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Guidelines for ready-to-use therapeutic foods











FAO and WHO. 2022. Guidelines for ready-to-use therapeutic foods. Codex Alimentarius Guideline No. CXG 95-2022. Codex Alimentarius Commission. Rome.



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    Lipid-based nutrient supplements (LNS) and ready-to-use therapeutic food (RUTF) are used to prevent and treat malnutrition in children. They are often produced in regions experiencing food insecurity and include edible oils obtained from oleaginous seeds or fruits that must be refined to remove undesirable substances and ensure adequate shelf-life for the product. However, the formation of the heat-induced contaminants 3-monochloropropane-1,2-diol (3-MCPD) fatty acid esters and glycidyl fatty acid esters (GEs) may occur during the refining process of edible oils. 3-MCPD and its fatty acid esters are present in many other foodstuffs and most of the total lifetime exposure is attributed to foods other than LNS/RUTF. While the only Codex standard developed for 3-MCPD is for liquid condiments containing acid hydrolyzed vegetable proteins, no Codex standards are available for GEs. This publication provides an overview of risk assessments for 3-MCPD and GEs previously performed by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), European Food Safety Authority (EFSA) and other authorities, based on chronic exposure. The use of LNS/RUTF is intended to be of finite duration and confined to a specific life stage. The aim of this report was to provide an assessment to characterize the risk of less-than-lifetime exposure to 3-MCPD (including 3-MCPD fatty acid esters) and GEs via LNS/RUTF in the context of limited food availability. The thresholds identified herein for concentrations of 3-MCPD and glycidol equivalents in LNS/RUTF products are considered to represent a level of exposure that is of low concern for human health.

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