Agriculture Reference
In-Depth Information
plant protein sources usually suggested are also susceptible to aflatoxin infection.
Unfortunately, importation from developed countries is expensive, creates depen-
dency, and is no guarantee of safety: maize and peanuts exported from the U.S. and
Europe can also be a source of this toxin (Flett, 2001). For these reasons, populations
who can grow them prefer local peanuts as a protein source.
Peanut-based RUTF products have been effective in treating child malnutrition
throughout the world (Briend et al. 1999, Maleta et al. 2004, Sandige et al. 2005,
Kuusipalo et al. 2006), such as in Ethiopia, Sudan, Malawi, and Haiti. Available
under various names, this particular type of RUTF is manufactured both in devel-
oped countries for sale and distribution by NGOs and by local organizations in the
very countries where they are needed. Local manufacture and sourcing of ingredients
should be the goal wherever possible:
The short life spans of aid programs, the short
attention span of world leaders with regard to food aid, the unpredictability of world
food trade policies, and common sense dictate that a successful, long-term sustain-
able program focused on the elimination of malnutrition be based on locally available
materials as much as possible. This is especially true of countries similar to Haiti, an
island nation with little ability to generate the foreign exchange needed to purchase
expensive food ingredients from overseas.
The greatest challenge to the manufacture of specialty food such as RUTF in a
third-world setting is to ensure the identity, safety, and consistency of such a product
without access to the equipment, reagents, personnel, and laboratory infrastructure
that is standard in developed countries. To do so requires using local resources and
the availability of critical information.
Example 4: Food Safety in Limited-Resource Settings
A good example of effecting quality assurance in a limited-resource environment is
the reduction of aflatoxin contamination of RUTF in a Haitian malnutrition program:
In 2006, in Haiti, my laboratory discovered high levels (380-1556 parts per billion
[ppb]) of aflatoxins in peanuts used for the preparation of a ready-to-eat therapeutic
food and in the RUTF itself. (As a point of reference, anything more than 20 ppb is
illegal to feed to U.S. cows.) These are extremely high levels, potentially harmful, quite
variable, and completely unacceptable. The general population was probably exposed
to these high levels on a regular basis. The local RUTF manufacturers became more
selective in the farmers they chose to buy peanuts from and added an enteroabsorbent
clay (bentonite) to the formulation. The process helped some, but there was never much
evidence that the bentonite was binding the aflatoxins.
Why were we so concerned about this compound in the peanuts? Aflatoxin is a
potent mycotoxin produced by
Aspergillus flavus
and
Aspergillus parasiticus
. This
toxin is produced in a variety of cereals, root crops, spices, oil seeds, and pulses but
most commonly reported to reach the human population directly through the ingestion
of maize and peanut products (Williams et al. 2004). Aflatoxin suppresses the immune
system (Turner et al. 2003), interferes with the uptake and absorption of nutrients
(Shane 1993), stops protein synthesis, stunts children (Gong et al. 2002, 2003, 2004),
destroys livers (Gorelick et al. 1993), and at lower chronic intakes, leads to liver can-
cer (Egner et al. 2001). In Haiti, there was little awareness of aflatoxin in the health
care community or the general population.
Since Haitian manufacturers of peanut butter and peanut-based RUTF source local
peanuts from farmers unaware of aflatoxin's threat, there was a special need to be
sure this special product for vulnerable, malnourished children is as free of aflatox-
ins as possible. Once informed of aflatoxin threat, local producers began sorting the
