Plumpy'nut

Plumpy'nut is a peanut-based paste in a plastic wrapper for treatment of severe acute malnutrition manufactured by a French company, Nutriset. Removing the need for hospitalization, the 92 gram packets of this paste can be administered at home and allow larger numbers to be treated.

Plumpy'nut may be referred to in scientific literature as a ready-to-use therapeutic food (RUTF) alongside other RUTFs such as BP-100, a solid form of therapeutic milk.

Usage
Plumpy’nut has a two-year shelf-life and requires no water, preparation, or refrigeration. Its ease of use has made mass treatment of malnutrition in famine situations more efficient than in the past. Severe acute malnutrition has traditionally been treated with therapeutic milk and required hospitalization. Unlike milk, Plumpy'nut can be administered at home and without medical supervision. The United Nations has recognized this utility, stating in 2007 that "new evidence suggests... that large numbers of children with severe acute malnutrition can be treated in their communities without being admitted to a health facility or a therapeutic feeding centre." Plumpy'nut conforms to the UN definition of a Ready-to-Use Therapeutic Food (RUTF).

Peanut allergies have not been found to be a problem in usage due to a lack of allergic reactions in the target populations.

Composition
The ingredients in Plumpy'nut include "peanut-based paste, with sugar, vegetable fat and skimmed milk powder, enriched with vitamins and minerals". Plumpy'nut is said to be "surprisingly tasty".

Local production
While the majority of Plumpy'nut was made in France as of 2010, this therapeutic food is easily produced and can be made locally in peanut-growing areas by mixing peanut paste with a slurry of other ingredients provisioned by Nutriset.

A number of partner companies and one non-profit organization make Plumpy'nut locally; most are in Africa. (There are 10 partners as of 2011 and 12 as of 2013. )

How it works
Plumpy’nut is frequently used as a treatment for emergency malnutrition cases. It supports rapid weight gain, which can make the difference between life and death for a young child. The product is also easy for children to eat since they can feed themselves the soft paste. The fortified peanut butter-like paste contains a balance of fats, carbohydrates and proteins (macronutrients), and vitamins and minerals (micronutrients). Peanuts contain easily-digested monounsaturated fats. They are also relatively high in calories, which means that a patient receives a lot of nutrition from small amounts, important because malnutrition shrinks the stomach. They are rich in zinc and protein — both supportive for the immune system and long bone growth in reversing stunted height, while protein also contributes to muscle development. Peanuts are also an excellent source of vitamin E, an essential nutrient.

Cost
A two month Plumpy'nut regimen for a child costs $60 in 2010.

History
Inspired by the popular Nutella spread, Plumpy'nut was formulated by André Briend, a French paediatric nutritionist, and Michel Lescanne, a food-processing engineer, in 1996.

Patent issues
Nutriset holds (published in 2002) for the production of nut-based, nutritional foods as pastes, which they have defended to prevent non-licensees in developed countries from producing any similar products.

Some seek invalidation of Nutriset's patent. In 2010, two non-profit organizations based in the US, a country with a large number of peanut producers, sued the French company in an attempt to remove Plumpy'nut patent protections.

Others have criticized Nutriset's licensing regime. Médecins Sans Frontières (Doctors Without Borders) wrote an open letter to Nutriset in November 2009 "call[ing] for the establishment of a more flexible licensing policy". Nutriset has responded to the criticism; in many African countries, companies and NGOs are free to make the patented paste and need not pay any license fees.