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Abstract
ABSTRACT
Severe acute malnutrition (SAM) remains a major concern in sub‐Saharan Africa. In the Democratic Republic of the Congo (DRC), health care providers in therapeutic feeding units produce locally formulated food preparations empirically, with unknown macro‐ and micronutrient compositions. This study compares ingredients and nutritional values of locally formulated food preparation with those of standard ready‐to‐use therapeutic foods, as per Codex Alimentarius standards. A descriptive, comparative case study design was employed across outpatient therapeutic nutrition units (OTNUs) in four provinces of the DRC. Food samples were collected. Analysis included theoretical nutritional values calculation using NutVal software and laboratory analyses for selected nutrients (phosphorus, iron, calcium, magnesium, energy, lipids, and proteins) via standard protocols. From theoretical nutritional values, we calculate percentages of WHO/Codex Alimentarius requirements covered by the recipes and recipes in deficit by nutrient group. Laboratory analyses of selected nutrients were compared with the cut‐off of the corresponding nutrient in the Codex Alimentarius. Analyses were conducted using Stata 18. Locally formulated food preparations were mostly milk‐ and peanut‐free, often exceeding protein and lipid recommendations but deficient in vitamins (A, D, E, K, B12, folate), and critical minerals (calcium, iron, iodine, selenium, zinc). Compliance with Codex standards was very low, confirming macronutrient inadequacy but widespread micronutrient gaps. This study highlights critical gaps in locally formulated preparations in the management of SAM compared with WHO/Codex standards, emphasizing the need for fortification, balanced nutrients, and regulatory oversight. Engaging local industries, optimizing ingredient value chains, and rigorous evaluation are essential to ensure sustainable, effective, and context‐appropriate SAM treatment solutions.
Details
Iron;
Malnutrition;
Mortality;
Nutrition;
Vitamin deficiency;
Vitamins;
COVID-19;
Proteins;
Dietary minerals;
Lipids;
Calcium;
Iodine;
Quality standards;
Food;
Nutrients;
Strategic materials;
Public health;
Recipes;
Micronutrients;
Standards;
International standards;
Laboratories;
Nutritive value;
Selenium;
Vitamin D;
Folic acid;
Comparative studies;
Nutrition therapy;
Nutrient requirements
; Mudogo, Celestin Nzanzu 2 ; Silverstein, Hannah 3 ; Fawole, Olufunmilayo I. 4 ; Compta, Gael 5 ; Ngbolua, Koto‐Te‐Nyiwa 6 ; Koba, Tesky 7 ; Mbuyi, Ruphin 8 ; Bondo, Berthold 9 ; Lusamba, Paul‐Samsom 10 ; Mapatano, Mala Ali 1 1 Department of Nutrition, Kinshasa School of Public Health, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
2 Faculty of Medicine, Department of Basic Sciences, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
3 School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
4 Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
5 Department of International Health and Sustainable Development, Celia Scott Weatherhead School of Public Health at Tulane University, New Orleans, Louisiana, USA
6 Faculty of Science, Department of Biology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
7 Research and Training Management in Public Health, National Institute of Public Health, Kinshasa, Democratic Republic of the Congo
8 Centre National d'Appui au Développement et à la Participation Populaire, Civil Society Organizations, Kinshasa, Democratic Republic of the Congo
9 Barumbu General Hospital, Kinshasa, Democratic Republic of the Congo
10 Department of Biostatistics and Epidemiology, Kinshasa School of Public Health, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo