Understanding the Nutrition Diet: What are the components of RUTF?

October 7, 2025 •

4 min read

According to UNICEF, Ready-to-Use Therapeutic Food (RUTF) has been instrumental in treating severe wasting in children under 5 years old for decades. Understanding what are the components of RUTF reveals how this high-energy, nutrient-dense paste provides critical support for nutritional recovery.

Quick Summary

RUTF is an energy-dense paste primarily made from a blend of macronutrient-rich ingredients like peanuts, milk, and sugar, which is heavily fortified with a complete mix of essential vitamins and minerals.

Key Points

Core Ingredients: Standard RUTF formulations typically contain peanut paste, milk powder, vegetable oil, and sugar.
Rich Micronutrient Fortification: RUTF includes a specially formulated premix of essential vitamins (like A, C, D, E, K, B-complex) and minerals (like iron, zinc, potassium) to correct deficiencies.
High Energy Density: The formula is designed to be energy-dense, providing a high number of calories per gram, which is crucial for reversing malnutrition quickly.
Long Shelf-Life: RUTF's low moisture and water activity inhibit microbial growth, allowing it to remain safe and effective for up to two years without refrigeration.
Ready-to-Use Format: As a paste in a sachet, RUTF requires no preparation or water, minimizing the risk of contamination and making it accessible in low-resource settings.
Diverse Formulations: While standard recipes are common, alternative RUTFs exist that use locally available ingredients like soy, maize, or legumes to reduce cost and address allergies.

The Core Macronutrient Ingredients

Ready-to-Use Therapeutic Food is expertly formulated to deliver a powerful nutritional punch in a small, shelf-stable package. At its core, a standard RUTF formulation is built from a few key macronutrient ingredients. The primary building blocks are selected for their caloric density, protein content, and stability. While standard formulations exist, adjustments are often made based on local availability, cost, and specific nutritional needs.

Peanut Paste

For many standard RUTFs, peanut paste serves as a foundational component, providing a significant source of energy and protein. However, due to potential peanut allergies and risk of aflatoxin contamination, alternative formulations have been developed using other legumes and seeds.

Milk Powder

Another crucial ingredient is milk powder, which contributes high-quality protein and additional energy. The milk content can be expensive and is sometimes reduced or replaced in alternative formulations to lower costs, especially in regions where dairy is not readily available or to address lactose intolerance.

Vegetable Oil

Vegetable oil is added to increase the energy density of the paste, providing a large portion of the overall calories. It also helps create the smooth, homogeneous texture that makes the product easy to consume. The type of oil used can vary and is often selected based on stability and local sourcing.

Sugar

Sugar is included to provide readily available carbohydrates for energy and to improve the palatability of the paste, making it more appealing to young children.

Essential Vitamins and Minerals

Beyond the macronutrients, RUTF's therapeutic power lies in its fortification with a special premix of micronutrients. This blend is vital for correcting the underlying vitamin and mineral deficiencies common in severely malnourished children.

Here is a list of some of the key micronutrients found in RUTF:

Vitamins: Vitamin A, Vitamin D, Vitamin E, Vitamin K, Vitamin C, Thiamin (B1), Riboflavin (B2), Niacin (B3), Pantothenic acid (B5), Vitamin B6, Biotin (B7), Folic acid (B9), Vitamin B12.
Minerals: Potassium, Calcium, Phosphorus, Magnesium, Iron, Zinc, Copper, Selenium, Iodine.

Formulations for Different Needs

While standard peanut-based, milk-inclusive RUTF is common, variations have been developed to address specific issues, including cost, ingredient availability, and allergies.

Standard Formulation: Typically includes peanut paste, milk powder, sugar, vegetable oil, and a vitamin/mineral mix. It is widely used and meets WHO standards for treating uncomplicated severe acute malnutrition (SAM).
Alternative Formulations: These products use locally available ingredients like soy, maize, sorghum, rice, chickpeas, or other cereals and legumes. They may use reduced or no dairy protein, replacing it with other protein sources or added amino acids. This can lower production costs and potentially mitigate issues like lactose intolerance or milk protein allergies.
Novel Formulations: These can include a wider range of ingredients and may use different types of protein or added amino acids to meet nutritional guidelines.

The Science Behind RUTF's Effectiveness

One of the most critical aspects of RUTF is its design for optimal nutritional delivery and safety. The formulation is a homogeneous mixture where protein, carbohydrate, vitamins, and minerals are embedded within a lipid matrix. This process ensures a consistent nutrient distribution throughout the paste. The low moisture content and low water activity are key features that inhibit bacterial growth without needing refrigeration, giving RUTF a long shelf life of up to two years. This makes it ideal for distribution in remote areas with limited infrastructure. Additionally, the paste form is easy to consume directly from the sachet, requiring no water or preparation, reducing the risk of contamination and simplifying use for caregivers.

Nutritional Comparison: Standard RUTF vs. Alternative Formulations


Feature	Standard (Peanut-based, Milk)	Alternative (e.g., Soy/Cereal)
Energy (per 100g)	~520-550 kcal	Varies, but designed to meet similar standards
Protein Source	Peanut, milk powder	Soy, cereals (maize, sorghum), legumes (chickpeas)
Dairy Content	Contains a significant amount of milk protein	Can have reduced or no dairy protein
Cost	Can be higher due to cost of imported milk	Potentially lower by using locally sourced ingredients
Allergen Risk	Peanut allergy risk present	Dependent on ingredients, potentially lower for milk allergy
Local Sourcing	Ingredients may need importing	Maximizes use of local food resources

The Manufacturing Process

The manufacturing of RUTF is a precise process to ensure safety, nutritional consistency, and stability. Key steps often include:

Preparation of raw materials: Legumes, cereals, and seeds are often roasted or otherwise heat-treated to reduce anti-nutritional factors and improve digestibility. Ingredients are milled to a very small particle size (<200-500 microns) to prevent separation.
Mixing: The lipid components (oils) are first mixed, often with heat. The powdered ingredients (carbohydrates, proteins, and micronutrient premix) are then slowly added and vigorously stirred to create a smooth, homogeneous paste.
Packaging: The paste is portion-controlled and sealed in foil sachets to protect it from moisture and oxygen, which extends its shelf life.

Conclusion

RUTF is a scientifically formulated food that combines energy-dense macronutrients with a comprehensive spectrum of vitamins and minerals. The components of RUTF, typically including peanut paste, milk powder, sugar, and vegetable oil, are carefully selected to create a product that is not only highly effective in treating severe malnutrition but is also safe, stable, and easy to use. Innovative formulations based on local ingredients are also expanding the reach and affordability of this life-saving nutritional tool. The specific blend of ingredients and its inherent safety features are what make RUTF such a cornerstone of modern nutritional therapy for children in crisis.

For more information on how RUTF is saving lives, you can visit the UNICEF website: https://www.unicef.org/supply/stories/saving-lives-rutf-ready-use-therapeutic-food.

Frequently Asked Questions

The primary purpose of RUTF is to treat severe acute malnutrition (SAM) in children, specifically by providing a dense source of energy, protein, vitamins, and minerals that promote rapid weight gain and recovery.

Yes, there are different RUTF formulations. While standard versions often include peanuts and milk, alternatives have been developed using other locally available ingredients like soy, maize, or legumes to address allergies or reduce costs.

RUTF is designed as a paste for several reasons: its homogeneous texture ensures consistent nutrient intake, it is easy for small children to consume, and it requires no preparation, which minimizes the risk of contamination in unhygienic environments.

RUTF has a long shelf life, often up to two years, due to its low moisture content and low water activity. These factors inhibit the growth of bacteria and other microorganisms without the need for refrigeration.

RUTF is fortified with a comprehensive blend of vitamins (including A, C, D, and various B vitamins) and minerals (such as potassium, calcium, magnesium, and zinc), all crucial for proper growth and physiological function.

While RUTF is specifically intended for severe acute malnutrition (SAM), similar products known as Ready-to-Use Supplementary Foods (RUSFs) are used for treating moderate acute malnutrition (MAM).

Using local ingredients can lead to reduced costs, greater sustainability, and better alignment with local food tastes. This approach also helps avoid issues related to food allergies (like peanut allergies) or lactose intolerance.

RUTF is safe and effective for treating uncomplicated severe acute malnutrition in children aged 6 to 59 months. Its formulation and production processes are subject to strict quality control to ensure safety. However, children with severe complications need initial hospital care.