Upload
duongkiet
View
251
Download
0
Embed Size (px)
Citation preview
RUSF & LNS-MQHarmonized Specifications
Copenhagen, 1 July 2015 Saskia de Pee
RUSF & LNS-MQ Harmonisation Objectives
• Improve sourcing of products and programming among agencies and suppliers, through harmonisation of product specifications and packaging
• Increase flexibility to respond to supply chain issues (emergencies)
• Support local production through– Using the same premix for RUSF and LNS-MQ
– Having one premix for different raw materials, e.g. peanut vs chickpea vs rice/lentil recipes
– Defining the premix
RUSF & LNS-MQ: Nutrient content aims
• Same nutrient density for RUSF & LNS-MQ (nutrient/1000 kcal or nutrients/100 g)
• Comply with nutrient targets of WHO technical note for MAM foods
• Provide approx 1 RNI in 50 g, for complementing diet of children at-risk of acute malnutrition
• Take RUTF composition targets into consideration as well
• Nutrients without max in RUTF & RUSF and no UL, aim to meet highest minimum target (LNS-MQ / RUTF / RUSF)
RUSF & LNS-MQ: Same composition
• 100g sachet in line with WHO MAM-food targets
• 50 g to provide a good contribution to daily requirement of essential nutrients
At or above RNI for normal healthy individuals for all vitamins, Iron, Zinc, Magnesium and Copper;
Half of RNI for
– Calcium: max = max of WHO MAM food
– Phosphorus: max = max of WHO MAM food
– Manganese: max = max of WHO MAM food
– Iodine: min = min of MAM food; max = RUTF ; note the use of iodized salt in diet also provides iodine
– Selenium: min & max from RUTF
– Potassium: No RNI, just DRI, 64% for 7-12 mo, 15% for 1-3 y, wide range & taste impact
RUSF & LNS-MQ: Different use = Different, harmonized, packaging
LNS-MQ: lipid-based nutrient supplement - medium quantity
for children 6 months and above at risk of acute malnutrition
50g sachets
Colour: Pantone 109
RUSF: ready-to-use supplementary food
for children 6 months and above with moderate acute malnutrition
100g sachets
Colour: Pantone 151
Cost and transition period
• Packaging size and dairy protein are driving cost, depending on supplier: – RUSF cost is expected to increase by 0 to 200$/MT– LNS MQ cost is expected to decrease by 0 to 400$/MT,
including the extra cost of the 50 g sachets (which is expected to be 0 to 100$/MT compared to RUSF)
• 4 months transition period– To give suppliers time to
• Update formula and packaging• Consume existing stock of premix and packaging material
– To give programme time to• Liaise with counterparts• Inform staff at all levels of programs
Harmonized RUSF & LNS-MQ, almost extendable to RUTF
Note: WHO min & max in joint statement for RUTF and technical note for MAM foods are targets for nutrient intake from these foods, they are not min and max for product specs
• WHO MAM foods technical note fatty acid specs, extendable to RUTF:
– Omega 3: 0.3-1.8 g/100 g
– Omega 6: 2.6-6.1 g/100 g
• Vitamin A, set below min for RUSF, as concurrent vitamin A intake was not taken into account when WHO set requirement for MAM foods, and RUTF target is lower
• Protein content min higher for RUTF than for RUSF (25 vs 20 g/1000 kcal)
– RUTF: 20% milk powder (50% protein from dairy source)
– RUSF: 10% milk powder (33% protein from dairy)
– Higher milk content provides more K, Ca, P
• RUTF has requirement for non-metabolisable base, for which content of Na, K, Ca, Mg, Cl, P need to be taken into account. This determines sources and amounts for Ca, P, K
– For RUSF/LNS-MQ, 900 (800-1400) mg K/100 g, with 50% K from potassium chloride and 50% from potassium citrate. This should be ok for taste impact in combination with 10% milk powder.
– For RUTF, min target 1100 mg K/100 g, most current formulations have 100% from KCl, which is ok with 20% milk powder
Nutrient content targets - 1
WHO target: Intake by consumer
Variation related to: Recipe variationVariation raw material nutrient contentPremix nutrient contribution ±10%Moment of consumption: T0 vs close to BBD (losses over time)
Label: Expected minimum intake (except for Vit A and potassium – as lowest is far from expected average)Min: Lowest level, at BBD, incl min from raw material, premix – 10%, expected losses over timeMax: Highest level, at T0, incl max from raw material, premix + 10%
Nutrient content targets - 2
Label: Expected minimum intake (except for Vit A and potassium – as lowest is far from expected average)T0 min: Lowest level at T0: min from raw material, premix – 10%T0 max: Highest level at T0: max from raw material, premix + 10%
RUSF: Different recipes, variation due to raw material and premix ± 10%RUTF: One recipe, variation due to premix ±10%
RUTF & RUSF – WHO intake targetsLNS-MQ: 1 DRI/50 g, max=UL
Set premix - vitamins!
3!/!9!
!
Table 1: Premix contribution and premix nutrient sources (approximate incorporation rate:
3.4%)
Nutrients Unit Recommended nutrient sources
(/alternative options)
Nutrient
added per
100g LNS
+/-10%
Retinol (Vit A)1 mcg
Dry Vitamin A Palmitate
/ Dry Vitamin A Acetate 1050
2
Thiamin (Vit B1) mg Thiamine mononitrate
/ Thiamine hydrochloride 1.5
Riboflavin (Vit B2) mg Riboflavin 2.6
Niacin (Vit B3) mg Niacinamide 16
Pantothenic Acid (Vit B5) mg Calcium d-Pantothenate 4.9
Pyridoxine (Vit B6) mg Pyridoxine hydrochloride 2.2
Biotin (Vit B7) mcg Biotin (1% trituration) 65
Folic acid (Vit B9) mcg Folic acid food grade 3003
Cobalamine (Vit B12) mcg Vitamin B12 (0.1 sd) 2.9
Ascorbate (Vit C) mg Ascorbic acid fine powder 90
Cholecalciferiol (Vit D) mcg Dry Vitamin D3 (sd) 18
Dl-α tocopherol acetate (Vit
E) mg
Dry Vitamin E acetate
(50% dl-α tocopherol acetate)) 20
Phytomenadione (Vit K) mcg Dry Vitamin K (5%) 27
Calcium (Ca) mg Di-Calcium Phosphate anhydrous
/ tricalcium phosphate 413
4
Copper (Cu) mg Copper sulphate anhydrous / copper
gluconate 1.2
Iodine (I) mcg Potassium iodide (10% trituration) 110
Iron (Fe) mg
2.5 mg from NaFeEDTA + 7.5 mg,
which can be from Ferrous sulphate
monohydrate, dried / ferrous sulphate /
ferrous fumarate, encapsulated or not
10
Magnesium (Mg) mg Magnesium sulphate monohydrate
/ magnesium citrate or gluconate 100
Manganese (Mn) mg Manganese sulphate monohydrate 1.0
Phosphorus (P) mg Di-Calcium Phosphate anhydrous
/ tricalcium phosphate 319
5
Potassium (K) mg 350 mg potassium chloride
+ 500 mg tri potassium citrate 350
Selenium (Se) mcg Sodium selenite
/ sodium selenate 15
Zinc (Zn) mg Zinc sulphate 11
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1 Beadlet or spray dried form can be used assuming there is no carryover of antioxidants not approved in Codex.
2 This is the recommended amount if there are no process losses. If process losses have been demonstrated by a
study, appropriate over dosage should be applied to ensure that analytical targets are reached 3 This is equivalent to 500 mcg Dietary Folates Equivalent
4 This is equivalent to a total of 1.4% Di-calcium phosphate: In final product Ca/P ratio should be 1-1.5, where
30% of P from plant sources and 100% from animal sources can be included in the estimate 5 This is equivalent to a total of 1.4% Di-calcium phosphate: In final product Ca/P ratio should be 1-1.5, where
30% of P from plant sources and 100% from animal sources can be included in the estimate
!
3!/!9!
!
Table 1: Premix contribution and premix nutrient sources (approximate incorporation rate:
3.4%)
Nutrients Unit Recommended nutrient sources
(/alternative options)
Nutrient
added per
100g LNS
+/-10%
Retinol (Vit A)1 mcg
Dry Vitamin A Palmitate
/ Dry Vitamin A Acetate 1050
2
Thiamin (Vit B1) mg Thiamine mononitrate
/ Thiamine hydrochloride 1.5
Riboflavin (Vit B2) mg Riboflavin 2.6
Niacin (Vit B3) mg Niacinamide 16
Pantothenic Acid (Vit B5) mg Calcium d-Pantothenate 4.9
Pyridoxine (Vit B6) mg Pyridoxine hydrochloride 2.2
Biotin (Vit B7) mcg Biotin (1% trituration) 65
Folic acid (Vit B9) mcg Folic acid food grade 3003
Cobalamine (Vit B12) mcg Vitamin B12 (0.1 sd) 2.9
Ascorbate (Vit C) mg Ascorbic acid fine powder 90
Cholecalciferiol (Vit D) mcg Dry Vitamin D3 (sd) 18
Dl-α tocopherol acetate (Vit
E) mg
Dry Vitamin E acetate
(50% dl-α tocopherol acetate)) 20
Phytomenadione (Vit K) mcg Dry Vitamin K (5%) 27
Calcium (Ca) mg Di-Calcium Phosphate anhydrous
/ tricalcium phosphate 413
4
Copper (Cu) mg Copper sulphate anhydrous / copper
gluconate 1.2
Iodine (I) mcg Potassium iodide (10% trituration) 110
Iron (Fe) mg
2.5 mg from NaFeEDTA + 7.5 mg,
which can be from Ferrous sulphate
monohydrate, dried / ferrous sulphate /
ferrous fumarate, encapsulated or not
10
Magnesium (Mg) mg Magnesium sulphate monohydrate
/ magnesium citrate or gluconate 100
Manganese (Mn) mg Manganese sulphate monohydrate 1.0
Phosphorus (P) mg Di-Calcium Phosphate anhydrous
/ tricalcium phosphate 319
5
Potassium (K) mg 350 mg potassium chloride
+ 500 mg tri potassium citrate 350
Selenium (Se) mcg Sodium selenite
/ sodium selenate 15
Zinc (Zn) mg Zinc sulphate 11
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1 Beadlet or spray dried form can be used assuming there is no carryover of antioxidants not approved in Codex.
2 This is the recommended amount if there are no process losses. If process losses have been demonstrated by a
study, appropriate over dosage should be applied to ensure that analytical targets are reached 3 This is equivalent to 500 mcg Dietary Folates Equivalent
4 This is equivalent to a total of 1.4% Di-calcium phosphate: In final product Ca/P ratio should be 1-1.5, where
30% of P from plant sources and 100% from animal sources can be included in the estimate 5 This is equivalent to a total of 1.4% Di-calcium phosphate: In final product Ca/P ratio should be 1-1.5, where
30% of P from plant sources and 100% from animal sources can be included in the estimate
Set premix - minerals
!
3!/!9!
!
Table 1: Premix contribution and premix nutrient sources (approximate incorporation rate:
3.4%)
Nutrients Unit Recommended nutrient sources
(/alternative options)
Nutrient
added per
100g LNS
+/-10%
Retinol (Vit A)1 mcg
Dry Vitamin A Palmitate
/ Dry Vitamin A Acetate 1050
2
Thiamin (Vit B1) mg Thiamine mononitrate / Thiamine hydrochloride
1.5
Riboflavin (Vit B2) mg Riboflavin 2.6
Niacin (Vit B3) mg Niacinamide 16
Pantothenic Acid (Vit B5) mg Calcium d-Pantothenate 4.9
Pyridoxine (Vit B6) mg Pyridoxine hydrochloride 2.2
Biotin (Vit B7) mcg Biotin (1% trituration) 65
Folic acid (Vit B9) mcg Folic acid food grade 3003
Cobalamine (Vit B12) mcg Vitamin B12 (0.1 sd) 2.9
Ascorbate (Vit C) mg Ascorbic acid fine powder 90
Cholecalciferiol (Vit D) mcg Dry Vitamin D3 (sd) 18
Dl-α tocopherol acetate (Vit
E) mg
Dry Vitamin E acetate
(50% dl-α tocopherol acetate)) 20
Phytomenadione (Vit K) mcg Dry Vitamin K (5%) 27
Calcium (Ca) mg Di-Calcium Phosphate anhydrous / tricalcium phosphate
4134
Copper (Cu) mg Copper sulphate anhydrous / copper
gluconate 1.2
Iodine (I) mcg Potassium iodide (10% trituration) 110
Iron (Fe) mg
2.5 mg from NaFeEDTA + 7.5 mg,
which can be from Ferrous sulphate
monohydrate, dried / ferrous sulphate /
ferrous fumarate, encapsulated or not
10
Magnesium (Mg) mg Magnesium sulphate monohydrate / magnesium citrate or gluconate
100
Manganese (Mn) mg Manganese sulphate monohydrate 1.0
Phosphorus (P) mg Di-Calcium Phosphate anhydrous
/ tricalcium phosphate 319
5
Potassium (K) mg 350 mg potassium chloride
+ 500 mg tri potassium citrate 350
Selenium (Se) mcg Sodium selenite / sodium selenate
15
Zinc (Zn) mg Zinc sulphate 11
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1 Beadlet or spray dried form can be used assuming there is no carryover of antioxidants not approved in Codex.
2 This is the recommended amount if there are no process losses. If process losses have been demonstrated by a
study, appropriate over dosage should be applied to ensure that analytical targets are reached 3 This is equivalent to 500 mcg Dietary Folates Equivalent
4 This is equivalent to a total of 1.4% Di-calcium phosphate: In final product Ca/P ratio should be 1-1.5, where
30% of P from plant sources and 100% from animal sources can be included in the estimate 5 This is equivalent to a total of 1.4% Di-calcium phosphate: In final product Ca/P ratio should be 1-1.5, where
30% of P from plant sources and 100% from animal sources can be included in the estimate
!
3!/!9!
!
Table 1: Premix contribution and premix nutrient sources (approximate incorporation rate:
3.4%)
Nutrients Unit Recommended nutrient sources
(/alternative options)
Nutrient
added per
100g LNS
+/-10%
Retinol (Vit A)1 mcg
Dry Vitamin A Palmitate
/ Dry Vitamin A Acetate 1050
2
Thiamin (Vit B1) mg Thiamine mononitrate
/ Thiamine hydrochloride 1.5
Riboflavin (Vit B2) mg Riboflavin 2.6
Niacin (Vit B3) mg Niacinamide 16
Pantothenic Acid (Vit B5) mg Calcium d-Pantothenate 4.9
Pyridoxine (Vit B6) mg Pyridoxine hydrochloride 2.2
Biotin (Vit B7) mcg Biotin (1% trituration) 65
Folic acid (Vit B9) mcg Folic acid food grade 3003
Cobalamine (Vit B12) mcg Vitamin B12 (0.1 sd) 2.9
Ascorbate (Vit C) mg Ascorbic acid fine powder 90
Cholecalciferiol (Vit D) mcg Dry Vitamin D3 (sd) 18
Dl-α tocopherol acetate (Vit
E) mg
Dry Vitamin E acetate
(50% dl-α tocopherol acetate)) 20
Phytomenadione (Vit K) mcg Dry Vitamin K (5%) 27
Calcium (Ca) mg Di-Calcium Phosphate anhydrous
/ tricalcium phosphate 413
4
Copper (Cu) mg Copper sulphate anhydrous / copper
gluconate 1.2
Iodine (I) mcg Potassium iodide (10% trituration) 110
Iron (Fe) mg
2.5 mg from NaFeEDTA + 7.5 mg,
which can be from Ferrous sulphate
monohydrate, dried / ferrous sulphate /
ferrous fumarate, encapsulated or not
10
Magnesium (Mg) mg Magnesium sulphate monohydrate
/ magnesium citrate or gluconate 100
Manganese (Mn) mg Manganese sulphate monohydrate 1.0
Phosphorus (P) mg Di-Calcium Phosphate anhydrous
/ tricalcium phosphate 319
5
Potassium (K) mg 350 mg potassium chloride
+ 500 mg tri potassium citrate 350
Selenium (Se) mcg Sodium selenite
/ sodium selenate 15
Zinc (Zn) mg Zinc sulphate 11
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1 Beadlet or spray dried form can be used assuming there is no carryover of antioxidants not approved in Codex.
2 This is the recommended amount if there are no process losses. If process losses have been demonstrated by a
study, appropriate over dosage should be applied to ensure that analytical targets are reached 3 This is equivalent to 500 mcg Dietary Folates Equivalent
4 This is equivalent to a total of 1.4% Di-calcium phosphate: In final product Ca/P ratio should be 1-1.5, where
30% of P from plant sources and 100% from animal sources can be included in the estimate 5 This is equivalent to a total of 1.4% Di-calcium phosphate: In final product Ca/P ratio should be 1-1.5, where
30% of P from plant sources and 100% from animal sources can be included in the estimate
Can harmonization include LNS-SQ as well?
• Note that iLiNS’ formulation is different from current Nutributter formulation
• Target – 1 RNI of essential nutrients, comparable to LNS-MQ, but less kcal/d
• Dose harmonized premix 2 - 2.5 times (50 vs 20 g)?– Taste issues with KCl– Split premix into small amount MN and macro-minerals (Ca, P, K),
so that K can be dosed separately? May also be good for RUTF
• Different inclusion of ingredients?– DSM: 4.8 g/20 g (LNS-MQ: 5/50 g)– N-6 EFA: 4.46 g vs 0.54 g (iLiNS vs LNS-MQ)– N-3 EFA: 0.58g vs 0.06g (iLiNS vs LNS-MQ)
Conclusion: Requires R&D for product specification + acceptability testing
Next Steps
• WFP to issue the new specs for RUSF and LNS-MQ, followed by interim period where both old and new specs are valid
• Interagency review of steps required for extending harmonized specs to RUTF
• R&D required to determine whether and how harmonization can be extended to LNS-SQ as well