title: Peanut-based ready-to-use therapeutic food: how acceptable and tolerated is it among malnourished pregnant and lactating women in Bangladesh?
abstract: Within a Medecins Sans Frontieres's nutrition programme in Kamrangirchar slum, Dhaka, Bangladesh this study was conducted to assess the acceptability of a peanut-based ready-to-use therapeutic food (RUTF) - Plumpy'nut(®) (PPN) among malnourished pregnant and lactating women (PLW). This was a cross-sectional survey using semi-structure questionnaire that included all PLW admitted in the nutrition programme, who were either malnourished or at risk of malnutrition and who had received PPN for at least 4 weeks. A total of 248 women were interviewed of whom 99.6% were at risk of malnutrition. Overall, 212 (85%) perceived a therapeutic benefit. Despite this finding, 193 (78%) women found PPN unacceptable, of whom 12 (5%) completely rejected it after 4 weeks of intake. Reasons for unacceptability included undesirable taste (60%) and unwelcome smell (43%) - more than half of the latter was due to the peanut-based smell. Overall, 39% attributed side effects to PPN intake including nausea, vomiting, diarrhoea, abdominal distension and pain. Nearly 80% of women felt a need to improve PPN - 82% desiring a change in taste and 48% desiring a change in smell. Overall, only 146 (59%) understood the illustrated instructions on the package. Despite a perceived beneficial therapeutic effect, only two in 10 women found PPN acceptable for nutritional rehabilitation. We urge nutritional agencies and manufacturers to intensify their efforts towards developing more RUTF alternatives that have improved palatability and smell for adults and that have adequate therapeutic contents for treating malnourished PLW in Bangladesh.
authors: Medecins Sans Frontieres, Medical department (Operational research), Brussels Operational Centre, Luxembourg, Luxembourg.
authors: Engy
authors: E
authors: Ali
authors: Medecins Sans Frontieres, Medical department (Operational research), Brussels Operational Centre, Luxembourg, Luxembourg.
authors: Rony
authors: R
authors: Zachariah
authors: Medecins Sans Frontieres, Kamrangirchar, Dhaka, Bangladesh.
authors: Zubair
authors: Z
authors: Shams
authors: Medecins Sans Frontieres, Medical department (Operational research), Brussels Operational Centre, Luxembourg, Luxembourg.
authors: Marcel
authors: M
authors: Manzi
authors: Medecins Sans Frontieres, Kamrangirchar, Dhaka, Bangladesh.
authors: Tajmary
authors: T
authors: Akter
authors: Medecins Sans Frontieres, Brussels Operational Centre, Brussels, Belgium.
authors: Petra
authors: P
authors: Alders
authors: Medecins Sans Frontieres, Brussels Operational Centre, Brussels, Belgium.
authors: Malik
authors: M
authors: Allaouna
authors: Medecins Sans Frontieres, Brussels Operational Centre, Brussels, Belgium.
authors: Pascale
authors: P
authors: Delchevalerie
authors: Centre for Operational Research, International Union against Tuberculosis and Lung disease, Paris, France.|London School of Hygiene and Tropical Medicine, London, UK.
authors: Anthony D
authors: AD
authors: Harries
mesh_terms: D000293:Adolescent; D010367:Arachis; D001459:Bangladesh / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057140:Fast Foods / Q000706:statistics & numerical data*; D005260:Female; D005518:Food Preferences; D006801:Humans; D007774:Lactation; D044342:Malnutrition / Q000178:diet therapy* / Q000453:epidemiology; D009752:Nutritional Status; D009812:Odorants; D057240:Patient Preference; D011247:Pregnancy; D037841:Pregnant People; D011795:Surveys and Questionnaires; D013649:Taste; D055815:Young Adult
keywords: Bangladesh; Plumpy'nut; RUTF; acceptability; pregnant and lactating women
references: Food Nutr Bull. 2007 Dec;28(4):375-83
references: 18274163
references: Matern Child Nutr. 2011 Oct;7(4):344-56
references: 21496207
references: Lancet. 2008 Jan 19;371(9608):243-60
references: 18207566
references: BMC Public Health. 2008 Jul 18;8:244
references: 18638377
references: Patient Prefer Adherence. 2009 Nov 03;3:67-75
references: 19936147
references: Matern Child Nutr. 2015 Oct;11(4):1028-35
references: 23647821
references: Food Nutr Bull. 2008 Mar;29(1):67-75
references: 18510207
references: Public Health Nutr. 2012 Feb;15(2):316-23
references: 21294939
references: J Pediatr Gastroenterol Nutr. 2004 Aug;39(2):141-6
references: 15269617