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Q&A with Mark Manary

By Christy Fricks
University of Georgia, Peanut & Mycotoxin Innovation Lab

Background

Mark Manary, MD, is one of ten Lead Scientists currently heading up research projects funded by PMIL. He is the Washington University Helene B Roberson Professor of Pediatrics, founder of "Project Peanut Butter" and the developer of a revolutionary peanut-based Ready-To-Use Therapeutic Food (RUTF). RUTF is successfully used to treat malnourished children worldwide. His current research with PMIL applies RUTF use in "Malnutrion Interventions" to prevent childhood stunting. He lives and works 11 months out of the year in Malawi, and has been involved in work in Sub-Saharan Africa for over 20 years.

PMIL: You have a long and impressive history of working with malnourished children. Tell me about your current research and why you’ve chosen to focus on pregnant women for this particular project?

Dr. Manary: "We are identifying and treating malnourished pregnant women with a Ready-To-Use Food Therapeutic Food. They (pregnant women) are a very vulnerable population, very high risk. The risk of dying while giving birth in Malawi is 1 in 400, which is the 3rd highest in the world. This project bridges science and practice. It involves screening and working in clinics. It helps people just by being in the project and has the potential to help lots of other people by generating information and it is entirely contingent upon peanuts. Since the food aid community has not focused on pregnant women in the past, we have neglected an opportunity to treat malnutrition in the very youngest children, until now. About 30% of stunting, chronic growth failure, occurs because of malnutrition in the womb, and this cannot be treated once the child is born. There is no standardized method to diagnose or treat moderate or severe malnutrition during pregnancy. This project is the first to venture into this area, and we start our journey in this area with a peanut-based food."

PMIL: Why did you decide to use a peanut-based food and not some other source of protein?

Dr. manary: "Peanuts are the right kind of food because it has a large oil composition. Peanuts are almost 50% fat or oil, and that is really the key element in the treatment of malnourished people. The beauty of the peanut formulation having so much oil in it is that the energy density of it is very high. This means a spoonful of peanut-based food is equal in calories to 5-6 spoonfuls of a traditional cereal like corn or rice. If you are malnourished and you need to get those nutrients in you to catch up, you can’t be given a pile of food as high as your computer screen. You need to eat something efficient and easy to get in. Also, the high oil, low water content of this peanut based food, means that it doesn’t spoil sitting around in a mud hut with a grass roof for 2-3 weeks. It is a hearty food, it is a clean food, and it is sometimes called a sanitary food. The food safety issues here are nominal, whereas if you cooked some kind of specialized porridge or dough and left it sitting around you couldn’t at it the next day."

PMIL: How is the program being received by the Malawian women and their community?

Dr. manary: "This program is very popular. This is a food that these women genuinely appreciate and enjoy. Rather than if you or I had to drink some kind of liquid milkshake. It is a well accepted and they want to come back in the program. This is something that the mother can use during the day—a ready to use food. She (the mother) is used to cooking meals and sharing for everyone. This is something that they can eat between meals as an addition to their regular diet. It is particularly formulated only for this purpose. We have to give them a product that meets their needs. Their needs are actually huge because we have a developing baby and a mother."

PMIL: What outcomes do you expect from this particular study?

Dr. Manary: "If the results are game changing, in terms of morbidity we will certainly initiate studying it in another location. We may develop a novel evidenced-based use for peanut-based foods to address a huge, neglected nutritional problem in Feed the Future Africa countries. It also creates a demand for high quality peanuts and it educates the public and health professionals about the high nutrient density of peanuts."

Published March 27, 2014