Therapeutic Food: Basics and Current Issue

Ready-to-use therapeutic food (RUTF) is a packaged paste nutritious food items like peanuts, oil, sugar, vitamins, mineral supplements etc. In addition to these ingredients, RUTF contains nuts, sweeteners and grains for improving the taste. RUTF is also known as energy dense nutritious food (EDNF).

Intake of RUTF is a type of medical intervention which is expected to improve the nutrition levels of children suffering from Severe Acute Malnutrition (SAM). RUTF provides 520-550 kilocalories of energy per 100g. RUTF is generally administered to children between 6 months to 6 years. Each child is permitted to intake three packets of RUTF daily for a month.

What is the stand of Indian government over using RUTF?

The Union Ministry of Women and Child Development (WCD) has asked the states and Union Territories not to use RUTF for managing malnutrition as it is not an accepted policy of the Indian government. According to Union Health Minister JP Nadda’s letter to a think tank named Nutrition Advocacy in Public Interest (NAPI), SAM alliance constituted under the Department of Biotechnology, Indian Council of Medical Research (ICMR) and the Union Health Ministry to assess the benefits of RUTF has discovered that RUTF was only temporarily helpful in nutritional rehabilitation.

Earlier in 2009 also, the union health ministry had stated that the use of RUTF is not an acceptable policy of the Indian government. In 2013, the union government had asked Jharkhand to stop administering RUTF to children. Similarly, after the recent WCD ministry’s notification, the Maharashtra government has halted the usage of RUTF and has asked the union government to reconsider its decision on RUTF.

Debate over the use of RUTF in India

The usage of therapeutic food has long been a subject of debate.

Arguments favouring intake of RUTF

• According to the Global Hunger Index report 2017, India has been placed at 100^th place in a list of 119 countries. In addition, the National Family Health Survey-4 (NFHS-4) has found out that in India around 35.7% children less than 5 years of age are underweight and around 38.4% are stunted.
• The usage of RUTF is common in Africa, where the number of children with malnutrition is high. India also has a huge population of children with malnutrition. According to The Lancet, malnourished children possess a 9 times higher risk of death when compared with normal children.
• The United Nations Children’s Fund (UNICEF), in its 2013 report has observed that the usage of RUTF is safe and can save the lives of thousands of children.
• The UNICEF is taking efforts to reduce the cost of RUTF by increasing the supplier base.

Arguments against RUTF intake

• India is a country with varying food habits and high incidence of malnutrition. Intake of RUTF may replace nutritional best practices and family foods. This would negatively impact the traditional eating habits of the children and continued breastfeeding in children older than 6 months. Hence, it is argued that RUTF may not help a common household in developing appropriate food habits for children.
• RUTF is expensive. Since over a third of all children aged under 5 years in India suffers from malnutrition, it will impose a huge financial burden on the government’s exchequer.
• As per the study conducted by Janarth Adivasi Vikas Sanstha in Nandurbar district of Maharashtra, it was found that once intake of RUTF is halted, children tend to slip back into malnutrition. So, the health activists argue that the intake of RUTF cannot be a permanent solution to treat malnourished children. There is also a point of view that argues that the children should not be driven away from hot cooked meals. It is feared that children will stop consuming home cooked meals.

Alternatives to RUTF in India

Government should move towards a more holistic solution that includes promotion of breastfeeding, ensuring proper functioning of anganwadis and promotion of family planning so as to ensure that low birth weight babies are not born. Similarly, adequate attention has to be placed on hygiene and sanitation. The union health ministry has already started to work in this direction. It has begun to develop guidelines and toolkits for the frontline workers to give counselling to families on nutrition and feeding practices.

Suggested Question for GS Mains

What do you understand by the term “Therapeutic food”? How safe, cost-effective and efficacious is the use of Therapeutic food in India? Discuss in the light of recent decisions taken by the Ministry of Women and Child Development in this regard.