Plumpynut.

(cross posted at Kickin it with CG)

Every year, malnutrition kills five million children - that's one child every six seconds.  Many do not get the milk, vitamins and minerals their developing bodies need. Some mothers in these villages can't produce enough milk themselves and can't afford to buy it. Even if milk was available, its very difficult to store -- there's no electricity, so no refrigeration. Powdered milk is useless because most don't have clean water.

But now, 'Doctors Without Borders' believes that there is a product that can save millions of these children.  And may possibly be the most important advance ever to cure and prevent malnutrition.

Plumpynut.

A ready-to-eat, vitamin-enriched paste - it's cheap, easy to make, and extremely easy to use.  It is a simple formula: made of peanut butter, powdered milk, powdered sugar, and enriched with vitamins and minerals. It tastes like a peanut butter and is very sweet, and because of that many of the children love it. Developed by a nutritionist. It does not need refrigeration, water, or cooking; it is simply squeezed out in a paste and thus many children can even feed themselves.

Each serving is the equivalent of a glass of milk and a multivitamin.

In Niger, in West Africa, where child malnutrition is so widespread that most mothers have watched at least one of their children die, 'Doctors Without Borders' has been handing out Plumpynut.  This was covered in a segment by 60 Minutes.

Niger has become Plumpynut's proving ground. A daily dose costs about $1; small factories mix it there and in three other African countries.  In Niger, most children need help now during what's called the "hunger season," just before the new harvest. Old food supplies have run out and about all that's left is millet, a basic grain women pound for porridge. But millet doesn't have enough nutrients to keep kids alive; in the western world it is used it as birdseed.

Dr. Susan Shepherd, a pediatrician from Butte, Mont., runs Doctors Without Borders in Niger, says children that would have been hospitalized in the past can now be treated at home. "The reason we can do that is because we can give children Plumpynut here in the ambulatory center, and they take a week's ration home. Moms treat their children at home and come back every week for a weight check," Dr. Shepherd explains.

Children are weighed and measured at the distribution sites. They're also examined to make sure they don't have any serious infections. Malnutrition destroys a child's immune system, so they're more susceptible to diseases and less capable of recovering from them.

If Plumpynut is the answer, how come kids are still dying?

"The answer is getting to kids earlier," Shepherd says. "Once children are as sick as she is, Plumpynut is not gonna save her."

What about peanut allergies?

"We just don't see it.  In developing countries food allergy is not nearly the problem that it is in industrialized countries."

On a list of 177 developing countries, the United Nations ranked Niger dead last. More than 70% of the people are illiterate and earn less than a dollar a day. The average woman will give birth at least eight times in her life. But largely because of malnutrition, one in five of their children will die before they reach the age of five. Of those who survive, half will have stunted growth and never reach full adult height.

Fortified ready-to-eat products, like Plumpynut, save children's lives. Dr. Tectonidis says if the more countries were willing to spend part of their food aid on this, more companies will start making it.

"Even by taking a miniscule proportion of the global food aid budget, they will have a huge impact, huge impact!" Tectonidis says. "We're not even asking for billions. It will solve so much of the underlying useless death. So we gotta do that now."

"Wasted life. Just totally wasted life for nothing. Because they don't have this product, a little bit of peanut butter with vitamins," Tectonidis says. "What a waste."



Display:


a little bit of peanut butter with vitamins.... (2.00 / 20)

that's it.


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Sun Jul 20, 2008 at 10:42:17 PM EST

Just for the Record (2.00 / 11)

The Médecins Sans Frontières international website.


by Shaun Appleby on Sun Jul 20, 2008 at 10:56:45 PM EST
[ Parent ]

Re: a little bit of peanut butter with vitamins... (2.00 / 8)

In 2005, nearly 60,000 children with malnutrition in the Maradi region of Niger were treated with a ready-to-use therapeutic food (Plumpy'nut), resulting in recovery rates of about 90% and death rates of less than 5%.

PLoS Med

The Public Library of Science articles should be free for those interested in reading more about general research in complex humanitarian emergencies (one mention of Plumpy'nut). A more specific article on Plumpy'nut (and its relatives) can be found in the New England Journal of Medicine, which may not be free to the public (my university has a lot of subscriptions), so I'll blatantly copy large chunks of important data and if anyone has a problem with it, I'll send you a quarter to call someone who cares. I summarized some of the more opinionated or redundant things outside of the blockquotes so I don't take over CG's diary any more than I already have.

(The author is a nutritional specialist with Médecins sans Frontiéres.)

Many people in Niger face chronic food insecurity, but there were clear warning signs that 2005 would be much worse than usual. In March 2005, severely malnourished children began pouring into the Médecins sans Frontières (MSF) feeding center in Maradi, and surveys warned of a disaster with the next harvest more than six months away. Food reserves began to run out, and cereal prices went up. People could no longer afford enough food for their families or medical care for their sick children. They resorted to selling off their cattle, and livestock prices plummeted. Urgent measures were required.

Yet Niger's consortium of decision makers -- the government and its international partners, including countries in the European Union, United Nations agencies, and the Famine Early Warning Systems Network of the U.S. Agency for International Development -- saw the food deficit as a circumscribed problem and feared that relief assistance would disturb the market and hamper long-term development goals. Instead of undertaking targeted distributions of free food, as had been done in neighboring countries, this consortium made cereals available at subsidized prices, but in insufficient quantities. In effect, food was sold to starving people at a price few could afford.


I just wanted to set the stage so people (like catfish, below) could understand the scope of the problem. They tried "teaching people to fish", unfortunately it was in dry lake beds. It had moved from an economic crisis to a humanitarian one.

Lots of starving kids, that's bad. So they came to the DWB medical tents for attention...

Until recently, severely malnourished children were routinely hospitalized in therapeutic feeding centers, where they received medical care and nutritional rehabilitation with therapeutic milk products. But because of the substantial resources required, it has rarely been possible to open a sufficient number of these centers rapidly enough to save the many children who require treatment during emergencies -- and it has been even less possible to maintain operations for those who require treatment during normal times in countries with chronic food insecurity.1

Such treatment programs also can be unexpectedly counterproductive, compromising the health of patients' siblings, who may be left at home without their mother while she remains at the feeding center with the patient. Furthermore, keeping large numbers of children in one place, even under ideal conditions, increases the risk of nosocomial transmission of infections, and the risk of treatment errors is increased in large centers during emergencies.


They did their best with nutritional products pre-Plumpynut, but resources were limited and they weren't a perfect solution. Enter Plumpynut, life gets a little bit easier, since it's nicely packaged and it's kind of hard to over-indulge on it. Also, it doesn't need water to hydrate it, to deal with what the article politely calls areas with water that "may be of suspect quality".

Although anthropometric data are essential for establishing entry and discharge criteria, it has become clear that the appetite and clinical status of the child are the most sensitive indicators of risk and of the necessity for hospitalization. Children who do not eat what they are fed at a nutritional rehabilitation center usually have serious infectious or metabolic disorders that necessitate hospitalization. But for most other children, and for children whose condition has been stabilized in an inpatient setting, weekly medical consultation is sufficient for health care providers to diagnose and treat the common, non-life-threatening complications and infections associated with severe malnutrition. Most children in outpatient programs for severe malnutrition who are treated with the new solid therapeutic foods are cured in four weeks, without having to be hospitalized.

Instead of hospitalizing starving children, you can hospitalize sick children and feed starving children. Whether inpatient or outpatient (hospitalized or Plumpy'nutted), the mortality rate was 5%.
For years, almost nothing was done for children in Niger with severe, acute malnutrition. This lack of treatment is all the more surprising because Niger is a peaceful country with a stable government and a functional ministry of health that has welcomed global assistance and followed the advice of international development consultants.

Among government and United Nations officials, aid workers, and media commentators, the catchword for the situation in Niger has been "chronic." For each affected child, however, acute malnutrition is not a chronic problem, but a medical emergency -- one that carries a high risk of death.

The families of our patients in Niger have clearly understood this fact. The rate of participation in our nutritional program has been very high, with less than 5 percent of patients dropping out once they have entered. Some mothers walk long distances each week to participate, and others from neighboring villages share taxi costs. They can see that the treatment is working for their children. Medical professionals, wherever they practice, must insist that the simple, effective, and affordable treatments that now exist be made available to all children who are affected by acute malnutrition.

The world is seriously screwed up sometimes.

Again, thanks to CG for the diary, since it's gotten me to read a couple of really interesting articles on the situation.


by TCQuad on Mon Jul 21, 2008 at 12:30:26 AM EST
[ Parent ]

Re: a little bit of peanut butter with vitamins... (2.00 / 5)

Heck I could have told you that a person can live on peanut butter :)  I did for years...well, with jelly.

Seriously, where can I send a big ol' bundle of money specifically for the purpose of underwriting some plumpynut distributioin?


I'm for a timeline on Iraq, public funding of elections, women's reproductive rights, gun restrictions and universal suffrage. So why should I vote for Obama?
by William Cooper on Mon Jul 21, 2008 at 10:52:40 AM EST
[ Parent ]

start with.... (2.00 / 1)

doctors without borders - i think.  

i saw some other sites - but they seemed fishy to me.  unless someone knows how to specifically donate to plumpynut distribution?


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 11:04:55 AM EST
[ Parent ]

Worst Case Scenarios are depressing (2.00 / 1)

$10 to save a child from malnutrition and inevitable death.

Sounds a lot better than a dollar a day, don't it? [yes, in one case we're talking Vitamin A deficiency, in another we're talking protein deficiency]

The science is cool. Can we get some nice genetically modified stuff that will grow the protein in Nigeria at a decent price? ;-)


His head is bowed. He thinks of men and kings. Yea, when the sick world cries, how can he sleep?
by RisingTide on Mon Jul 21, 2008 at 04:26:39 PM EST
[ Parent ]

Re: Plumpynut. (2.00 / 6)

Thank you.


by rayj on Sun Jul 20, 2008 at 10:42:55 PM EST

Re: Plumpynut. (2.00 / 4)

I think the problem there is larger than the lack of "peanut butter and vitamins". I read the article above and what jumped out at me most is the average of eight (8) children in one lifetime. I realize, however, that your diary isn't specifically about that facet of what's wrong in third world countries.

Bottom line - this can save lives. Kudos for posting. -j


by jandz on Sun Jul 20, 2008 at 11:02:07 PM EST

oh certainly. (2.00 / 3)

you are right that the problems are much larger...
but thanks for the comment though.
"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Sun Jul 20, 2008 at 11:05:26 PM EST
[ Parent ]

Re: Plumpynut. (2.00 / 1)

that's a cultural and religious issue that needs addressing all over the world.

p.s. yes this is Jeff, Tony uses ellipsis's (...)a lot, one way to tell between us, and he get's a lot more passionate about some stuff then I do. enjoy your tin-foil theory's :)


by trytobereal on Sun Jul 20, 2008 at 11:28:40 PM EST
[ Parent ]

economic issue (none / 0)

kids on farms are an economic resource, kids in cities are an economic drain


His head is bowed. He thinks of men and kings. Yea, when the sick world cries, how can he sleep?
by RisingTide on Mon Jul 21, 2008 at 04:29:13 PM EST
[ Parent ]

Re: Plumpynut. (none / 0)

BUT ABSTINENCE-ONLY EDUCATION WORKS!!!!!!

(Sorry, that's me impersonating Bush and his cronies)


by ProgressiveDL on Mon Jul 21, 2008 at 10:12:07 AM EST
[ Parent ]

This strikes me as giving them a fish (1.33 / 3)

instead of teaching them to fish for themselves. Something seems suspect. But thank you for posting it.

Also - how come so many kids today have peanut allergies?


by catfish2 on Sun Jul 20, 2008 at 11:27:06 PM EST

Re: This strikes me as giving them a fish (2.00 / 14)

When a little girl needs something to eat right now or she'll die, it's better to give her a fish than to not give her a fish, no?  It's no substitute for a long-term plan, but there are a lot of people in this world who need to see the sun rise tomorrow before thinking about what happens in months or years.


Join the Matthew 25 Network and help Democrats win the next generation of evangelicals.
by mistersite on Sun Jul 20, 2008 at 11:32:18 PM EST
[ Parent ]

Re: This strikes me as giving them a fish (2.00 / 2)

Agreed. If a person is too weak to fish, then teaching them how to tie flies and cast lures is pointless. They need to be fed FIRST. After they've had a couple of meals, teach them to fish.


by SuGeAtARC on Mon Jul 21, 2008 at 12:00:21 PM EST
[ Parent ]

not sure about the peanut allergy... (2.00 / 4)

thing - but its a serious problem here in canada.  if you have young children (at least here in my city) you cannot bring any products with peanuts in them to schools, parties etc.

and with regard to plumpynut - i believe that its only being used:

as a treatment for emergency malnutrition cases.


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Sun Jul 20, 2008 at 11:37:13 PM EST
[ Parent ]

I think because it's a patented product (none / 0)

that my suspicion flag immediately goes up. Why not refer to it (and I'm not blaming the diarist, I saw Anderson Cooper do this too,) as a peanut substance?

It sounded like a commercial.


by catfish2 on Mon Jul 21, 2008 at 01:20:20 AM EST
[ Parent ]

It sounded like a commercial??? (2.00 / 5)

what you mean like we are trying to sell it?  your comment is strange.

but for the record - i have no problem with the manufacturer or inventor of this problem patenting or in fact making a profit on this considering IT WILL POTENTIALLY ERADICATE MALNUTRITION!


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 01:25:47 AM EST
[ Parent ]

problem=product. (none / 0)


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 01:26:59 AM EST
[ Parent ]

Healthy skepticism (2.00 / 1)

Is all I'm asking for.

Many African peoples who suffered for years under colonialism still suffer from the colonialism mindset, they are infantilized by this mindset. Plumpynut sounds like a short-term solution but a long-term solution would be to wean this area off of this product they can't produce themselves (or get them to grow the crops so they can produce Plumpynut themselves.)

Seems the long-term solution is to get the mothers to the point that they, like mothers for thousands of years have done, can produce the milk themselves:

Why are so many kids dying? Because they can't get the milk, vitamins and minerals their young bodies need. Mothers in these villages can't produce enough milk themselves and can't afford to buy it. Even if they could, they can't store it -- there's no electricity, so no refrigeration. Powdered milk is useless because most villagers don't have clean water. Plumpynut was designed to overcome all these obstacles.

The World Bank and WTO have instituted some/many top-down policies that in the long run have been a boon to certain corporations but have not made third-world countries more self-sustaining or better off.


by catfish2 on Mon Jul 21, 2008 at 10:33:26 AM EST
[ Parent ]

Re: Healthy skepticism (2.00 / 2)

your comment is fair.  however - the situation is such that it if not acting now - children are dying.

so while i am in total agreement that 'teaching to fish' is the only true solution - its a real ignorance of the problem on the ground.  these people know how to fish - what they don't have is water to fish from.


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 10:37:28 AM EST
[ Parent ]

Good diary, good cause (none / 0)

I had the same reaction after seeing Anderson Cooper's report - that he didn't ask enough questions. And I come from the school of if your mother tells you she loves you, check it out.


by catfish2 on Mon Jul 21, 2008 at 11:35:42 AM EST
[ Parent ]

Solutions are coming... (2.00 / 1)

in the form of genetically modified foods (yellow rice, for now, because it's relatively easy!). But we have to stop standing in the way of humanitarian scientists so that kids can stop dying...

I remember reading about women being encouraged to not breastfeed as a PR campaign to sell more formula by an American company. Nevermind that after they stopped breastfeeding, they coudln't go back, and they often couldn't afford the formula... (south America, in case you're interested)


His head is bowed. He thinks of men and kings. Yea, when the sick world cries, how can he sleep?
by RisingTide on Mon Jul 21, 2008 at 04:31:59 PM EST
[ Parent ]

Asking questions is not standing in the way (none / 0)

Yes the breastfeeding story is exactly what I'm talking about.


by catfish2 on Mon Jul 21, 2008 at 10:22:38 PM EST
[ Parent ]

Re: not sure about the peanut allergy... (none / 0)

I thought I saw a study recently where it said that either eating or not eating nuts during pregnancy has a strong correlation to peanut allergies.  Of course, it would be nice if I could remember which way it was.  Anyone know what I'm talking about?


by ProgressiveDL on Mon Jul 21, 2008 at 10:14:03 AM EST
[ Parent ]

Re: not sure about the peanut allergy... (none / 0)

um i have heard this - but i have also heard that the removal of peanuts from pregnant women and/or babies is also suspected as a reason....


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 10:23:14 AM EST
[ Parent ]

Re: not sure about the peanut allergy... (2.00 / 1)

Yeah, I did some looking online but I couldn't find real good evidence either way.  I may try LexisNexis  after my class ends.  I did come across this tidbit from Wikipedia (admittedly, not the best source):

"On July 20, 2007, the North Carolina Agricultural & Technical State University announced that one of its scientists, Dr. Mohamed Ahmedna, had developed a process to make allergen-free peanuts. Initial testing showed a 100 percent inactivation of peanut allergens in whole roasted kernels, and human serums from severely allergic individuals showed no reaction when exposed to the processed peanuts. Food companies have expressed an interest in licensing the process, which purportedly does not degrade the taste or quality of treated peanuts, and even results in easier processing to use as an ingredient in food products."


by ProgressiveDL on Mon Jul 21, 2008 at 10:54:19 AM EST
[ Parent ]

Re: This strikes me as giving them a fish (2.00 / 12)

Something seems suspect?  I'm going to assume the intent of that comment isn't as mean spirited as it sounds.

Sometimes you need to give someone the fish before you teach them to catch their own.  Otherwise, they tend to die of starvation. This product can save lives right now. It's not intended to be a long term solution, but it's an important part of a larger strategy to feed people.

Excellent diary.


No Way. No How. No McCain.
by Denny Crane on Sun Jul 20, 2008 at 11:55:38 PM EST
[ Parent ]

bingo! (2.00 / 4)

but it's an important part of a larger strategy to feed people.

and its just getting going - imagine if these organizations had what they needed? wow.


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 01:22:57 AM EST
[ Parent ]

Re: bingo! (2.00 / 1)

Seriously canadian gal - thanks for writing this important diary.  We could use a lot more diaries like this.  It's so important that we not develop tunnel vision and forget why we are progressives.  Often we get so wrapped up with the election we forget there are actual life and death issues that we can help with.


No Way. No How. No McCain.
by Denny Crane on Mon Jul 21, 2008 at 01:06:20 PM EST
[ Parent ]

Re: This strikes me as giving them a fish (2.00 / 8)

Mistersite beat me to the punch on the first question. Kids need to be alive to learn how to fish. Also, they need water to fish in.

On the second question, no one knows. Recent article in Lancet summarized it thusly:

Peanut allergy has become a major health concern worldwide, especially in developed countries. However, the reasons for this increasing prevalence over the past several decades are not well understood.

That's the scientific equivalent of shrugging shoulders. It's definitely something early on, probably not genetic if the stats are right.

The rise in peanut allergy has been well documented in a population-based study of 3-year olds in the UK, in which the prevalence of sensitisation to peanuts rose from 1·3% to 3·2% between 1989 and 1995

Far too quick of an uptick for a genetic shift (unless there's peanut population changes I'm unaware of). It's obviously developed by age 3, since that's the test range, but I'd need to actually have a kid to figure out what sort of exposure variables would come into play.

 a newer study in the USA, the rate of peanut allergy increased from 0·4% in 1997 to 0·8% in 2002 in young children. In an epidemiological study in Canada, the estimated prevalence of peanut allergy in children was 1·34%.

Different metric (levels of sensitivity cutoffs, from "sensitization" above to "allergic" here), same stats and interpretation.  

Data from the UK's Avon Longitudinal Study of Parents and Children, a geographically defined cohort study of 13 971 preschool children, was used to identify those with a convincing history of peanut allergy and the subgroup that reacted to a double-blind peanut challenge. Peanut allergy was independently associated with intake of soy milk or soy formula and with the use of skin preparations containing peanut oil, although these results have yet to be confirmed in other studies. Other researchers have suggested that the presence of peanuts in the mother's diet before birth could be a risk factor for the development of peanut allergy, but this finding has not been replicated. The explanation for the increase in the diagnosis of peanut allergy in the past several years has yet to be explained adequately. Allergic disease in general has been shown to have a genetic predisposition, although the development of peanut allergy has not been linked to a specific genetic predisposition.

I'm a little out of my field (this is a medical journal rather than biochemical), but buzzword interpretation for the layman: there was a big study, found maybe soy or peanut oil. Another one said mother eating peanuts, but don't believe that. Maybe it's genetic, because allergies are generally genetic, but no one can prove that. (Soliloquy: every time non-genetics people run into a problem, they say it may be genetics. Jeez... It's like a mechanic looking at your car and saying the problem may be a loose connection. No duh there's some truth to the statement, but did the connection/gene products fail because they're defective or was it because the fan belt came flying across and shredded it? It's such a cop out answer.)

Then there was a huge section on how to diagnose, treat, blah blah blah, back to changes in the epidemiology. Again with the mother's diet either in utero or while breastfeeding. Maybe it's the thermal processing (it causes sugars to bond with the proteins, which can change how immunogenic they are), but that hasn't changed for decades, so probably not. Maybe we're getting peanuts too early (peanut oil products), but since the usage of the peanut oil products is high in Britain and low in the US but there's been a similar increase in both places, probably not.

The paper concludes with talking about hypoallergenic peanuts and other treatments, but that's sort of tangental.

I guess I could've just said "we don't know", but it was an interesting (if brief) read.


by TCQuad on Sun Jul 20, 2008 at 11:56:26 PM EST
[ Parent ]

Re: This strikes me as giving them a fish (2.00 / 3)

I was curious about the statistical frequency of peanut allergy and you answered my curiosity: At most, about 3.5%. So PlumpyNut would likely be perfect for at least 96.5% of starving children. Darn good result there, if you ask me.

I was also wondering if maybe a SunnyNut alternative made with sunflower seeds or a WallyNut allternative made with walnuts or even an AllyNut alternative made with almonds could be created to offer to those children who might develop peanut allergy.

You're very right. Kids need to be alive to learn how to fish and farm.

If the "dear Lord" won't help them, maybe we can.


by RickWn on Mon Jul 21, 2008 at 12:51:50 AM EST
[ Parent ]

On allergies, I recall an article (none / 0)

that investigated how many deaths from peanut allergies have occurred over this same time period in which diagnoses have skyrocketed, and they found deaths (which are always serious, of course) have not increased at all.

Also, we took care of some inner-city kids and found out after the fact (after one had eaten a peanut butter sandwich or maybe it was a peanut butter cookie) that one had a peanut allergy. But he didn't get sick, swell up, nothing. That's just one example, but it is strange. Of course I suspect the makers of the epipen are behind this.


by catfish2 on Mon Jul 21, 2008 at 01:23:32 AM EST
[ Parent ]

Re: On allergies, I recall an article (2.00 / 1)

I don't quite have enough tinfoil to justify a conspiracy theory against the makers of the epipen, but a couple quick notes:

-Lots of injuries and illnesses have had an increase in survival over the last decade or so. For instance, people wounded in Iraq have a 90% survival rate, but I don't think people would look at the numbers of injured survivors and say "some of them aren't actually injured". It's entirely possible that a simultaneous rise in allergic reactions and allergy treatments led to the stabilization in deaths.

-People can become sensitized to various allergens over time. Personal example: my mother. In the pharmacy, exposed to antibiotic dust so often she was probably never had a bacteria on her in 20 years. Then, she got sick. Got some antibiotics. Had a horrible allergic reaction. Hasn't been able to dispense penicillin since (they have a separate tray to count out those pills for people who are generally allergic to it). It's called chemical sensitization (here's a generic web definition close to my old HazWOper one):

Chemical sensitization is caused by an allergic reaction the body can develop to many chemicals. This allergy may exist already or may develop following a few days, weeks or even years of exposure. Once a person becomes sensitized, even very small amounts of chemicals can bring out an allergic reaction -- usually a blistering, swelling, itching, reddening or acne-like condition.

So, again, it's possible that something in the immune system is reacting, but not enough (yet) to cause a visible allergic reaction.  It's like lighting an old Bic lighter. Sometimes you spin the wheel and not get a spark (no reaction), sometimes the spark doesn't light the butane (invisible reaction) and sometimes you get a flame (allergic reaction).

Your boy probably had a reaction to a skin-test, which could indicate a sensitization or a reaction to a specific type of peanut allergen (which your peanut butter may not have had; as mentioned before, different cooking processes can have different antigens created). Heck, depending on the brand, there may have never been any peanuts in there in the first place. Over time, he may develop a more severe allergy. Or none at all and just remain sensitized.

Either way, I wouldn't go feeding him handfuls of roasted peanuts, but at the same time I do agree that the fear of peanut allergies can drive some hysterics.


by TCQuad on Mon Jul 21, 2008 at 02:11:52 AM EST
[ Parent ]

Capitalism is like an innocent racket (none / 0)

I don't quite have enough tinfoil to justify a conspiracy theory against the makers of the epipen, but a couple quick notes:

Why do so many kids get medicated for ADD and ADHD and even bipolar disorder before they reach the age of 5?
by catfish2 on Mon Jul 21, 2008 at 10:22:08 AM EST
[ Parent ]

Re: Capitalism is like an innocent racket (none / 0)

Because parents are terrified and gullible or lazy and want their children to be little adults, because some doctors are too eager to appease parents, and because kids are kids.

I do agree ADD is over-diagnosed (my mother was a teacher before recently retiring, so I've heard stories about how many ADD students there are nowadays). The problem is that there's no clear diagnostic criteria for 99% of the cases. It's simply "this kid is acting out, I never did that when I was young, there must be something wrong with him that isn't my fault!"  Usually at least two of those three statements are in error.

In that case, I think you could make the case that it's pushed by pharmaceuticals, but I still think that, no matter how hard they lobbied, they couldn't do anything without doctors and, more importantly, parents.

On the flip side, allergic reactions can be physically quantified, empirically tested and accurately diagnosed. That sort of takes it out of the hands of the epipen manufacturers.


by TCQuad on Mon Jul 21, 2008 at 11:41:45 AM EST
[ Parent ]

Didn't get sick... (none / 0)

are you sure he wasn't just lying? ;-)
I knew a kid who "loved" fish, but kept barfing them up in the bathtub. (because it was the only thing his parents would actually make for him...). Finally couldn't take it anymore. Don't think the parents know to this day how sick he was getting.

Also, allergic responses can come in the form of shock, even food allergies. Dizziness, poor judgement, shiverring, reduced breathing.

Allergies are nasty nasty things. Particularly the closer they get to being lifethreatening. Hives ain't bad.


His head is bowed. He thinks of men and kings. Yea, when the sick world cries, how can he sleep?
by RisingTide on Mon Jul 21, 2008 at 04:37:41 PM EST
[ Parent ]

Re: This strikes me as giving them (2.00 / 1)


Gluten allergy is common and its cause is quite clear.  Basically, it's a result of putting babies on cereal grain-containing baby formula too early.
by killjoy on Mon Jul 21, 2008 at 03:31:58 AM EST
[ Parent ]

cite me a source on that? (2.00 / 2)


His head is bowed. He thinks of men and kings. Yea, when the sick world cries, how can he sleep?
by RisingTide on Mon Jul 21, 2008 at 04:38:03 PM EST
[ Parent ]

You're incorrect (2.00 / 1)

At least as far as your claim that early gluten exposure is the cause of celiac disease (the gluten "allergy" you're referring to; technically it is not an allergy).  In fact, it's not even clear that such exposure is a cause at all.  This is an important interest of mine, as my sister and cousin are celiacs, so my potential future offspring are at greatly increased risk, as research has demonstrated a prominent genetic component -- for example, one study on Ireland (one of the most common ancestries among celiacs) showed a very strong correlation between celiac prevalence rates and the county of birth.

This is not to say that the link is nonexistent;  As far as I'm aware, there is at least one study that has found a link between early exposure to gluten and increased risk for the disease (not the same as "cause is quite clear").  However, another study found the reverse, that early introduction of gluten actually protects against the disease.  There are also many other suspected risk factors.  

Anecdotally, my sister and I are only a year apart, had very similar diets as infants, yet I did not develop the disease (nor did billions of other infants that consumed cereal-containing formula at an early age).

I and millions of others could only wish that the link was as simple as you think it is.  I don't mean to come off as harsh, and I do appreciate your mentioning this disorder which doesn't get nearly enough attention, but my point is that celiac disease is an ongoing area of substantial research, and as far as science is concerned, the cause is currently unknown.


by semiquaver on Mon Jul 21, 2008 at 09:47:48 PM EST
[ Parent ]

Re: This strikes me as giving them a fish (2.00 / 1)

I personally don't want little kids to fish unless it's for fun.  I'm of the opinion that little kids need time to be little kids no matter which country they live in.  If you would think it improper and bizarre to tell your own kids to go out and fend for themselves, I don't think we should be saying that to any children.


by Tenafly Viper on Mon Jul 21, 2008 at 06:16:26 PM EST
[ Parent ]

Re: This strikes me as giving them a fish (2.00 / 1)

Giving a five year old food before teaching him how to fend for himself is a problem?

I guess we should let all infants fend for themselves, by your logic.

BTW - the number of children who die of kwashiokor far exceeds the number who die of peanut alleries.


by Khun David on Tue Jul 22, 2008 at 11:31:07 AM EST
[ Parent ]

Wow, this is an awesome (2.00 / 9)

and incredibly important diary. Highly rec'd!


Even John McCain lusts after teh engels.
by sricki on Sun Jul 20, 2008 at 11:28:17 PM EST

this has been on my mind for weeks. (2.00 / 6)

and i finally decided to get off my butt and write about it.  so simple - plumpynut.  hopefully - doctors without borders will get the funds they need to kick this into high gear.


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Sun Jul 20, 2008 at 11:32:39 PM EST
[ Parent ]

So simple (2.00 / 10)

Plus... It's kind of fun to say "plumpynut". Plumpynut. Plummmmpynut.

Hee hee.


by TCQuad on Mon Jul 21, 2008 at 12:00:13 AM EST
[ Parent ]

lol. (2.00 / 8)

i was going to call the diary peanut butter w/vitamins - but then said to myself - hell no - its got to be plumpynut.


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 12:05:43 AM EST
[ Parent ]

Re: lol. (2.00 / 2)

HAD to be plumpynut.

Great diary as usual canadian darlin, woops! ;o)

I mean, canadian gal.

I'm just messin wid you.


We want to see Ivana [Trump] because we are so desperate in Alaska for any semblance of glamour and culture. - Sarah Palin
by spacemanspiff on Mon Jul 21, 2008 at 12:18:09 AM EST
[ Parent ]

Soylent Green (2.00 / 2)

"ready-to-eat, vitamin-enriched paste"

Sounds like an advert for Soylent Green


by gil44 on Mon Jul 21, 2008 at 09:17:16 AM EST
[ Parent ]

Re: So simple (2.00 / 3)

PuuuuhhhhLumpyNut is kind of fun too!  :-)


by RickWn on Mon Jul 21, 2008 at 01:01:10 AM EST
[ Parent ]

Re: this has been on my mind for weeks. (2.00 / 1)

Thank you, great diary, and hopeful...


Join the California Nurses Association/National Nurses Organizing Committee to fight for guaranteed, single-payer healthcare: www.GuaranteedHealthcare.org/blog
by California Nurses Shum on Tue Jul 22, 2008 at 04:40:36 PM EST
[ Parent ]

hopeful! (none / 0)

great way of putting it.  and love the sig btw.


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Tue Jul 22, 2008 at 04:51:18 PM EST
[ Parent ]

Re: Plumpynut. (2.00 / 4)

Great issue and I love the diary.


by Politicalslave on Mon Jul 21, 2008 at 12:44:07 AM EST

Graet diary.. (2.00 / 1)

..CG, keep up the good work!!  The Pens signed Crosby Malkin and Fleury to long term deals and we have Satan and Fedetenko...2009-2012  Stanley Cup Champions.Whoooooot.....Whoooot!!


A useless "Community Organizer" from Pennsylvania as noted by Republicans, Rudy Giuliani and Sarah Palin
by hootie4170 on Mon Jul 21, 2008 at 01:34:01 AM EST

Re: Graet diary.. (2.00 / 1)

Ah...That would be "Great"...


A useless "Community Organizer" from Pennsylvania as noted by Republicans, Rudy Giuliani and Sarah Palin
by hootie4170 on Mon Jul 21, 2008 at 01:34:28 AM EST
[ Parent ]

Does MSF have a... (2.00 / 1)

...dedicated Plumpynut drive going?  Is there a link?

Of the various projects, this has serious promise.


Visiting the hopium dens proudly since 2007.
by AZphilosopher on Mon Jul 21, 2008 at 02:59:57 AM EST

Re: Plumpynut. (2.00 / 1)

Oh and I looked at this diary instead of the PUMA/non-PUMA flame war thingy that's going on today.  So please direct me to what to do next, I want to help.


Visiting the hopium dens proudly since 2007.
by AZphilosopher on Mon Jul 21, 2008 at 05:25:26 AM EST

i saw some stuff online... (none / 0)

but i am not sure of their validity.  shaun up above kindly provided the link to Médecins Sans Frontières which is the international arm of Doctors without Borders.

i think i would start there.


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 09:18:02 AM EST
[ Parent ]

REC-REC! (2.00 / 3)

Great work, CG!

We need to keep up the (at least) two-pronged effort to feed the children.

1/  Make the food available, and

2/  See that it gets to them.

The first we can do with donations, the second is a political problem.  My 99-year-old neighghbor Up North (would have been 100 now, RIP Ronnie) told me a story from 50 years ago about another Kawagama Lake fellow, good Christian, who had heard about starving children in Africa and chose to do something about it.  He raised money, bought a shipload of food and went with it to Africa.

When he got off the ship on the other end he was beaten nearly to death with rifle-butts and watched the Men With Guns take all the food...

But it is not a hopeless effort.  In 1960 1/3 of the population (1B people) lived in endemic agricultural starvation.  By ~2005 that number was reduced to 1/8 (850M) and the geographic area of the world where this occurs greatly reduced (but of course population density has risen).  [I believe those numbers are from this SciAm article but my SciAm magazines are still packed and I can't see the whole article online.]

Thanks for promoting the focus, CG.

-chris


Donate!
by chrisblask on Mon Jul 21, 2008 at 07:35:03 AM EST

Re: Plumpynut. (2.00 / 4)

How dare they steal my high school nickname.


Ornithological Vaccinations and Aviary Heuristics
by OVAH on Mon Jul 21, 2008 at 10:55:55 AM EST

Neat (2.00 / 1)

The allergy thing does worry me though.  Just because we don't see it as much in poorer countries doesn't mean it isn't there, and some kids die with just a whiff of the stuff.

I guess there really isn't any food SOMEONE won't be allergic to though.


by libertyleft on Mon Jul 21, 2008 at 12:40:29 PM EST

Re: Neat (2.00 / 1)

The question seems to be why are so many American children allergic to peanuts. Certainly peanut allergies were not that common 30 years ago when my children were young. And when I was going to Catholic school 50 years ago, with 60 kids in my class, almost all of us ate peanut butter and jelly for lunch, and there was no problem.


"For what do we live, but to make sport for our neighbors, and laugh at them in our turn?"
by redstocking on Mon Jul 21, 2008 at 01:48:09 PM EST
[ Parent ]

Re: Neat (none / 0)

Could be the problem was there but simply not known about, which is the same fear I have for developing countries with this.

As I said though, yeah, better than nothing.


by libertyleft on Mon Jul 21, 2008 at 03:27:59 PM EST
[ Parent ]

probably not... (2.00 / 1)

the idea seems like an epidemic, like autism (which, bear in mind, might have the same level of occurence in agricultural regions, without the level of incapacitation -- you can deal with the less stressful, less interactive life).

This seems to be something related to exposure -- either exposure to semi-toxic chemicals or the ABSENCE of exposure to bacteria.

In ages past, people ate a lot more bacteria (and a lot less ratshit. they have a legal amount of ratshit allowed in candy bars).


His head is bowed. He thinks of men and kings. Yea, when the sick world cries, how can he sleep?
by RisingTide on Mon Jul 21, 2008 at 04:41:03 PM EST
[ Parent ]

Re: Neat (2.00 / 1)

It is possible that they may die from a whiff of the stuff, but we know they will die without it.

Most allergies require repeat exposure to develop and it is unlikely that these children have had that exposure.  They may develop after a while and then we would have to find a new protein source.

This is still the most hopeful advance that I have seen in a long time.  Now, if we could only afford some for the poor and hungry children here at home.


by Susan from 29 on Mon Jul 21, 2008 at 02:24:01 PM EST
[ Parent ]

Re: Neat (2.00 / 1)

How many children die from kwashiokor vs. peanut allergies?  It seems to me that the billions who died of malnutrition or from poor sanitation until the early 60s never had a chance to die from peanut allergies.


by Khun David on Tue Jul 22, 2008 at 11:37:40 AM EST
[ Parent ]

Re: Plumpynut. (2.00 / 1)

Highly Rec'd.

Honestly, this diary is truly more important that 99% of what gets posted here.  This is life or death.

CG - Thanks!


Obama/Adam West or Bruce Campbell or Lucy Lawless '08
by Purple with Green Stipes and Pink Polka Dots Dem on Mon Jul 21, 2008 at 03:33:00 PM EST

thank you kindly. (none / 0)

this diary is a perfect example of how you see who the real progressives are in the comments, rec's and ratings.  many have stayed out of this diary because it does not promote a candidate or create a flame war.

to me its v. telling.  


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 03:39:11 PM EST
[ Parent ]

Re: Plumpynut. (2.00 / 1)

This is a great diary.  But does anybody else think this sounds exactly like the concept behind astronaut food?  So why didn't we think of this sooner?


by Tenafly Viper on Mon Jul 21, 2008 at 06:25:57 PM EST

crazy huh? (none / 0)

such a simple concept - how did no one think of this earlier?


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 10:24:31 PM EST
[ Parent ]

google'd plumpynut. my fav pic---- (2.00 / 1)




great diary canada. 5 million kids is just way too many.
by alyssa chaos on Mon Jul 21, 2008 at 06:46:10 PM EST

Re: Plumpynut. (2.00 / 1)

If I could use my full weeks rec on one diary, this would be it.

Kudos CG.


"Either you're the butcher Or the lamb but even so, Everybody pays as they go-Jakob Dylan"
by WashStateBlue on Mon Jul 21, 2008 at 07:18:15 PM EST

wow. (none / 0)

thanks for a great compliment!


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Mon Jul 21, 2008 at 10:26:10 PM EST
[ Parent ]

Re: wow. (2.00 / 1)

You're more then welcome.

It was very nice to read a diary chock full of tasty info (Wink) and nutrionally GOOD for us liberals all.

Sigh. We seem to talk too little about what we have in common, and more what we disagree on.

I see a lot of other folks agree, this is hanging on the Rec list for a deservedly long time.


"Either you're the butcher Or the lamb but even so, Everybody pays as they go-Jakob Dylan"
by WashStateBlue on Tue Jul 22, 2008 at 11:45:32 AM EST
[ Parent ]

Dumb question (2.00 / 2)

from a Dumbo...  But isn't much of the population of Africa lactose-intolerant?  I seem to recall past food aid failures that involved massive donations of powdered milk that, it turned out, couldn't be eaten by the indigenous population without making them sick.  If Plumpynut is made from powdered milk, I wonder if it might not have the same portability issues.


by Dumbo on Mon Jul 21, 2008 at 10:40:14 PM EST

good point (2.00 / 1)

I thought that Asians were the only group with a serious lactase problem, but according to this site, which references a paper called Probiotics: Compensation for Lactase Insufficiency, American Journal of Clinical Nutrition, Feb., 2001, 70-90% of Africans are lactose intolerant (though the same page says that 75% of African Americans are LI, which sounds pretty high).

I would think that plumpynut's ability to counter malnutrition greatly outweigh the problems with lactose -- any port in a storm.  Including lactase in the mix might help, but would probably raise the price a bit.  At any rate, it's a point I hadn't thought of and that the 60 minutes piece didn't address.  I know that powdering milk leaves most of the lactose intact.  Would plumpynut be much less nutritious without it?


by semiquaver on Tue Jul 22, 2008 at 12:02:06 AM EST
[ Parent ]

my guess would be yes. (none / 0)

i think the specific concoction is designed to meet nutritional needs...  but i think the window in which plumpynut is used is until 4 years old.  interestingly - although i have no data to back this up - it is my understanding that lactose intolerance is developed from a lack of dairy in the diet rather than a milk allergy which is completely different.  then if that is true than maybe plumpynut has the ability to reduce LI?


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Tue Jul 22, 2008 at 12:14:18 AM EST
[ Parent ]

Lactose tolerance is a recessive gene. (2.00 / 1)

It's common in North Europeans, reaching its highest numbers in Sweden.  Here's a link where they suggest that the gene probably mutated in Sweden around 4000 B.C.  In other words, the ability to digest lactose, as an adult, is something you are either born with or without.

Almost all mammals are lactose intolerance after they reach the age of weaning.  Interestingly, according to this article, western kitty cats are less likely to be lactose intolerant than kitty cats of asian heritage, which suggests that western breeds of cat, too, may have evolved their lactose tolerance from centuries of living with lactose tolerant European dairy farmers.

The reason I bring all this up: There was a report, maybe it was even on Sixty Minutes, a long, long time ago, about the failures of western food aid to Africa, and one of the worst failures was the well-meant dumping of tons of surplus dried milk powder on starving parts of Africa.  Back in the 70s, I think...  The milk made the adults so sick that Africans ended up using the powdered milk as building mortar for their homes.

I have to confess I have some reservations about this Plumpynut.  The powdered milk part leapt out at me for obvious reasons, but it makes some sense, because powdered milk is such a cheap source of protein.  But the $1 a day price tag...  Whew!  That I don't understand at all.  That may sound cheap to us, but when you consider the low price of the ingredients, my eyebrows go up.  

As for the milk powder: soy powder is more expensive, but still very cheap.  The protein is not as complete as milk, but it would be digestible by most people in Africa, not just babies.  That might help save some poor starving mothers.  As for the toddlers, plain ol' powdered milk is cheaper than dirt.


by Dumbo on Tue Jul 22, 2008 at 06:46:57 PM EST
[ Parent ]

Oops... the link. (2.00 / 1)

http://goldbamboo.com/topic-t1480-a1-6La ctose_Intolerance.html


by Dumbo on Tue Jul 22, 2008 at 06:48:12 PM EST
[ Parent ]

Canadian Gal (2.00 / 1)

Did you cross-post this at Daily Kos?  I think it needs broad attention and I'm sure OrangeClouds115 would cover it at her new foodie blog, La Vida Locavore.


by vbdietz on Tue Jul 22, 2008 at 01:13:09 PM EST

not a member at kos. (none / 0)

but if you are (or anyone else wants to) - please feel free to post it.  and let me know the link so i can add it to the diary!


"Me Fail English? That's Unpossible." Ralph Wiggum
by canadian gal on Tue Jul 22, 2008 at 03:11:13 PM EST
[ Parent ]

Re: Plumpynut. (2.00 / 1)

Already posted a diary over there today and I've two more planned.  If I don't get them done, I'll post this instead.  


by vbdietz on Tue Jul 22, 2008 at 06:53:46 PM EST


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