Systematic review evaluating locally sourced food resources alternatives to standard milk-based ready-to-use therapeutic food
Paper Details
Systematic review evaluating locally sourced food resources alternatives to standard milk-based ready-to-use therapeutic food
Abstract
Severe acute malnutrition (SAM) remains a leading cause of illness and death among children aged 6–59 months in developing countries. Although community-based management of acute malnutrition has expanded treatment through ready-to-use therapeutic foods (RUTF), standard milk-based formulations rely heavily on imported ingredients, raising concerns about cost, sustainability, and supply-chain insecurity. This systematic review evaluated locally sourced alternatives to standard milk-based RUTF, focusing on low-milk and milk-free products for uncomplicated SAM. Following PRISMA guidance, the review searched Scopus, Web of Science and PubMed for peer-reviewed studies published between 1999 and 2025. Search terms were structured using a PECO framework covering children with SAM, alternative RUTF formulations, standard RUTF comparators, nutritional composition and treatment performance. Forty-eight studies met the inclusion criteria. Data were extracted on study setting, ingredients, protein, lipid, vitamin A, mineral composition, weight gain velocity, and recovery rate. Most RUTF initiatives were reported in Sub-Saharan Africa, South and Southeast Asia, and the Middle East. Three product categories were identified: standard RUTF, low-milk RUTF, and fully milk-free RUTF. As milk content decreased, legumes and other non-dairy protein sources became more prominent. However, many alternative formulations showed nutritional gaps, particularly in iron, zinc, calcium, and potassium. Weight gain velocity ranged from -0.2 to 5.7 g/kg/day, and no alternative formulation consistently met the minimum target of 5 g/kg/day. Nevertheless, 66.7% achieved recovery rates above 75%. Locally sourced alternatives are promising, but require further optimization to improve nutrient adequacy, growth outcomes and resilience to dependence on imported milk supplies globally.
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Folachodé Ulrich Gildas Akogou*, Janvier Mêlégnonfan Kindossi, Dona Gildas Hippolyte Anihouvi, Gamèli Justin Gandeho, Carole Nadia Adjouavi Sossa – Vihotogbé, Franck Hongbété, Polycarpe Kayodé, 2026. Systematic review evaluating locally sourced food resources alternatives to standard milk-based ready-to-use therapeutic food. Int. J. Biosci., 29(1), 138-148.
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