MEND-SAM – MFGM-EnhaNceD RUTF for children with SAM

Severe acute malnutrition (SAM) affects millions of children globally and remains a major cause of child morbidity and mortality. Ready to use therapeutic food (RUTF) has transformed SAM treatment by enabling effective home-based care and improving survival. Despite successful physical recovery, many children treated for SAM continue to show delayed neurodevelopment. 

By: Anne Lau Heckmann

There is a need to further optimize therapeutic foods to support both survival and long-term child development. The objective of MEND‑SAM is to determine whether a novel RUTF enriched with milk fat globule membrane (MFGM) can improve outcomes for children with severe acute malnutrition. This project focuses on whether MFGM‑enhanced RUTF can improve neurodevelopmental recovery and reduce the most severe clinical outcomes of SAM, including death, hospitalization, and persistent severe malnutrition.

MEND‑SAM is a randomized, blinded, controlled clinical trial conducted at 20 government‑run clinics in Sierra Leone. The study will enroll 1,600 children aged 6–59 months diagnosed with severe acute malnutrition. They will receive either standard RUTF or a novel RUTF formulation containing whey fat concentrate with MFGM. Children will be followed throughout treatment until a clinical outcome is reached. Neurodevelopmental outcomes will be assessed using a validated, culturally adapted developmental assessment shortly after treatment and again several months later. A subgroup of children will also undergo blood sampling to analyze lipid profiles following treatment.

The project is expected to generate new evidence on the role of dairy‑derived lipids in improving neurodevelopmental recovery and clinical outcomes in children treated for severe acute malnutrition. If effective, the results could support future improvements to RUTF formulations used globally, with the potential to benefit millions of vulnerable children. The project also strengthens the evidence base for the importance of dairy fat in therapeutic and specialized nutrition products and contributes to knowledge relevant to child growth, cognitive development, and food matrix design.