About 20 million children worldwide are affected by severe malnutrition each year, with a fatality rate of 30 percent. Eight million of these are in India, where local conditions pose challenges for the conventional treatments, so MIT is working on an anti-malnutrition "milkshake" that can put these children on the road to recovery at lower cost and less risk of waterborne infections.
Famine and malnutrition, especially in children is much more difficult condition to treat than many people realize. One would think that a prescription that read "food" would be enough, but it's not as simple as that. When the body is put on very short rations or, worse, is starving, it adapts to the situation by re-prioritizing all its functions. The gastrointestinal tract is essentially put on standby while the body starts to feed off fat reserves and the liver. If food is still not forthcoming, the body then starts in on drawing nutrients from the muscles and other organs.
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This depressing scenario is even worse in children as their small bodies, which are geared to fast growth, go into their own holding pattern. The result can be edema, stunted skeletal growth, a compromised immune system, wasted muscles, a compromised immune system, and even neurological problems that can persist through adulthood.
So how do you treat such severe cases? In near-starvation conditions, the body is so compromised that it must be coaxed back into taking in nutrients. This is why survival literature is filled with stories of shipwrecked mariners being rescued at sea and celebrating their deliverance with a slap-up meal, only to be found dead the next morning. It's also the reason their modern counterparts find their first meal is often a disappointing affair of chicken broth and lime gelatin – if they aren't restricted to an intravenous drip.
In fact, treating severely malnourished children in the developing world is a long process that requires 100 special meals of Ready-to-Use Therapeutic Food (RUTF). Developed by a French company, this is a heavy, viscous paste made mainly from milk powder, peanut butter, oil, and sugar. It works, but, according to MIT, it has several drawbacks. For one thing, in India it costs 30 rupees (US$0.47) per meal, which is more than most families can afford. In addition, it's hard to eat without water to wash it down with and in a land without access to much in the way of clean water, this can be a real problem.
But the main difficulty is that the present form of RUTF, which was developed for Africa, is very unpalatable to Indian children, who are reluctant to eat it and often only finish a third of the required portions.
To resolve this, MIT chemical engineer Tonghan Gualong with T Alan Hatton, the Ralph Landau Professor in the Department of Chemical Engineering are working on an alternative that's a bit more palatable, cheaper, and less water dependent. They say that advances in stabilizing emulsions at the nanoscale have made it possible to produce a low-viscosity food that can be powdered and spray-dried for storage and transportation. It also sounds a bit more tasty with its combination of local ingredients and spices.
"We are trying to make something more like a milkshake," says Gu. "It's a mix of high-energy components, using local foods like [chickpeas]. We can even add spices to create different flavors. We've found that children really like the drinkable version."
So far, the MIT team has managed a pilot-scale demonstration in Mumbai, where using spray drying and a colloid mill has allowed them to stabilize the oil droplets in an emulsion in the product, so it has a decent shelf life, and micro-encapsulating the oils and nutrients inside the solids to produce a dry powder. Reconstituting the food can be done using clean water or milk with only 30 seconds of hand stirring. Milk is preferred because the cow acts as a living filter and avoids the dangers or water contamination.
Working with the Indian Institute of Technology in Bombay, the MIT team hopes to iron out the final problems before going on to the final phases of mass production and marketing.