Acceptability of alternative ready-to-use therapeutic foods in acute malnutrition management—a systematic review

"Commercial" Ready-To-Use Therapeutic Foods (RUTFs) are used in acute malnutrition management, but they are not always appropriate being expensive and unfamiliar. Much research has tried to develop alternative RUTF formulations and this work systematically reviewed eight articles discussing the approaches used to assess the children's sensory satisfaction, families' acceptance, and the cultural appropriateness of 13 alternative RUTFs. Different approaches were used by the authors and much research to standardise methodologies and findings is urgent to ensure that food products are culturally appropriate, acceptable and appreciated, with the final aim of completing the development process of alternative RUTFs. This work proposed some indications to follow in alternative RUTF acceptability evaluation processing. Moreover, community engagement and education resulted key aspects in alternative RUTF acceptance. An innovative, multi-disciplinary, multi-stakeholder approach could develop alternative "fit-for-the-purpose" RUTFs to help food-insecure communities acquire sufficient, safe, nutritious food in long-term Community Management of Acute Malnutrition.