In the global fight against child malnutrition, Ready-to-Use Therapeutic Foods (RUTF) and Fortified Blended Foods (FBFs) emerge as effective treatments. Both play critical roles in global nutritional programs. However, the differences in formulation, cost, impact, and suitability for treating various forms of malnutrition make them fundamentally distinct.
With millions of children suffering from wasting and undernutrition, it’s critical to understand what the data tells us about these two nutrition tools and which delivers more bang for the buck when saving lives.
What Are RUTF and Fortified Blends?
RUTF – an energy-dense, micronutrient-rich paste used to treat Severe Acute Malnutrition (SAM) in children under five.
The rich paste is made from peanut paste, milk powder, sugar, oil, and added vitamins and minerals. It doesn’t require refrigeration, cooking, or clean water for preparation; a game-changer in low-resource or emergency settings.
Fortified Blended Foods, such as Corn-Soy Blend Plus (CSB+) are flours enriched with vitamins and minerals. These are mainly used to prevent or treat Moderate Acute Malnutrition (MAM). Unlike RUTF, they require cooking and water, making them more logistically complex and potentially less safe in unhygienic environments.
Cost Comparison: What’s the Financial Investment?
At face value, RUTF is more expensive. The average cost of a full RUTF treatment course for a child with SAM (usually 6–8 weeks) is $40–$60, depending on local manufacturing and supply chain costs. In contrast, FBFs cost roughly $10–$20 for a similar treatment period for MAM.
However, looking at the cost per child recovered paints a more accurate picture. According to several studies, including those from UNICEF and the CMAM Forum:
RUTF yields higher recovery rates (up to 90%) in community-based treatment programs for SAM.
FBFs have lower recovery rates (around 60–75%) and higher rates of relapse or treatment failure.
When adjusted for treatment success, the cost per child fully recovered narrows, making RUTF more economically justifiable despite its higher per-unit price.
Efficacy and Impact: Who Recovers Better?
RUTF is proven to save lives in extreme cases. It is a fact that home-based treatment with RUTF results in recovery rates of up to 89%, compared to just 42% with standard hospital-based care using fortified blends.
Fortified blends, though effective for prevention and mild-to-moderate cases, fall short in cases of complicated malnutrition. Children often need more protein, fat, and bioavailable micronutrients than what FBFs can provide. In side-by-side trials:
RUTF led to faster weight gain and catch-up growth.
FBFs required longer treatment durations with slower recovery trajectories.
In humanitarian settings where time is critical and infrastructure is limited, RUTF consistently outperforms FBFs in both speed and success of treatment.
Practicality: The Real-World Advantage
In emergency or low-infrastructure zones, the ease of use of RUTF is unmatched. It:
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- Doesn’t require preparation or water (lowering the risk of contamination)
- Has a long shelf life, even in hot climates
- Can be administered at home by caregivers
FBFs, by contrast, require:
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- Clean water
- Cooking equipment and fuel
- Time and supervision
These added requirements limit their utility in crisis or displacement settings, where caregivers are under pressure and safe food prep is not guaranteed.
Local Production & Supply Chain Considerations
One major argument in favour of fortified blends is the potential for local sourcing and production, especially in agrarian economies. However, RUTF is increasingly being produced locally, with manufacturers in India, reducing costs and boosting supply chain resilience.
Moreover, UNICEF and WFP continue to invest in regional RUTF production hubs, creating job opportunities and reducing reliance on imports.
When it comes to severe acute malnutrition, RUTF is the gold standard. The higher cost is offset by its effectiveness, safety, and ease of administration. Fortified blends remain essential for moderate malnutrition prevention and for communities where food insecurity is chronic but not acute.
The most effective approach is not either-or but a layered nutrition response:
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- RUTF for SAM treatment, especially in emergencies or for high-risk children.
- FBFs for MAM, stunting prevention, and longer-term community feeding programs.
When the goal is saving lives quickly and effectively, the data is clear: RUTF delivers results that justify the investment.