Lipid – based Nutrient Lipid – based Nutrient SupplementsSupplements

Heidi Sandige, MDHeidi Sandige, MD

LNS = Lipid-based Nutrient LNS = Lipid-based Nutrient SupplementsSupplements

A family of products designed to deliver A family of products designed to deliver nutrients to vulnerable people. The nutrients to vulnerable people. The majority of the energy provided is lipid majority of the energy provided is lipid based.based.

All LNS provide a range of vitamins and All LNS provide a range of vitamins and minerals, as well as energy, protein, and minerals, as well as energy, protein, and essential fatty acids.essential fatty acids.

LNS formulations can be tailored to meet LNS formulations can be tailored to meet the nutrient needs of specific groups and the nutrient needs of specific groups and to fit in particular programmatic contexts.to fit in particular programmatic contexts.

Why LNS?Why LNS?

Simplicity (home Simplicity (home use)use)

Ease of Use (no Ease of Use (no cooking)cooking)

Good storage Good storage SafetySafety

EffectivenessEffectiveness

How much LNS?How much LNS?

LNS FamilyLNS Family

RUTFRUTFReady-to-Use Ready-to-Use Therapeutic Therapeutic FoodFood

Universal Universal Formulation:Formulation:•Peanut PastePeanut Paste•Milk PowderMilk Powder•OilOil•SugarSugar•Vitamin/Mineral MixVitamin/Mineral Mix

RUTFRUTFFor Severely For Severely Malnourished Malnourished ChildrenChildren

100% of dietary 100% of dietary needsneeds

Distributed Distributed according to a according to a medical modelmedical model

RUTFRUTFEvidence BasedEvidence Based

ValidatedValidated

AdvocatedAdvocated

Programmatic Programmatic Guidance existsGuidance exists

RUSF (s)RUSF (s)Ready-to-Use Ready-to-Use Supplementary Supplementary FoodsFoods

Many Different Many Different FormulationsFormulations

Many Different Many Different applicationsapplications

RUSFRUSFComplement to the Complement to the dietdiet

Designed to PurposeDesigned to PurposeMicronutrient needsMicronutrient needsCaloric needsCaloric needs

RUSFRUSFActive area of Active area of researchresearch

Evidence is Evidence is accumulatingaccumulating

http://ilins.org/

LNS to treat Moderate Acute LNS to treat Moderate Acute MalnutritionMalnutrition

10 Years of Evidence 10 Years of Evidence 75 kcal/kg day75 kcal/kg day Reduced presentation of children Reduced presentation of children

with SAMwith SAM Becoming standard part of CMAM Becoming standard part of CMAM

guidelinesguidelines

LNS to Prevent Malnutrition LNS to Prevent Malnutrition

MSF in Niger 2010 “critical and MSF in Niger 2010 “critical and significant effect on mortality”significant effect on mortality”

Columbia reduced GAM Columbia reduced GAM South Darfur significantly higher South Darfur significantly higher

anthropometric indexesanthropometric indexes

UNHCR is developing operational UNHCR is developing operational guidance for refugee useguidance for refugee use

LNS to prevent Linear StuntingLNS to prevent Linear Stunting

Multiple ongoing studies: Malawi, Multiple ongoing studies: Malawi, Burkina Faso, Ghana, BangladeshBurkina Faso, Ghana, Bangladesh• TargetTarget• AmountAmount

Key research finding – LNS does NOT Key research finding – LNS does NOT decrease breast milk intakedecrease breast milk intake

LNS as part of HIV LNS as part of HIV programmingprogramming

Treatment of WastingTreatment of Wasting Improve nutritional status of non-Improve nutritional status of non-

wasted individualswasted individuals Medication adherenceMedication adherence

We’ve heard a lot about We’ve heard a lot about Sharing. . .Sharing. . .

We’ve hear a lot about quality We’ve hear a lot about quality control . . .control . . .

We’ve heard a lot about We’ve heard a lot about promoting local agriculture and promoting local agriculture and

local capacity. . .local capacity. . .

We’ve heard a lot about cost-We’ve heard a lot about cost-effectiveness . . .effectiveness . . .

Thank youThank you