NNI BITES, BIG LEARNINGS

For Healthcare Professionals OnlyNestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Mark Manary from Washington University and Adeline Lescanne, CEO of Nutriset, about ready-to-use therapeutic foods (RUTF) for severe acute malnutrition (SAM). Professor Manary describes how hospital-based treatment historically achieved only 45% recovery rates, prompting exploration of home-based alternatives. The RUTF concept, inspired by low-moisture foods like chocolate spread and halva, emerged through collaboration between André Briend and Michel Lescanne. Initial clinical trials in 2001 demonstrated dramatic improvements, achieving 90% recovery rates compared to 45% with traditional hospital care. The low water content prevents bacterial growth, enabling safe community-based treatment. Nutriset developed the Plumpy Field network, establishing local manufacturing facilities across 12-13 countries including Haiti, Nigeria, Ethiopia, and India, maintaining rigorous quality control from raw material sourcing through finished product testing. The company has treated over 65 million malnourished children. The episode highlights how RUTF has become a standard of care for community-based SAM management and underscores the importance of sustained partnerships and investment to ensure continued access for children who need treatment.For Healthcare Professionals OnlyNestlé Nutrition Institute

For Healthcare Professionals OnlyNestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Hania Szajewska from the Medical University of Warsaw about probiotics and prebiotics in pediatric nutrition. Professor Szajewska emphasizes the importance of evidence-based definitions from the International Scientific Association for Probiotics and Prebiotics (ISAPP), requiring documented health benefits in randomized controlled trials before products can be classified as probiotics or prebiotics. The discussion highlights critical factors influencing infant gut microbiota development, including mode of delivery, feeding method, and antibiotic exposure, with breastfeeding providing human milk oligosaccharides (HMOs) that selectively promote bifidobacteria. Professor Szajewska reviews current evidence from ESPGHAN guidelines, noting that while biotic-supplemented formulas demonstrate safety and adequate growth support, clinical benefit evidence remains limited and strain-specific. She discusses targeted probiotic applications, including necrotizing enterocolitis prevention and acute gastroenteritis management, while acknowledging the need for identifying populations most likely to benefit from these interventions.For Healthcare Professionals OnlyNestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Chittaranjan Yajnik about the Developmental Origins of Health and Disease (DOHaD) theory. Professor Yajnik traces its origins to David Barker's "Fetal Origins of Adult Disease" hypothesis, which demonstrated geographic correlations between early-life deprivation and adult cardiovascular disease mortality across English counties. The theory has evolved beyond hypothesis status, supported by cohort studies, animal models, and research demonstrating how intrauterine and early-life conditions influence later risk of non-communicable diseases. Professor Yajnik discusses his collaboration with Barker beginning in 1991 and explains why India provided an ideal research setting given its high prevalence of low birth weight and rapidly increasing diabetes rates. He highlights the "Yajnik-Yudkin (YY) paradox," demonstrating that Indians develop diabetes at younger ages with lower BMI but higher body fat percentages compared to Europeans. The "thin-fat Indian baby syndrome" further showed that Indian newborns, despite being 800 grams lighter, exhibit proportionally higher adiposity and metabolic risk markers at birth, establishing critical evidence for DOHaD's relevance in South Asian populations and informing early-life intervention strategies.For Healthcare Professionals OnlyNestlé Nutrition Institute