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The End Of Malnutrition?

Prince William did a little food sampling while in Copenhagen today—and it was a far cry from the mouth-watering appetizers served at his wedding back in April, which included Cornish Crab Salad on Lemon Blini, Roulade of Goat Cheese with Caramelized Walnuts, and Scottish Smoked Salmon Rose on Beetroot Blini. Today, William sampled a humbler food: a high-protein peanut paste used to alleviate extreme hunger. The paste, known as Plumpy’nut, can be administered at home and does not require added water, which makes some observers hopeful that it could be the silver bullet needed to end malnutrition. Indeed, a 2010 New York Times Magazine piece detailed the astonishing success of Plumpy’nut in treating people suffering from severe acute malnutrition—recovery rates, in some instances, exceeded 90 percent, and the food has been embraced by the UN and Doctors Without Borders. But is this silver bullet hope or just hype?

Public health and development experts seem to differ on the question. In 2010, four scholars published a skeptical take on ready-to-use therapeutic foods (RUTF) in World Nutrition. The scholars argue that while RUTF like Plumpy’nut have a place in treating severe acute cases of malnutrition, they must not be seen as a preventive step against the broader problem of hunger. Using RUTF in this way “distracts attention from rational and sustainable policies and programmes,” and may even produce unintended negative side effects. For one, since RUTF generally contain no water, they actually increase the need for additional water—creating the perverse result that “any child fed with RUTF has an increased risk of being infected by water-borne diseases.” The experts are also concerned that RUTF discourages breastfeeding, which they see as integral to any solution to long-term problems of hunger. Of course, they admit, Plumpy’nut has a role in addressing malnutrition—but it is “essential,” the scholars argue, that so-called miracle cures not be misused, or they could actually undermine public health efforts. Put simply: Don’t mistake these advances, however important, for a solution. When it comes to malnutrition, a cure-all remains elusive.