Combating Malnutrition: Nutrient and Energy Composition of Locally Formulated Ready-to-Use Therapeutic Foods for Children

1. Introduction

Malnutrition remains one of the most urgent and persistent global public health challenges, particularly among children under five years of age. According to the World Health Organization, undernutrition contributes to nearly half of all deaths in this vulnerable age group, with far-reaching consequences on survival, physical growth, cognitive development, and long-term productivity [1]. Global estimates suggest that stunting, wasting, and micronutrient deficiencies continue to affect millions of children, with the highest burden concentrated in low- and middle-income countries [2]. These forms of undernutrition not only increase susceptibility to infectious diseases but also perpetuate intergenerational cycles of poor health outcomes [3].

In sub-Saharan Africa, and particularly Nigeria, the prevalence of childhood malnutrition remains alarming despite decades of nutritional interventions. The 2023/2024 Nigeria Demographic and Health Survey reported that 40% of children under five are stunted, 8% are wasted, and 27% are underweight, reflecting a sustained burden of undernutrition [4]. These statistics place Nigeria among the countries with the highest number of malnourished children globally, underscoring the urgent need for effective, accessible, and sustainable solutions [5].

Ready-to-use therapeutic foods (RUTFs) have been introduced as one of the most effective innovations for addressing severe acute malnutrition (SAM). These nutrient-dense, lipid-based pastes are designed to deliver high energy and protein content, along with essential vitamins and minerals, without requiring refrigeration or cooking [6]. Their stability, ease of distribution, and suitability for both inpatient and community-based treatment programs make them uniquely valuable in emergency and resource-limited contexts [7]. Evidence shows that RUTF significantly improves recovery rates and reduces mortality among children with SAM, thus becoming a cornerstone of child nutrition programs [8].

Despite these successes, challenges remain regarding the sustainability and scalability of RUTF programs in Nigeria. Most therapeutic foods currently used are imported, creating issues of affordability, supply chain disruptions, and dependence on external donors [2]. The high costs of imported products limit availability, especially in rural and low-income settings, while cultural unfamiliarity sometimes reduces compliance [9]. According to the UNICEF Supply Division [10], global RUTF supply chains remain vulnerable to rising costs, production delays, and distribution constraints, which further compound challenges in countries like Nigeria. These limitations point to the need for developing locally produced alternatives that are not only nutritionally adequate but also affordable, culturally acceptable, and supportive of the domestic agricultural sector [11].

Recent research has demonstrated that locally available cereals, legumes, and plant-based proteins can be effectively utilized in RUTF formulations. For instance, Adewumi et al. reported that Bambara groundnut combined with Moringa oleifera leaf protein complex produced nutritionally rich, stable formulations [12]. Similarly, Umar and Orishagbemi [13] highlighted that cereal–legume samples yielded products with acceptable nutrient profiles and sensory qualities comparable to standard RUTF. Studies conducted in Nigeria and Ghana further showed that formulations based on maize, soybeans, groundnut, and wheat are not only cost-effective but also culturally familiar, which enhances acceptability among caregivers and children [14,15]. Moreover, Ishaq et al. emphasized the feasibility of community-level production of RUTFs, suggesting that decentralized approaches could address availability gaps [16].

However, gaps remain in the systematic evaluation of locally formulated RUTFs in terms of nutrient adequacy and sensory acceptability. While energy and macronutrient requirements are often prioritized, micronutrient fortification and bioavailability, as well as cultural preferences regarding taste and texture, require further attention to ensure effectiveness and compliance [5]. Addressing these gaps is particularly important in Nigeria, where regional variations in food availability and cultural diets may influence both formulation and acceptance.

The present study therefore aims to contribute to this growing body of knowledge by formulating and evaluating RUTF blends from locally available food resources in Kano State, Nigeria. Specifically, the study investigates proximate composition, mineral and vitamin profiles, and sensory properties of the formulations. By doing so, it seeks to provide evidence for the feasibility of affordable, culturally acceptable, and nutritionally adequate RUTFs that could support efforts to reduce the burden of severe acute malnutrition in Nigerian children.

2. Materials and Methods

2.1. Study Design

This was an experimental laboratory study involving the formulation and evaluation of three Ready-to-Use Therapeutic Food (RUTF) blends prepared with locally available ingredients. Nutritional (proximate, mineral, and vitamin) composition and sensory properties were analysed to determine the adequacy of the formulations.

2.2. Location and Sample Size

This study was conducted in Kano State, Northwestern Nigeria, a major commercial and agricultural hub with active local markets where staple crops such as rice, wheat, groundnut, and soybean are widely available. Laboratory analyses were performed at Bayero University Kano (BUK), which provides well-equipped facilities for food and nutrition research. Raw materials were sourced from Brigade Market, Nassarawa Local Government Area, and identified at the University Herbarium with assigned voucher numbers: rice (0289), wheat (0398), groundnut (0405), and soybean (0506).

2.3. Ingredients and Equipment

The ingredients included soybeans (Glycine max), groundnut (Arachis hypogaea), brown sugar, soya oil, baobab (Adansonia digitata), date palm (Phoenix dactylifera), wheat (Triticum aestivum), and white rice (Oryza sativa).

Key equipment included: muffle furnace, Soxhlet extractor, oven, spectrophotometer, weighing balance, measuring cylinders, and beakers. Analytical grade reagents used included hydrochloric acid (HCl), nitric acid (HNO₃), sodium hydroxide (NaOH), and n-hexane.

All analyses were carried out in replicates to ensure reproducibility. Equipment was calibrated before use, and reagents were of analytical grade. Samples were stored in airtight containers at room temperature to prevent contamination or spoilage before analysis.

2.4. Formulation of RUTF Blends

The raw materials were sorted, washed, and sun-dried. Each was processed into flour or paste:

• Soybean flour: fermented for 24 h, dehulled, toasted, and ground.
• Groundnut paste: roasted for 20 min and ground.
• Rice and wheat: decorticated, sun-dried, and milled into powder.
• Brown sugar: milled into powder.

Three RUTF formulations were developed by varying ingredient proportions (Table 1).

2.5. Proximate Analysis

Proximate composition (moisture, ash, crude protein, crude fat, crude fibre, and carbohydrate by difference) was determined using standard AOAC methods (AOAC, 2005; AOAC, 2010).

• Moisture content: Oven-drying at 105 °C to constant weight.
• Ash content: Dry ashing in a muffle furnace at 550 °C.
• Crude protein: Kjeldahl method using a 6.25 nitrogen-to-protein conversion factor.
• Crude fat: Soxhlet extraction with petroleum ether.
• Crude fibre: Sequential acid–alkali digestion.
• Carbohydrate: Determined by difference:

%CHO = 100 − (% moisture + % ash + % protein + % fat + % fibre).

2.6. Determination of Micronutrient Composition

Minerals (calcium, magnesium, iron, zinc, sodium, and potassium) were determined using Atomic Absorption Spectrophotometry (AAS) after dry ashing and dissolution in 1% HCl. Vitamins (A, C and E) were determined using High-Performance Liquid Chromatography (HPLC) following standard procedures.

2.7. Sensory Evaluation

Panelists evaluated the sensory attributes (taste, texture, aroma, colour, and overall acceptability) of the three RUTF blends using a 9-point hedonic scale (1 = extremely dislike, 9 = extremely like). Samples were presented in coded, randomized order under identical conditions. Panelists rinsed their mouths with water between evaluations.

2.8. Statistical Analysis

Data obtained from proximate and microbiological analyses were expressed as mean ± standard deviation (SD). Statistical comparisons among the samples were performed using Analysis of Variance (ANOVA), and differences were considered significant at p < 0.05. Statistical analyses were carried out using the Statistical Package for the Social Sciences (SPSS, Version 25.0).

2.9. Ethics

Ethical approval was sought for, and obtained from the Health Research Ethics Committee of the Ministry of Health, Kano State with approval number: NHREC/17/03/2018. The document is dated March 23, 2025.

3. Results

3.1. Proximate Composition of the RUTF Blends

The proximate composition of the RUTF blends is presented in Table 2. The results show that among the three blends, Blend A had the highest energy value (563.08kcal) while Blend B had the lowest energy value of 503.67 kcal. Blend A also recorded significantly (p<0.05) higher carbohydrate content of 46.57% when compared to the others. Blend B had the highest protein content (16.71%) and ash (3.76%) which was significantly higher than the values recorded by Blend A. Blend B also had the lowest fat content of 28.15% which significantly differed from that of Blends A and C.

3.2. Sensory Evaluation of the RUTF Blends

Table 3 shows the results for the sensory evaluation of the RUTF blends using the 9-point hedonic scale. The results are the calculated mean scores recorded by the 20 panelists who carried out the evaluation. No significant difference (p>0.05) is observed between all the three blends in terms of their taste, aroma, flavour and overall acceptability. Notably, Blend C differs significantly (p<0.05) from Blend A and B in terms of appearance with a lower mean score of 5.73 $\pm$ 2.56.

3.3. Vitamin Content of the RUTF Blends

The vitamin analysis revealed significant differences among the three RUTF blends for vitamins A, C, and E (p < 0.05). Blend B contained the highest level of vitamin A (15.89 ± 0.37 µM), significantly greater than Blend C (12.86 ± 0.15 µM) and Blend A (9.13 ± 0.02 µM), indicating Blend B may better support visual function and immune health in target populations. For vitamin C, Blend C delivered the highest concentration (11.70 ± 0.14 mg/100g), which was statistically higher than both Blend B (9.57 ± 0.24 mg/100g) and Blend A (7.39 ± 0.10 mg/100g). Elevated vitamin C content in Blend C could enhance antioxidant intake. Regarding vitamin E, Blend A presented the highest content (9.29 ± 0.19 mg/100g), which was significantly higher than Blend B (8.16 ± 0.19 mg/100g) and Blend C (8.59 ± 0.12 mg/100g). Vitamin E is essential for cell membrane protection and immune function, indicating Blend A’s potential advantages in reducing oxidative stress.

Table 4. Vitamin concentrations of the three RUTF blends.

Blends	Vitamin A (µM)	Vitamin C (mg/100g)	Vitamin E (mg/100g)
A	9.13 ± 0.02b	7.39 ± 0.10c	9.29 ± 0.19a
B	15.89 ± 0.37a	9.57 ± 0.24b	8.16 ± 0.19b
C	12.86 ± 0.15c	11.70 ± 0.14a	8.59 ± 0.12c

Values are presented as mean ± standard deviations of triplicate readings n=3.value within the same. column bearing different superscripts letters are statistically (p<0.05) different.

Table 4. Vitamin concentrations of the three RUTF blends.

Blends	Vitamin A (µM)	Vitamin C (mg/100g)	Vitamin E (mg/100g)
A	9.13 ± 0.02b	7.39 ± 0.10c	9.29 ± 0.19a
B	15.89 ± 0.37a	9.57 ± 0.24b	8.16 ± 0.19b
C	12.86 ± 0.15c	11.70 ± 0.14a	8.59 ± 0.12c

Values are presented as mean ± standard deviations of triplicate readings n=3.value within the same. column bearing different superscripts letters are statistically (p<0.05) different.

3.4. Mineral Composition of the RUTF Blends

Statistically significant differences (p < 0.05) were observed among the three RUTF blends for all analysed minerals as seen in Table 5. Blend B demonstrated the highest concentrations of iron (2.40 ± 0.02 mg/100g) and calcium (21.05 ± 0.04 mg/100g), suggesting it provides better support for haematological function and bone health compared to the other blends. Blend C exhibited a remarkable potassium level (61.65 ± 1.43 mg/100g), far exceeding the values found in Blends A and B, which may offer a key advantage for maintaining electrolyte balance. In contrast, Blend A contained the highest magnesium content (1.07 ± 0.04 mg/100g), and moderate levels of other minerals. For zinc, Blend B also led (0.39 ± 0.00 mg/100g), while Blend A contained the lowest sodium (6.04 ± 0.00 mg/100g), which may be preferable for specific dietary requirements. Each blend displayed a unique mineral profile: Blend B as the richest in iron, calcium, and zinc; Blend C as the highest in potassium; and Blend A as notable for magnesium and lower sodium content.

4. Discussion

This study formulated and evaluated Ready-to-Use Therapeutic Foods (RUTF) from locally available Nigerian ingredients, focusing on their nutritional composition, vitamin and mineral content, and sensory acceptability for the management of severe acute malnutrition (SAM). The findings showed distinct differences across the three formulations, with each demonstrating unique strengths. This highlights the potential of locally produced RUTF to serve as effective alternatives or complements to imported products.

In terms of proximate composition, the formulations varied in their contributions of energy, protein, fat, and fibre, reflecting how ingredient selection influences overall nutrient balance. One blend was richer in protein and ash, another was characterized by higher energy and fat, while the third provided greater fibre and moisture content. Similar variations have been reported by Nwankwo et al. [14], who observed comparable energy and protein values in locally produced formulations. Ishaq et al. [16] also found protein and fat levels within a similar range, while Edafioghor et al. [11] reported lower energy densities, suggesting that formulation design plays a crucial role in achieving nutrient adequacy. These findings support the feasibility of formulating RUTF that aligns with WHO recommendations using locally sourced crops.

The mineral composition also differed substantially across the blends. One formulation was richest in iron, zinc, and calcium, while another was distinguished by its higher potassium content. These differences mirror the variability observed in studies such as Adewumi et al. [12], where snack bars formulated with Bambara groundnut and Moringa provided minerals comparable to RUTF, though potassium was lower. In contrast, Edafioghor et al. [11] reported suboptimal levels of zinc and potassium, underlining the importance of ingredient selection in mineral adequacy. Umar and Orishagbemi [13] further emphasized that local crop profiles significantly determine mineral contributions. The present study therefore suggests that locally formulated RUTF can be tailored through formulation adjustments to target specific nutritional deficiencies. The variations observed demonstrate the feasibility of producing RUTF blends optimized for particular health needs, such as anaemia or electrolyte management. Collectively, all RUTF blends exhibited mineral levels appropriate for addressing micronutrient gaps in children at risk of malnutrition, with potential for further enhancement through ingredient and processing choices.

The vitamin profiles also revealed complementary strengths across the formulations. Overall, each RUTF blend excelled in specific vitamins: Blend B in vitamin A, Blend C in vitamin C, and Blend A in vitamin E. This reflects patterns reported by Yakubu et al. [15], who highlighted the variability of vitamin content in local RUTF compared with WHO standards. Edafioghor et al. [11] also demonstrated that vitamin A and E levels in their formulations fell within recommended ranges, though vitamin C information was limited. These findings indicate that while no single local formulation provides complete vitamin coverage, combining or adjusting formulations can enhance micronutrient adequacy. These variations may allow for targeted nutritional support depending on priority micronutrient needs. The results suggest that the formulation process can be adjusted to optimize vitamin content, contributing to the design of more effective and nutrient-rich therapeutic foods for children at risk of undernutrition.

In terms of sensory acceptability, all blends were generally well received, with one being most preferred overall, another ranking higher for taste, and another for aroma. These results are consistent with Nwankwo et al. [14], who reported that locally formulated RUTF achieved acceptability comparable to imported alternatives. Ishaq et al. [16] similarly observed that formulations with locally familiar ingredients were well accepted, while Yakubu et al. [15] noted that although WHO standard RUTF remained the most preferred, local formulations were still considered acceptable. This suggests that culturally familiar ingredients may improve compliance, an important factor in therapeutic feeding. Readily available and easily accessible ingredients also make these locally-formulated RUTFs more acceptable.

Taken together, the findings demonstrate the feasibility of formulating nutritionally adequate and acceptable RUTF using Nigerian indigenous crops. Previous studies have shown that locally sourced formulations can reduce production costs while maintaining nutritional quality [9]. Nwankwo et al. [14] similarly highlighted that local production improves sustainability and accessibility. Systematic reviews have also confirmed that both standard and locally produced RUTF are effective in improving recovery outcomes among malnourished children [7]. It is worthy of note that the RUTFs contribute a significant percentage to the recommended daily intakes for both the macro and micronutrients.

A strength of this study is the detailed evaluation of proximate, vitamin, mineral, and sensory attributes, providing a holistic view of the formulations. However, the absence of amino acid profiling, which is critical for assessing protein quality [12], is a limitation. Furthermore, clinical trials assessing recovery outcomes in children are needed to validate the practical effectiveness of these formulations.

This study demonstrates that RUTF made from locally available Nigerian ingredients can meet nutritional requirements while maintaining sensory appeal. Although one formulation emerged as the most acceptable overall, others provided unique strengths in specific nutrients. These results suggest that combining or optimizing local formulations may produce balanced, cost-effective, and culturally appropriate therapeutic foods for the management of severe acute malnutrition in Nigeria.

5. Conclusion

The locally formulated RUTF met the energy requirements of more than 500kcal per 100g and contained an appreciable amount of macro- and micronutrients. The appearance, taste, flavour, and overall acceptability of the blends were commendable, highlighting the potential for local production to effectively combat severe acute malnutrition among children under five using locally available plant-based crops in Northern Nigeria. Consequently, this study highlights the promising potential of Ready-to-Use Therapeutic Foods (RUTFs) formulated from locally available ingredients to address malnutrition in children – a vulnerable population. These findings align with global evidence supporting local production as a cost-effective, sustainable approach to improving nutritional interventions for vulnerable children. While the study provides comprehensive compositional data, future research should include clinical trials to validate health outcomes and explore protein quality in depth. RUTF formulations based on nutrient strengths may enhance therapeutic efficacy. Ultimately, locally formulated RUTF can play a critical role in combating malnutrition in resource-limited settings, contributing to improved child health and survival.