1. RUSF – LNS MQ Harmonized specifications
Geneva, March 2015
Saskia de Pee

2. RUSF & LNS-MQ Harmonisation Objectives
Improve sourcing and programming through harmonisation of product specifications and packaging (among agencies and suppliers)
Bring RUSF composition in-line with WHO technical note on foods for treatment of MAM
Support local production through
Defining the premix
Using the same premix for RUSF and LNS-MQ
Having one premix for different raw materials
Increase flexibility to respond to supply chain issues (emergencies)

3. RUSF & LNS-MQ: Nutrient content aims
Same nutrient density for RUSF & LNS-MQ (nutrient/1000 kcal or nutrient/100 g)
Comply with 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 into consideration
Min target met
Max not exceeded, except for nutrients for linear growth
Note, nutrients without max in RUTF & RUSF and no UL, meet highest minimum requirement (LNS-MQ / RUTF / RUSF)

4. RUSF & LNS-MQ: Same composition
100g sachet in line with management of MAM requirements - Above min and below max of WHO technical note for MAM treatment foods for all nutrients
50 g to provide a good contribution to daily requirement of essential nutrients At or above recommended nutrient intake for normal healthy individuals [RNI] 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 WHO MAM food; max = RUTF ; note the use of iodized salt in diet also provides iodine
Selenium: min & max from RUTF; note that blending must be homogenous
Potassium: No RNI, just DRI, 57% for 7-12 mo, 13% for 1-3 y, wide range & taste impact

5. Harmonized RUSF & LNS-MQ vs RUTF
100g sachets almost in line with management of SAM requirement
Above the min for most nutrients, except:
Protein: requirement higher for RUTF than for RUSF, ratio of milk powder to other ingredients higher in RUTF – can be maintained
Potassium: at 80% of the min because of max of WHO for MAM foods; also taste reasons
Below the max in 100g for most nutrients, except:
Calcium, Phosphorus and Magnesium: in line with WHO MAM foods, because of linear growth
Vitamin A: max for RUTF = min for RUSF & heat sensitive (staying within target over 24 mo is very challenging); RUTF intake >100 g/d
Vitamin K: max for RUTF = min for RUSF; no max for RUSF, no UL, why max for RUTF?

6. RUSF & LNS-MQ: Different use = different, harmonized, packaging
RUSF: ready-to-use supplementary food
for children 6 months and above with moderate acute malnutrition
100g sachets
Colour: Pantone 151
LNS-MQ: lipid-based nutrient supplement - medium quantity
for children 6 months and above at risk of acute malnutrition
50g sachets
Colour: Pantone 109

7. RUSF & LNS-MQ Harmonisation, steps taken
Discussions among WFP, UNICEF, USAID and MSF & supplier interaction
Checked with WHO for RUTF composition, any change likely?
Decision to first align RUSF & LNS-MQ, while also taking RUTF into account
Shelf-life test, harmonized premix v0, tested retention over time (WFP, GAIN, DSM)
Nutrient goals set
Raw material contribution estimated using food composition tables
Premix proposed
Target nutrient content for consumption & labelling = min
Max includes overage for loss over time & respects max of nutrient content target
Proposed specification circulated for feedback:
Harmonized premix
Nutrient targets RUSF & LNS-MQ
Harmonized packaging
Microbiological criteria

8. Back up slide 1

9. Back up slide 2