The Nutrition Potential of Food Aid

The Nutrition Potential of Food Aid photo by Todd Post

New food aid products are improving the health of those suffering from both moderate and severe levels of malnutrition. Probably the best known is Plumpy’nut, developed by the French company Nutriset. Plumpy’nut has garnered a great deal of attention in the mainstream media; it’s sometimes called a “miracle drug” for its ability to bring children wasted from malnutrition back from the brink of death. A recent study in Niger showed that feeding Plumpy’nut to severely malnourished children under age 2 was associated with a reduction in mortality of roughly 50 percent.¹

Plumpy’nut and products like it are known as lipid-based nutritional supplements (LNS). Lipids are fats—key ingredients in food aid since they promote rapid weight gain, which is precisely what malnourished children need.  LNS can also treat adults with chronic malnutrition, HIV/AIDS, and/or long-term illnesses. LNS products have revolutionized the use of ready-to-use supplemental and therapeutic foods in treating malnutrition. LNS are normally available in the form of a spreadable paste and can be made from legumes (peas, lentils), peanuts, chickpeas, sesame seeds, maize, and/or soybeans.

LNS can also be manufactured with simple technology available in developing countries. Dr. André Briend, the French pediatrician who invented Plumpy’nut, demonstrated by whipping up batches in a home blender.² There are still some quality and safety concerns about local production, mainly related to preventing bacterial contamination. For example, in-country testing must be done to ensure that the foods can be produced without being contaminated by aflatoxin, which can come from mold growth on peanuts and corn—particularly because exposure to aflatoxin causes malnutrition and suppresses the immune system.³ But where solutions to such risks have been developed, local production and distribution of LNS can cut costs significantly.

Another group of nutritional supplements that show promise in treating moderate and severe malnutrition is micronutrient powders, which can be formulated to address specific micronutrient deficiencies and can be added as a complement to home meals or to other types of food aid to boost nutritional content. The World Food Program has successfully introduced micronutrient powders in South Asia but noted that packaging and labeling must make it clear that, for example, a supplement is for pregnant women or for babies and toddlers.⁴ These supplements are low-cost and, as with lipid-based products, they can be produced locally.

The cost of different types of food aid varies widely. In 2011, the GAO determined the cost ranges of one day’s worth or one dose of a product to be: grain-based food aid, 2-5 cents; micronutrient powders, 3-4 cents; corn-soy blend, 6-24 cents; and lipid-based, 12-41 cents.⁵ Clearly, the cost determines the number of people who can be assisted for a given amount of money.

U.S. food aid fills many empty bellies, but it hasn’t made nutrition the priority it should be. Policymakers should identify and implement the most effective and rapid ways to change the situation. One starting point: a review of the quality of U.S. food aid by researchers from Tufts University, commissioned by USAID, outlined ways to enhance its quality and effectiveness. The Tufts review affirmed the importance of nutrition during the 1,000-day window of opportunity between pregnancy and age two; identified how food aid can improve nutritional outcomes in older infants, young children, and pregnant and lactating women;⁶ and recommended reformulating food aid products to take advantage of developments in nutrition science.

These new developments are, in fact, fueling discussions at both the policy and program levels about improving the quality of food aid.⁷ Additional studies are needed to assess the effectiveness of new food aid products in actual field settings. In the absence of a substantive body of evidence on nutrition outcomes, cost considerations are likely to carry disproportionate weight. But it’s quite clear that the nutritional quality of U.S. food aid can be improved by fortifying and targeting various types of foods and by including a wider range of foods.

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