

bull When only considering valid and comparable (base) offers price reduction ranges from 016 - 427 US$ 04 - 101 with below medians

Tender results for alternative version of RUTF support to tender price objectives

Renovation Novel

Off-shore Local Off-shore Local

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

US$ 206 48 US$ 193 40 US$ 165 40 US$ 278 58

Technical Screening of Alternative RUTFs

1 Completed Interagency product

Questionnaires

2 Product specification

3 Product sample submitted

3 Product sample organoleptic testing against specification

4 Short listing of products

UNICEF organoleptic requirements as per specification

Texture Smooth homogeneous thick paste easy to squeeze out of sachet It should be a uniform paste with no lumps or grittiness having a small particle size (size lt 200 microns) to minimise phase separation granularity and oil leaking out of the sachet The paste should not elicit chewing when consumed by the target population

Flavour and odour

RUTF paste should have a pleasing sweet fresh flavour RUTF paste should be free from foreign odours and flavours such as (but not limited to) burnt scorched rancid malted sour or stale

Colour RUTF paste should have cream to light or orangey brown colour The RUTF paste should not have a dull grey tinge or other abnormal cast It should show no evidence of excessive heating (materially darkened or scorched)

From RUTF Renovation Specification

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 3: Alternative Recipes for RUTF - UNICEF

Background

- 2015 UNICEF proposal for RUTF guideline accepted at the CCNFSDU- Member state emphasis on locally adapted guideline RUTF that

is affordable and culturally acceptable- The section on Ingredients and raw materials now includes cereals

legumes and seeds ndash not just peanuts

Studies on alternative products

- Meanwhile the literature on RUTF started to feature alternative recipes of RUTF with different combinations aiming to reduce cost include more local ingredients or more suitable products to otherwise untreated populations

UNICEF RUTF Tender December 2018- Included alternative RUTF formulations- Competitive framework to assess quality and price of the 3 categories

of RUTF alternatives

Renovation

Innovative

Novel

bull Legumes

bull Cereals

bull Seeds

bull Egg

bull Insect

bull Fish

bull Added amino acid to meet protein requirements

bull Increased micronutrients

Alt

ern

ativ

e In

gre

die

nts

Var

iati

on

s

Tender results Financial offers for alternative version of RUTF

Renovation Novel

Offshore Local Offshore Local

Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Total

Financial offers

27 27 9 9 3 4 0 1 80

bull 80 financial offers from 15 manufacturers for 35 different product formulations

bull Mixture of offers for off-shore supply only combined off-shore amp local and local only Most offers are for Year 1 and Year 2 some are only for Year 2

bull No offers were received for the Innovation category

Tender condition that products with alternative ingredientsrecipes are offered at a lower price than the standard peanutmilk version offered by the same manufacturer

bull All offers for Year 1 (Year 2 when no offer for Year 1) are cheaper than offers for standard product (S0000240) of the same year

bull With the exception of one offer which is more expensive and will therefore not be considered

bull One supplier only offered for the alternative RUTF and not for the standard version

bull When only considering valid and comparable (base) offers price reduction ranges from 016 - 427 US$ 04 - 101 with below medians

Tender results for alternative version of RUTF support to tender price objectives

Renovation Novel

Off-shore Local Off-shore Local

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

US$ 206 48 US$ 193 40 US$ 165 40 US$ 278 58

Technical Screening of Alternative RUTFs

1 Completed Interagency product

Questionnaires

2 Product specification

3 Product sample submitted

3 Product sample organoleptic testing against specification

4 Short listing of products

UNICEF organoleptic requirements as per specification

Texture Smooth homogeneous thick paste easy to squeeze out of sachet It should be a uniform paste with no lumps or grittiness having a small particle size (size lt 200 microns) to minimise phase separation granularity and oil leaking out of the sachet The paste should not elicit chewing when consumed by the target population

Flavour and odour

RUTF paste should have a pleasing sweet fresh flavour RUTF paste should be free from foreign odours and flavours such as (but not limited to) burnt scorched rancid malted sour or stale

Colour RUTF paste should have cream to light or orangey brown colour The RUTF paste should not have a dull grey tinge or other abnormal cast It should show no evidence of excessive heating (materially darkened or scorched)

From RUTF Renovation Specification

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 4: Alternative Recipes for RUTF - UNICEF

Renovation

Innovative

Novel

bull Legumes

bull Cereals

bull Seeds

bull Egg

bull Insect

bull Fish

bull Added amino acid to meet protein requirements

bull Increased micronutrients

Alt

ern

ativ

e In

gre

die

nts

Var

iati

on

s

Tender results Financial offers for alternative version of RUTF

Renovation Novel

Offshore Local Offshore Local

Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Total

Financial offers

27 27 9 9 3 4 0 1 80

bull 80 financial offers from 15 manufacturers for 35 different product formulations

bull Mixture of offers for off-shore supply only combined off-shore amp local and local only Most offers are for Year 1 and Year 2 some are only for Year 2

bull No offers were received for the Innovation category

Tender condition that products with alternative ingredientsrecipes are offered at a lower price than the standard peanutmilk version offered by the same manufacturer

bull All offers for Year 1 (Year 2 when no offer for Year 1) are cheaper than offers for standard product (S0000240) of the same year

bull With the exception of one offer which is more expensive and will therefore not be considered

bull One supplier only offered for the alternative RUTF and not for the standard version

bull When only considering valid and comparable (base) offers price reduction ranges from 016 - 427 US$ 04 - 101 with below medians

Tender results for alternative version of RUTF support to tender price objectives

Renovation Novel

Off-shore Local Off-shore Local

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

US$ 206 48 US$ 193 40 US$ 165 40 US$ 278 58

Technical Screening of Alternative RUTFs

1 Completed Interagency product

Questionnaires

2 Product specification

3 Product sample submitted

3 Product sample organoleptic testing against specification

4 Short listing of products

UNICEF organoleptic requirements as per specification

Texture Smooth homogeneous thick paste easy to squeeze out of sachet It should be a uniform paste with no lumps or grittiness having a small particle size (size lt 200 microns) to minimise phase separation granularity and oil leaking out of the sachet The paste should not elicit chewing when consumed by the target population

Flavour and odour

RUTF paste should have a pleasing sweet fresh flavour RUTF paste should be free from foreign odours and flavours such as (but not limited to) burnt scorched rancid malted sour or stale

Colour RUTF paste should have cream to light or orangey brown colour The RUTF paste should not have a dull grey tinge or other abnormal cast It should show no evidence of excessive heating (materially darkened or scorched)

From RUTF Renovation Specification

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 5: Alternative Recipes for RUTF - UNICEF

Alt

ern

ativ

e In

gre

die

nts

Var

iati

on

s

Tender results Financial offers for alternative version of RUTF

Renovation Novel

Offshore Local Offshore Local

Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Total

Financial offers

27 27 9 9 3 4 0 1 80

bull 80 financial offers from 15 manufacturers for 35 different product formulations

bull Mixture of offers for off-shore supply only combined off-shore amp local and local only Most offers are for Year 1 and Year 2 some are only for Year 2

bull No offers were received for the Innovation category

Tender condition that products with alternative ingredientsrecipes are offered at a lower price than the standard peanutmilk version offered by the same manufacturer

bull All offers for Year 1 (Year 2 when no offer for Year 1) are cheaper than offers for standard product (S0000240) of the same year

bull With the exception of one offer which is more expensive and will therefore not be considered

bull One supplier only offered for the alternative RUTF and not for the standard version

bull When only considering valid and comparable (base) offers price reduction ranges from 016 - 427 US$ 04 - 101 with below medians

Tender results for alternative version of RUTF support to tender price objectives

Renovation Novel

Off-shore Local Off-shore Local

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

US$ 206 48 US$ 193 40 US$ 165 40 US$ 278 58

Technical Screening of Alternative RUTFs

1 Completed Interagency product

Questionnaires

2 Product specification

3 Product sample submitted

3 Product sample organoleptic testing against specification

4 Short listing of products

UNICEF organoleptic requirements as per specification

Texture Smooth homogeneous thick paste easy to squeeze out of sachet It should be a uniform paste with no lumps or grittiness having a small particle size (size lt 200 microns) to minimise phase separation granularity and oil leaking out of the sachet The paste should not elicit chewing when consumed by the target population

Flavour and odour

RUTF paste should have a pleasing sweet fresh flavour RUTF paste should be free from foreign odours and flavours such as (but not limited to) burnt scorched rancid malted sour or stale

Colour RUTF paste should have cream to light or orangey brown colour The RUTF paste should not have a dull grey tinge or other abnormal cast It should show no evidence of excessive heating (materially darkened or scorched)

From RUTF Renovation Specification

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 6: Alternative Recipes for RUTF - UNICEF

Tender results Financial offers for alternative version of RUTF

Renovation Novel

Offshore Local Offshore Local

Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Year 1 Year 2 Total

Financial offers

27 27 9 9 3 4 0 1 80

bull 80 financial offers from 15 manufacturers for 35 different product formulations

bull Mixture of offers for off-shore supply only combined off-shore amp local and local only Most offers are for Year 1 and Year 2 some are only for Year 2

bull No offers were received for the Innovation category

Tender condition that products with alternative ingredientsrecipes are offered at a lower price than the standard peanutmilk version offered by the same manufacturer

bull All offers for Year 1 (Year 2 when no offer for Year 1) are cheaper than offers for standard product (S0000240) of the same year

bull With the exception of one offer which is more expensive and will therefore not be considered

bull One supplier only offered for the alternative RUTF and not for the standard version

bull When only considering valid and comparable (base) offers price reduction ranges from 016 - 427 US$ 04 - 101 with below medians

Tender results for alternative version of RUTF support to tender price objectives

Renovation Novel

Off-shore Local Off-shore Local

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

US$ 206 48 US$ 193 40 US$ 165 40 US$ 278 58

Technical Screening of Alternative RUTFs

1 Completed Interagency product

Questionnaires

2 Product specification

3 Product sample submitted

3 Product sample organoleptic testing against specification

4 Short listing of products

UNICEF organoleptic requirements as per specification

Texture Smooth homogeneous thick paste easy to squeeze out of sachet It should be a uniform paste with no lumps or grittiness having a small particle size (size lt 200 microns) to minimise phase separation granularity and oil leaking out of the sachet The paste should not elicit chewing when consumed by the target population

Flavour and odour

RUTF paste should have a pleasing sweet fresh flavour RUTF paste should be free from foreign odours and flavours such as (but not limited to) burnt scorched rancid malted sour or stale

Colour RUTF paste should have cream to light or orangey brown colour The RUTF paste should not have a dull grey tinge or other abnormal cast It should show no evidence of excessive heating (materially darkened or scorched)

From RUTF Renovation Specification

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 7: Alternative Recipes for RUTF - UNICEF

Tender condition that products with alternative ingredientsrecipes are offered at a lower price than the standard peanutmilk version offered by the same manufacturer

bull All offers for Year 1 (Year 2 when no offer for Year 1) are cheaper than offers for standard product (S0000240) of the same year

bull With the exception of one offer which is more expensive and will therefore not be considered

bull One supplier only offered for the alternative RUTF and not for the standard version

bull When only considering valid and comparable (base) offers price reduction ranges from 016 - 427 US$ 04 - 101 with below medians

Tender results for alternative version of RUTF support to tender price objectives

Renovation Novel

Off-shore Local Off-shore Local

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

Median Price

Reduction

Median Price

reduction

US$ 206 48 US$ 193 40 US$ 165 40 US$ 278 58

Technical Screening of Alternative RUTFs

1 Completed Interagency product

Questionnaires

2 Product specification

3 Product sample submitted

3 Product sample organoleptic testing against specification

4 Short listing of products

UNICEF organoleptic requirements as per specification

Texture Smooth homogeneous thick paste easy to squeeze out of sachet It should be a uniform paste with no lumps or grittiness having a small particle size (size lt 200 microns) to minimise phase separation granularity and oil leaking out of the sachet The paste should not elicit chewing when consumed by the target population

Flavour and odour

RUTF paste should have a pleasing sweet fresh flavour RUTF paste should be free from foreign odours and flavours such as (but not limited to) burnt scorched rancid malted sour or stale

Colour RUTF paste should have cream to light or orangey brown colour The RUTF paste should not have a dull grey tinge or other abnormal cast It should show no evidence of excessive heating (materially darkened or scorched)

From RUTF Renovation Specification

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 8: Alternative Recipes for RUTF - UNICEF

Technical Screening of Alternative RUTFs

1 Completed Interagency product

Questionnaires

2 Product specification

3 Product sample submitted

3 Product sample organoleptic testing against specification

4 Short listing of products

UNICEF organoleptic requirements as per specification

Texture Smooth homogeneous thick paste easy to squeeze out of sachet It should be a uniform paste with no lumps or grittiness having a small particle size (size lt 200 microns) to minimise phase separation granularity and oil leaking out of the sachet The paste should not elicit chewing when consumed by the target population

Flavour and odour

RUTF paste should have a pleasing sweet fresh flavour RUTF paste should be free from foreign odours and flavours such as (but not limited to) burnt scorched rancid malted sour or stale

Colour RUTF paste should have cream to light or orangey brown colour The RUTF paste should not have a dull grey tinge or other abnormal cast It should show no evidence of excessive heating (materially darkened or scorched)

From RUTF Renovation Specification

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 9: Alternative Recipes for RUTF - UNICEF

UNICEF organoleptic requirements as per specification

Texture Smooth homogeneous thick paste easy to squeeze out of sachet It should be a uniform paste with no lumps or grittiness having a small particle size (size lt 200 microns) to minimise phase separation granularity and oil leaking out of the sachet The paste should not elicit chewing when consumed by the target population

Flavour and odour

RUTF paste should have a pleasing sweet fresh flavour RUTF paste should be free from foreign odours and flavours such as (but not limited to) burnt scorched rancid malted sour or stale

Colour RUTF paste should have cream to light or orangey brown colour The RUTF paste should not have a dull grey tinge or other abnormal cast It should show no evidence of excessive heating (materially darkened or scorched)

From RUTF Renovation Specification

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 10: Alternative Recipes for RUTF - UNICEF

Organoleptic Testing

Specification criteria assessments

o Taste

o Homogeneity amp

o Granularity

o Texture (smoothsandyflaky)

o Appearance (dryoilyrunny)

o Color appearance and smell

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 11: Alternative Recipes for RUTF - UNICEF

Organoleptic tastingRejected samples

Scores for ge10 for bitter rancid or burned tasteandorScores of ge3 for grainy granular or adhesive granularity

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 12: Alternative Recipes for RUTF - UNICEF

Invitees Financial product offers

Evaluated products Samples received

Eligible for further assessment

49 35 (from 15 companies)

30 (from 15 companies)

18 11

Tender Results (so far) Alternative Version of RUTF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 13: Alternative Recipes for RUTF - UNICEF

Country of origin ndash are the ingredients used local

3338

86

50

38

56

7089

86

88

89

Percentage comparison of local ingredients used

product 1

product 2

product 3

product 4

product 5

product 6

product 7

product 8

product 9

product 10

product 11

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 14: Alternative Recipes for RUTF - UNICEF

Next Steps

What are the next steps in progressing with alternative formulations of RUTF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 15: Alternative Recipes for RUTF - UNICEF

How do we define a new product

What is needed to ensure quality of new RUTF products

What factors do we need to consider using different cereals seeds and legumes

Is a trial or evidence needed to program new RUTF products Eg acceptability trials

What kind of trial design would be needed to demonstrate acceptability of a new RUTF products

Technical Expert

Meeting

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 16: Alternative Recipes for RUTF - UNICEF

What is needed to validate new RUTF products

2 Product specification

meets UNICEF specification

3 Shelf life supported by

stability studies

4 Process capability and batch release

based on aggregated data

5 Level of Anti-nutrients is

below that of the peanut

version

1 Facility meets Interagency standards

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 17: Alternative Recipes for RUTF - UNICEF

What is the definition of a new RUTF product

Any new addition of ingredient type

Any change of typekind of bulk ingredient that is likely to alter the organoleptic properties from the previous product

Excludes minor changes in formulations such as changes in additives vitamins and minerals premix and other processing aids

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 18: Alternative Recipes for RUTF - UNICEF

Levels of phytates vary between raw materials and between processed and unprocessed ingredients

Is the quantity in RUTF alternatives significant to have an effect on the treatment

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 19: Alternative Recipes for RUTF - UNICEF

Addressing anti-nutrients in alternative ingredientsTitle Description Link

Implications of antinutritional components in soybean foodsLiener IE1 Nissar

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins

Online articleOnline Article 2

Reduction of phytic acid and enhancement of bioavailable micronutrients in food grainsRaj Kishor Gupta 1

Pre-treatment methods such as milling hulling roasting fermentation soaking germination and enzymatic treatment of grains with phytase enzyme reduce the content of phytic acid in food products

Fermentation and germination improve nutritional value of cereals and legumes through activation of endogenous enzymesSmith G Nkhata 1

Trypsin inhibitors and phytates inherent in cereals and legumes reduce protein digestibility and mineral release respectively Fermentation and germination are commonly used to disrupt these interactions and make nutrients and phytochemicals free and accessible to digestive enzymes

Nutritional quality of roasted and pressure-cooked chickpea compared to raw (Cicer arietinum L) seedsIhsanullah Daur 1

Chickpea is nutritionally better in both roasted and pressure-cooked form and except methionine and phenylalanine it has sufficient amounts of all essential amino acids

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 20: Alternative Recipes for RUTF - UNICEF

Pre-requisites for new

formulations that meet the

Joint Statement

1 Meets interagency standards for quality 128505

2 Meet interagency specification requirements 128505

3 Facility that meets interagency requirements 128505

4 Must have le antinutrients compared to current peanut and cereal (BP100) RUTF versions 128505

5 Must have shelf life supported by stability studies 128505

6 Have acceptability study to demonstrate consumption is as per standard RUTF 128505

7 Product monitoring in the field 128505

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 21: Alternative Recipes for RUTF - UNICEF

Comply with Joint statement And QA

requirements (including anti-

nutrients)

Minimum 1 Non-inferiority efficacy RCT

Effectiveness trial in appropriate field

settings

Formula not used in programs yet

Similar ingredient used in MAM in similar

population

Qualitative Acceptability study for

SAM

(1) Study in MAM populations include

6-24 months

Comparison trial with cross-over design in community setting

Statistically valid sample size

(2) Study In SAM populations include 6-

24 months

Comparison trial with cross-over design in community setting

100-200 subjects per arm

No Yes

Yes

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 22: Alternative Recipes for RUTF - UNICEF

Outcomes of acceptability

study

1 Energy intake kilo body weight per feed measured

2 Overall acceptance from caretakers (including questions on adverse effects such as increase of diarrhea fluctuance rashvomiting associated with the consumption)

3 Record if any serious adverse effects (eg mortality) recorded and monitored

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 23: Alternative Recipes for RUTF - UNICEF

Pre-requisite for establishing contracts for renovation products

Phase 2 QA assessment

(anti-nutrients full CoA)

Commercial viability

Sustainability considerations

Program feedback on eligible products

Thank you

Page 24: Alternative Recipes for RUTF - UNICEF

Thank you