Relief Foods: BP-5 and Plumpy'Nut

Last Sunday morning, I was in Grant Park and happened upon the mock refugee camp set up by Medecins Sans Frontieres (Doctors Without Borders). I had read about the “camp in the heart of the city” when it was in Central Park and was curious so I decided to take the tour. I was somewhat skeptical of the outdoor exhibit format, but my guide Michael--a Canadian-tree-planter-turned-logistician at a camp in the DR Congo--was really engaging, and I learned quite a bit about the basic structure of MSF camps. Since Sunday, I’ve been thinking a lot particularly about MSF’s nutrition programs and the foods distributed therein. Wikipedia categorizes these foods as “therapeutic,” (this may be a category used by more than Wikipedia, I can’t tell yet from my initial reading) which seems a little misleading given how facilely this designation is used for any number of things in North America. In fact, the designation didn’t seem appropriate either for the one other food I recognized in the Wikipedia entry, Ensure.

The two foods our guide Michael highlighted, which I had never heard about before, were BP-5 and Plumpy’Nut. BP-5 is one of the main foods MSF distributes at its camps. It comes in a box probably triple the size of a Jello box but the same shape. Inside, I think there are five small Jello-like paper packets that contain the BP-5 biscuits. Michael showed us how the biscuits could be broken into granules and eaten dry. The texture and taste were similar to dry, crumbly yellow cake. (I got to try some.) I didn’t get the exact ingredients, but the main components seem to be dry milk and sugar (like Filipino polvoron) in addition, of course, to all of the vitamins added to make this food suitable for severely malnourished people. With water, BP-5 can also be made into porridge.

There doesn’t seem to be much information on BP-5 on the web (and no Wikipedia article), but I did find one report from 1996 written by an MSF nutritionist that actually advised against distributing BP-5 in food programs because the finding in Afghanistan was that BP-5 was widely coveted by non-IDPs (internally displaced persons) and therefore sold by individuals in refugee camps to people outside, hindering relief efforts. I had thought about food as currency before but never in this context.

The other food Michael introduced to us during the tour was Plumpy’Nut--such a goofy, onomotopaeiac name compared to the technical, non-descriptive BP-5! MSF distributes Plumpy’nut, which comes in palm-sized foil pouches, to the mothers of the most malnourished children in refugee camps because of how quickly it supposedly can bring people back to health. I didn’t actually get to open a package of this stuff, but from what Michael said and photos, it looks like very smooth peanut butter and tastes sweeter than, say, Skippy or Jif.

What interested me most about BP-5 and Plumpy’nut was the research that must have gone into developing these inexpensive, shelf-stable, nutrient-rich, easy-to-distribute and -dispense foods by nutriset (Plumpy’s inventor) and others. In particular, I’m fascinated that these foods have been declared “acceptable to all cultures and religious faiths.” I have to remind myself of the context, that the designation is universal in a somewhat limited sense (i.e. the foods are acceptable to people starving).

My introductory lesson on Sunday made me eager to learn more about relief foods so that, at the very least, I can fill in the gaps on Wikipedia. I don’t really have a main point for this post; it’s just more food for thought.

This sounds suspiciously like Soylant Green. It's interesting that you can't find any info on what's actually in it.

Isn't Homaro Cantu working on something similar to BP-5?

happy_stomach wrote:I don’t really have a main point for this post; it’s just more food for thought.

who needs a point when you've got a pun?

Seriously, fascinating.

My husband is on the Board of Advisors of MSF-USA. If you would really like to know more about these foods and MSF's nutrition programs generally, please send me a personal message; I'm sure he can put you in touch with the MSF people who can fill in what you'd like to know. One of the most important advantages of Plumpy'Nut is its portability. Typically, severely malnourished children are admitted to a hospital for a few days to ensure that they are receiving adequate nutrition and have reached some level of stability. The practical problem with that in the areas that MSF serves is that mothers would be unwilling to leave their child in the hospital alone, but could not stay with them because they had other children to care for at home -- and home is often many miles away, reached on foot. MSF doctors now can provide mothers with Plumpy'Nut to take home, and of course they send along lots of extra packets so that the kids at home -- who are probably borderline malnourished as well -- will eat some too. Also important as far as their food and nutrition efforts go are the bracelets they've developed that can quickly assess the degree of malnutrition in children -- astonishing to see that four-year old children can have upper-arm circumferences that are no larger than an adult male's thumb.

I'm glad you got to see the camp -- the weather was great and the crowds were substantial; we were told that they broke the attendance records that had been set at the NYC exhibit. MSF is trying to raise its midwest profile, and the "refugee camp" was its first effort. They had several recruiting events as well which were quite successful. For anyone interested, keep in mind that you don't need a medical degree to volunteer for MSF: they need administrators and logisticians as well. It does require, of course, a substantial commitment of time and energy, but one that is well worth it, from all accounts I've heard. Certainly, it changes one's perspective on food and heightens awareness of the general abundance we enjoy here, to put it mildly.

ToniG wrote:My husband is on the Board of Advisors of MSF-USA. If you would really like to know more about these foods and MSF's nutrition programs generally, please send me a personal message; I'm sure he can put you in touch with the MSF people who can fill in what you'd like to know.

Thanks. I'd like to do more reading and clarify my questions, but I may very well be in touch.

ToniG wrote:Also important as far as their food and nutrition efforts go are the bracelets they've developed that can quickly assess the degree of malnutrition in children -- astonishing to see that four-year old children can have upper-arm circumferences that are no larger than an adult male's thumb.

Our guide on Sunday showed us these color-coded bracelets. It's such a simple but, I imagine, extremely helpful tool.

There was a story on 60 Minutes last night on PlumpyNut and the entire video can be seen online

http://www.cbsnews.com/stories/2007/10/19/60minutes/main3386661_page3.shtml

I caught some of the 60 minutes report. A comment made by one of the doctors was particularly intriguing to me. She stated that they rarely, if ever, see any peanut allergies. This is such a marked difference from from what we see in the States where, it appears, peanut allergies are rampant. Schools have to have peanut free tables in cafeterias, no birthday treats etc. etc. At any rate, it got me wondering about environmental or food additives that might be causing this increase in allergies.

jygach wrote:A comment made by one of the doctors was particularly intriguing to me. She stated that they rarely, if ever, see any peanut allergies. This is such a marked difference from from what we see in the States...

Here's one explanation (with footnote) from Wikipedia:

A theory of the development of peanut allergy has to do with the way that peanuts are processed in North America versus other countries like China and India. Peanuts are widely eaten in China and India but peanut allergies are almost unheard of there. According to a 2003 study, roasting peanuts, as more commonly done in North America, causes the major peanut allergen Ara h2 to become a stronger inhibitor of the digestive enzyme trypsin, making it more resistant to digestion.[14] Additionally, this allergen has also been shown to protect Ara h1, another major peanut allergen, from digestion - a characteristic further enhanced by roasting.

14. ^ a b Soheila J. Maleki, Olga Viquez, Thomas Jacks, Hortense Dodo, Elaine T. Champagne, Si-Yin Chung and Samuel J. Landry. "The major peanut allergen, Ara h 2, functions as a trypsin inhibitor, and roasting enhances this function." Journal of Allergy and Clinical Immunology 112.1 (July 2003): 190-195.

At any rate, it got me wondering about environmental or food additives that might be causing this increase in allergies.

There's also the theory that we're causing peanut allergies in kids by advising pregnant women to stay away from them.

Regardless of where that comes out, thanks for a very interesting post, Happy Stomach.

For more information that augments the 60 Minutes report related to the various MSF programs endeavoring to combat malnutrition, you can also look here:
http://doctorswithoutborders.org/news/malnutrition/index.cfm?msource=ADC071001D01

Hi,

ON the peanut allergy front, there was a medical mycologist who thought the whole peanut allergy issue may not be the peanut. There was the opinion there might be a mold on peanuts, due to storage issues, causing the allergen.

Regards,

happy_stomach wrote:What interested me most about BP-5 and Plumpy’nut was the research that must have gone into developing these inexpensive, shelf-stable, nutrient-rich, easy-to-distribute and -dispense foods by nutriset (Plumpy’s inventor) and others. In particular, I’m fascinated that these foods have been declared “acceptable to all cultures and religious faiths.”

"Is Food Aid Culturally Specific?"

MSF just released a very interesting report, specifying that US food aid in the form of Corn-Soy blend (CSB) is causing malnutrition rather than treating it. They specifically state that Ready to Use Foods (RUF) like Plumpy'Nut are needed in this report. Interestingly, they are coming right out and stating that children under the age of 5 need animal-based foods (specifically, dairy, fish and eggs) in order to thrive - that plant-based foods do not provide enough iron, zinc and calcium in a form that is easily absorbed. They maintain that children in the rest of the world who don't eat these foods are receiving supplements to compensate for these deficiencies in the food supply.

They offer a very interesting video on the subject here,which discusses the WIC program as a successful model to ensure children get adequate nutrition - and then goes on to say that US agricultural policy that is exacerbating malnutrition in children overseas by offering only CSB grown in the US.

Thanks for the link!