TOPNUTRI. for complete food fortification. What is TopNutri Why use TopNutri How to use TopNutri TopNutri in the field

Transcription

1 TOPNUTRI What is Why use How to use in the field

2 What is is a sprinkle developed by Compact AS for local food fortification in families, communities and institutions. Product description is a sprinkle product containing soy protein concentrate and highly bioavailable vitamins and macro- and microminerals. is easily mixed with local food, especially with cereal based porridges, and does not alter its appearance or taste, when used in recommended doses. The use of will secure the Daily Recommended Intake (DRI) of all essential vitamins and minerals, and improve the food s protein quantity and quality. is designed to prevent and treat micronutrient deficiencies and promote adequate tissue building, while respecting food habits and culture. is not a luxury, it assures the basic supply of nutrients needed for normal body functions. Logistics Compact AS guarantees a 2 years shelf life of TopNuri, with a possible minor decrease in some vitamin contents. is available in 3 package sizes, keeping it adapted to your objective: packaging Fortification program / Target 1 kg Bag in Box Institutional / Large scale 52,5 g Sachets Community / Family 7,5 g Sachets Home / Individual Child The aluminium-foil sachets are easy to distribute and simple to use. They are the ideal tool to encourage self-sufficiency through community-based food fortification. 1

3 Why use A complete range of essential micronutrients Micronutrient deficiencies are the consequence of inadequate diets, for example based exclusively on one cereal. This type of diet fails to provide the required amounts of a range of nutrients. Thus a deficiency rarely occurs alone, and malnourished persons are likely to suffer from multiple-micronutrient deficiencies. These deficiencies are difficult to assess due to individual variations, and because very often one deficiency predominates, making other deficiencies harder to detect. As a consequence, most of the fortified foods distributed by aid agencies (of the type Corn-Soy Blend) only provide some of the required micronutrients, leaving other deficiencies untreated. is able to mend those multiple deficiencies by providing sufficient amounts of the entire spectrum of essential micronutrients. Proteins : The big difference Most micronutrients do not actually take part in the body s chemical reactions. Their role is merely to activate enzymes, which will then catalyse specific reactions. So providing micronutrients will certainly restore the efficiency of the tissue-building reactions but will not provide the elements needed to build tissue. In the case of protein synthesis, which is the basis for body tissue building, essentials aminoacids are required in specific proportions. Most cereal-based diets only provide proteins with an unbalanced amino acid pattern, containing a disproportionately low amount in one or several amino acids. Because it contains high quality proteins, is able to re-establish the amino acid balance in the local food. This ensures the optimal use of the provided micronutrients and proteins in tissue building and growth. Facts on haemoglobin synthesis Vitamins and minerals in Heme Synthesis Vitamin B2 Vitamin B6 Pantothenate Iron Copper Zinc Essentials amino-acids in the Haemoglobin proteins 12,6% 1,8% 7,7% Histidine 6,6% 5,6% Phenylalanine 4,9% Methionine 1,4% Tryptophan 1,% 2

4 and Vitamins DRI values for a 1-3 years old child*. Wheat Flour (g) Wheat Flour (g) + (7,5g) Wheat Flour 2 2 Maize Flour (g) Maize Flour (g) + (7,5g) Maize Flour 2 2 Rice Flour (g) Rice Flour (g) + (7,5g) Rice Flour * From The DRI reports U.S. National Academy of Sciences

5 and Minerals DRI values for a 1-3 years old child*. Wheat Flour (g) Wheat Flour (g) + (7,5g) Wheat Flour Maize Flour (g) Maize Flour (g) + (7,5g) Maize Flour Rice Flour (g) Rice Flour (g) + (7,5g) Rice Flour * From The DRI reports U.S. National Academy of Sciences. 4

6 and Proteins The Concept of Amino Acid Balance: 1) Tissue protein synthesis will be limited unless all amino acids are present together in appropriate relative amounts. 2) This implies that essentials amino acids must be supplied through the food in amounts that match the proportions needed in protein synthesis. 3) The food s essential amino acid which amount is further from matching the required proportion is called the limiting amino acid. 4) The proportion of the food s amino acids that will be used for tissue protein synthesis will then be limited to the proportion of the limiting amino acid. The effect of : A food product with an ideal amino acid balance would have an amino acid composition that, after digestion, matches exactly the proportions needed in protein synthesis. This would ensure that % of its amino acids would be used in tissue protein synthesis. Unfortunately most cereal based diets have an unbalanced amino acid composition, strongly limiting the use of the dietary amino acids in tissue protein synthesis. is able to improve the amino acid balance of cereal based diets, ensuring that a significantly higher proportion of the dietary amino acids is used in tissue protein synthesis. 5

7 and Proteins Examples of the effect of on the amino acid balance of 3 different flours. Protein Digestibility Corrected Amino Acid Scores for a ½ -1 year old child*. 1 Rice 1 Rice + Methionine (+ Cyst) Methionine (+ Cyst) 1 Wheat 1 Wheat + Methionine (+ Cyst) Methionine (+ Cyst) 1 Maize 1 Maize + Methionine (+ Cyst) Methionine (+ Cyst) * Joint FAO/WHO/UNU Expert Consultation on Energy & Protein Requirements. WHO Tech. Rep. Ser. No. 724 (1985) 6

8 How to use Target groups and Dosage is suitable for children from 6 months of age, with no upper age limit. It can be used for any category of people with one-sided diets to prevent or treat micronutrient deficiencies and promote normal growth. It is particularly recommended for children and pregnant or lactating women. Recommended Dosage : Children (½ to 8 years) Older Children (8 years and plus) Adults Family (2 Adults, 3 children) Quantity per Day 7,5 g (1 little spoonful) 11,5 g (1,5 small spoonful) 15 g (2 small spoonful) 52,5 g (1 Sachet) Sachets per week 1 1,5 2 7 Preparation is not intended to be eaten on its own and contains salt to discourage direct use. is easy to prepare: just mix with the food after cooking. can be added to cereal porridges, family pot type of food, soups and other dishes where the product can be evenly distributed. None of the ingredients in needs cooking prior to consumption. Remember to control how much of the food is actually eaten. 7

9 in the field Mongolia Study by the School of Public Health in collaboration with the Health Science University of Mongolia and ACF-Mongolia s International Network. Title: Influence of on the Nutritional status of Stunted Children months old. (Thesis for Master Degree of Public Health) Time period: 7 Location: Ulaanbaatar, Mongolia Target: 152 children with moderate and severe stunting, in 4 family clinics This study was designed as a clinical test. The children were separated in two groups (target and control) with similar age repartition, life conditions and stunting status. The improvement of stunting condition was 1,95 times higher for children who received than peer children who did not receive this supplement. The improvement of underweight condition was 2,14 times higher for children who received than peer children in the control group. can be an acceptable product for young children in Mongolia: 94,7% of children provided with had not encountered any difficulties to use it according to recommendations; and 97,4% of the target group children did not experience any side effect. Afghanistan Study by Action Contre la Faim Title: A study of the acceptability of protein, mineral and vitamin concentrate Time period: Spring 5 Location: Dasht-e-Barchi, Kabul, Afghanistan Target: 1 families for 14 days Some families reported minor changes to food, concerning either colour, texture, smell or taste. But these changes did not prevent them from consuming. is therefore considered an acceptable product for the supplementation of foods with protein and micronutrients within this sample of Hazara population in Dasht-e-Barchi in Kabul city. 8

10 Ethiopia in the field Study by MSF-Holland Title: Supplement diet for the chronically ill Time period: February April 5 Location: Humera, Ethiopia Target: Malnourished patients suffering from HIV, KA and TB received a hospital diet enriched with Topnutri There was a significant increase of the number of discharged patients who ate food fortified with. The study concludes that the fortification with is beneficial and that the possibility to use local diets for the treatment of severe malnutrition in chronically ill patients gives better results than milk-based treatments. Zambia Study by Médecins sans Frontières Title: Feasibility and acceptability of food supplementation with for PLWHA Time period: 1 Location: Nchelenge, zambia Target: 31 persons were supplied for a month The overall acceptability was good, provided that Topnutri was used in the recommended amounts. An average of 93% judged its organoleptic qualities from good to acceptable. Myanmar will be part of a new project entitled A double blind Efficacy Trial of Multiple Micronutrient Sprinckles with and without protein supplementation in Myanmar to investigate the effectiveness, acceptability and feasibility of as an intervention strategy to reduce anaemia and improve growth among children in Myanmar 9