Background
In 2015, Member States committed to eliminating all forms of malnutrition by 2030 as one of the Sustainable Development Goals (SDGs). To achieve this objective, the SDGs incorporated the Global Nutrition Targets approved by the World Health Assembly that aim to reduce the proportion of children suffering from wasting to < 5% by 2025 and to < 3% by 2030.
Globally, an estimated 13.6 million children aged 6–59 months are estimated to have suffered from severe wasting in 2020. Severe wasting in children is associated with increased risk of mortality, morbidity, and poor neuro-cognitive outcomes. Treatment of uncomplicated severe wasting includes providing ready-to-use therapeutic food (RUTF) in outpatient care for up to 8 weeks. The current RUTF formulations contain 45–60% fat, with 3–10% omega-6 and 0.3–2.5% omega-3 fatty acids. The fatty acid profile in RUTF was not designed to optimize long term long-chain polyunsaturated fatty acid (LCPUFA) status).
Infants and young children need LCPUFA to support their rapidly growing brain and nervous system during the first 2 years of life. Essential fatty acids (EFA) such as Linoleic acid (LA, 18:2 omega-6) and alpha-linolenic acid (ALA, 18:3 omega-3) cannot be synthesized by the body and must be supplied in the diet. EFAs are required for human health and are included in the nutritional composition for the Codex Guideline for RUTF.
Emerging evidence suggests that the current RUTF formulations do not have fatty acid profiles that support optimal brain development, and that alternative fatty acid profiles in RUTF could be used to promote brain and nervous system development.
As part of the work to develop a Codex RUTF guideline, the scientific evidence regarding the fatty acid profiles will be reviewed to improve and harmonize the lipid composition in RUTF and related products used in the treatment of severe wasting.
WHO plans to conduct a systematic review of the available evidence on the EFA content of RUTF. The findings will be used to make recommendations for the Codex RUTF guideline in November 2021.
Scope
The Actions in Health Systems Unit of the WHO Department of Nutrition and Food Safety is extending a call for authors to conduct a systematic review of the evidence on EFA content in RUTF. The authors will be required to submit a report of the findings to WHO by 1 October 2021.
How to submit the proposal
Interested author(s) or teams are invited to submit a proposal (maximum 6 pages) by sending an email to Dr Jaden Bendabenda bendabendaj@who.int, no later than 18 June 2021. The subject heading of the email should read as: “Systematic review: EFA content in RUTF”.
The proposal should contain the following (a single pdf document):
The specific competencies and contributions of each author or team member. Interested author(s)/teams must have vast knowledge of EFA, RUTF formulations (or similar food products) as well as experience in conducting systematic reviews and should provide references of reviews that they have published in peer-reviewed journals.
An abstract outlining the background and justification for the review, the search strategy and databases to be searched, the definition of inclusion/exclusion criteria, the process of data extraction and analytical approach. Successful authors will be required to submit a protocol prior to performing the review. They will also be required to work with WHO in preparing a summary of findings for presentation at the Codex meeting.
A detailed budget in US $.
Timeline
18 June 2021 – Deadline for submitting proposal to WHO
30 June – WHO review of proposals complete and authors/teams contacted and contracts agreed
30 July 2021 – Draft protocol submitted to WHO
15 September 2021 – Draft report submitted to WHO
1 October 2021 – Final report submitted to WHO