PUBLIC REVIEW 
DRAFT   DRAFT  UGANDA STANDARD  
 DUS 908 
First  Edition  
2012 -mm-dd 
 
 Reference number  
DUS 908:2012  
©UNBS 2012   
  
Nutrient -concentrated foods for 
therapeutic uses — Specification  
 
 DUS 908: 2012  
ii © UNBS  2012  – All rights reserved  
 Compliance with this standard does not, of itself confer immunity from legal obligations  
A Uganda Standard does not purport to include all necessary provisions of a contract. Users are 
responsible for its correct application  
© UNBS  2012   
All rights reserved. Unless otherwise specified, no part of this publication may be reproduced or utilised in any 
form or by any means, electronic or mechanical, including photocopying and microfilm, witho ut prior written 
permission from UNBS.  
Requests for permission to reproduce this document should be addressed to  
The Executive Director  
Uganda National Bureau of Standards  
P.O. Box 6329  
Kampala  
Uganda  
Tel: 256 31 2 262688/ 9 
Fax: 256 41 4 286 123 
E-mail: info @unbs.go.ug  DUS 908: 2012  
©  UNBS  2012  – All rights reserved  iii 
 Contents  Page 
1 Scope and application  ................................ ................................ ................................ ..........................  1 
1.1 Scope  ................................ ................................ ................................ ................................ ......................  1 
1.2 Application  ................................ ................................ ................................ ................................ .............  1 
2 Normative references  ................................ ................................ ................................ ............................  1 
3 Terms and definitions  ................................ ................................ ................................ ...........................  2 
4 Product description  ................................ ................................ ................................ ...............................  2 
5 Requirements  ................................ ................................ ................................ ................................ .........  3 
5.2 Composition requirements  ................................ ................................ ................................ ...................  3 
5.2.1  Proteins source  ................................ ................................ ................................ ................................ ..... 3 
5.2.2  Vitamins and mineral salts  ................................ ................................ ................................ ...................  3 
5.2.3  Nutrient composition  ................................ ................................ ................................ ............................  3 
5.3 Anti-nutritional factors  ................................ ................................ ................................ ..........................  4 
6 Food additives  ................................ ................................ ................................ ................................ ....... 4 
7 Contaminants  ................................ ................................ ................................ ................................ .........  4 
7.1 Pesticide and veterinary drug residues  ................................ ................................ ..............................  4 
7.2 Heavy metal and other contaminants ................................ ................................ ................................ .. 5 
7.3 Mycot oxins  ................................ ................................ ................................ ................................ .............  5 
8 Management systems  ................................ ................................ ................................ ...........................  5 
9 Hygiene  ................................ ................................ ................................ ................................ ...................  5 
10 Packaging  ................................ ................................ ................................ ................................ ...............  6 
11.1  General food labeling  ................................ ................................ ................................ ............................  6 
11.2  Nutrition and health labeling and claims  ................................ ................................ ............................  6 
12 Methods of sampling and test  ................................ ................................ ................................ ..............  6 
 
 
 DUS 908: 2012  
iv © UNBS  2012  – All rights reserved  
 Foreword  
Uganda National Bureau of Standards (UNBS) is a parastatal  under the Ministry of Trade, Industry and 
Cooperatives established by the Act of Parliament of 1983, of the Laws  of Uganda.  UNBS is mandated to co -
ordinate the elaboration of standards and is  
(a) a member of International Organisation for Standardisation (ISO) and  
(b) a contact point for the WHO/FAO Codex Alimentarius Commission on Food Standards, and  
(c) the National Enqui ry Point on TBT Agreement of the World Trade Organisation (WTO).  
The work of preparing Uganda Standards is carried out through Technical Committees. A Technical 
Committee is established to deliberate on standards in a given field or area and consists of re presentatives of 
consumers, traders, academicians, manufacturers, government and other stakeholders.  
Draft Uganda Standards adopted by the Technical Committee are widely circulated to stakeholders and the 
general public for comments. The committee reviews the comments before recommending the draft standards 
for approval and declaration as Uganda Standards by the National Standards Council.  
Committee membership  DUS 908: 2012  
©  UNBS  2012  – All rights reserved  v 
 Introduction  
Severe Acute M alnutrition  (SAM)  is a major killer of children under five  years of ag e. Treatment of SAM is 
often achieved with admiss ion to a health facility or a therapeutic feeding centre . Where the availability of 
health facilities  is limited  or the number of malnourished children is high this approach is very limiting. T imely 
detect ion of SAM  in the community and provision of nutrient -dense foods at home  is known to offer a solution 
to this limitation. This approach ca n cover the majority of children who may not have medical complication 
leaving only those with medical  complication to be referred  to a medical facility. By using the community to 
actively search, detect and treat malnourished  children, large number of deaths can be prevented.  
Children with severe acute malnutrition need safe, palatable foods with high energy content and a dequate 
amounts  of vitamins and minerals. When there are no medical complications, a malnourished child with 
appetite, if aged six months or more, can be given a dose of nutrient -dense foods adjusted to their weight  at 
home .  
The use of specially processed  or formulated food for the dietary management of patients is a long known 
practice. In such cases food is used under medical supervision . The use of community based approach to 
manage malnutrition especially where medical supervision is limited present s new challenges. The concept of 
therapeutic foods1 has risen to offer solutions to this challenge. In this case foods  are designed for specific, 
usually nutritional, therapeutic purposes as a form of  dietary supplement. Such foods may be used in  
emergency fe eding of malnourished children or to supplement the diets of persons with special nutritional 
requirements . 
Therapeutic foods  are usually made of a mixture of protein, carbohydrate, lipid and vitamins and minerals. The 
food is produced and packaged without  using water, to eliminate the issue of spoilage of the food. These 
foods are produced by grinding and mixing all ingredients together. The mixing process allows for the protein 
and carbohydrate components of the food to be embedded in the lipid matrix . Since the ingredients need to be 
suspended in liquid, the liquid used in producing such foods needs to be fat/lipid. Most of the protein should 
come from dairy products. The size of the particles within the mixture has to be very minute  in order for the 
mixture to maintain its consistency  and not readily separate . 
Therapeutic foods  are designed and manufactured to ensure that the foods are ready to eat straight from the 
packaging. Those foods should be safe and require no cooking.  Therapeutic foods have to be  soft or 
crushable and taste is acceptable and suitable for children of young ages o r other intended age group. Such 
foods should have a long shelf -life and that they are micro -organism contamination resistant, without the need 
for expensive packaging.  Som e therapeutic foods require reconstitution before administering, while others can 
be consumed as is.  
Facilitating the local production of therapeutic foods is very important for the promotion of active search, 
identification and treatment of malnourished i nfants and young children  in communities.  A major concern of  
therapeutic foods is the safety and quality including nutrient content and acceptability of the foods. There is a 
need to ensure the food does not present hazards to the health of the already mal nourishe d individuals. 
Presence of  contaminants such as heavy metals and pesticide residues need to be avoided or minimised. 
Due to preference for locally available raw materials there is also a need to ensure the food is not 
contaminated with mycotoxins, especially aflatoxins, or other contaminants such as melamine.  
This standard is intended to facilitate the production of safe and quality foods for use in therapeutic purposes  
within the policy guidance of the Ministry of Health .  
 
                                                      
1 The use of the word the rapeutic foods is more or less a misnomer to the effect that the foods offers therapy  DRAFT UGANDA STANDARD  DUS 908: 2012  
 
UNBS 2012 – All rights reserved  1 
 Nutrient -concentrated f oods for therapeutic uses — Specification  
1 Scope  and application  
1.1 Scope  
This draft Uganda Standard specifies the requirement s and method s of sampling and test for nutrient -
concentrated foods  for therapeutic uses . 
1.2 Application  
This standard applies t o nutrient -concentrated foods  for therapeutic uses presented in the form of powder, 
paste, granules, or flakes, which are to be consumed as such or to be reconstituted before consumption 
intended for use  in the management of acute m alnutrition . 
This standa rd does not apply to vitamin and mineral food  supplements . 
2 Normative references  
The following referenced documents are indispensable for the application of this document. For dated 
references, only the edition cited applies. For undated references, the l atest edition of the referenced 
document (including any amendments) applies.  
US 7, General standard for labelling of pre -packaged foods  
US 28, Code of practice for hygiene in the food and drink manufacturing industries  
US 45, General standards for food a dditives  
US 201, Drinking (potable) water — Specification  
US 500, General requirements for nutrition labelling  
US 508, General requirements for nutrition and health claims  
US 566, Use of nutrition terms ─ Requirements  
US 738, General standard for contaminants and toxins in food and feed  
US ISO 6888 -3, Microbiology of food and animal feeding stuffs — Horizontal method for the enumeration of 
coagulase -positive staphylococci (Staphylococcu s aureus and other species) — Part 3: Detection and MPN 
technique for low numbers  
ISO 11290 -1, Microbiology of food and animal feeding stuffs -- Horizonta l method for the detection and 
enumeration of Listeria monocytogenes -- Part 1: Detection method  
ISO 7937,  Microbiology of food and animal feeding stuffs -- Horizontal method for the enumeration of 
Clostridium perfringens -- Colony -count technique  
ISO 6579 , Microbiology of food and animal feeding stuffs -- Horizontal method for the detection of Salmonella 
spp. DUS 908: 2012  
2 ©UNBS 2012  – All rights reserved  
 US ISO 4832,  Microbiology of food and animal feeding stuffs -- Horizontal method for the enumeration of 
coliforms -- Colony -count technique  
US ISO 48 33, Microbiology of food and animal feeding stuffs — Horizontal method for the enumeration of 
microorganisms —Part 2: Colony count technique at 30 °C  
US ISO 6579,  Microbiology of food and animal feeding stuffs — Part 6: Horizontal method for the detection of 
Salmonella spp.  
US ISO 7954 , Microbiology of food and animal feeding stuffs — General guidance for enumeration of yeasts 
and moulds — Part 8: Colony count technique at 25 degrees C  
US ISO 16050,   Foodstuffs -- Determination of aflatoxin B1, and the total content of aflatoxins B1, B2, G1 and 
G2 in cereals, nuts and derived products -- High-performance liquid chromatographic method  
US ISO 11290 -1, Microbio logy of food and animal feeding stuffs — Horizontal method for the detection and 
enumeration of  Listeria monocytogenes — Part 1: Detection method  
CAC/GL 10 -1979 , Advisory List of Mineral Salts and Vitamin Compounds for Use in Foods for Infants and 
Children   
3 Terms and definitions  
For the purposes of this standard, the following terms and definitions shall apply.  
3.1 
severe acute malnutrition  
severe acute malnutrition is defined by a very low weight for height (below -3 z scores1 of the median WHO 
growth st andards), by visible severe wasting, or by the presence of nutritional oedema.  
3.2 
vitamin and mineral food supplements  
are sources in concentrated forms of those nutrients alone or in combinations, marketed in forms such as 
capsules, tablets, powders and solutions that are designed to be taken in measured small -unit quantities  but 
are not in a conventional food form . 
3.3 
ready to use therapeutic foods  
are energy -dense, micronutrient -enriched pastes that have a nutritional profile similar to the traditional  F-100 
milk based diet used in inpatient therapeutic feeding programs and are often made of peanuts, oil, sugar and 
milk powder . 
3.4 
Anti-nutritional factors  
are natural or synthetic substances found in the human diet or animal feed that have the potential  to adversely 
affect health and growth by preventing the absorption of nutrients from food.  
4 Product description  
Nutrient -concentrated foods for therapeutic uses are food products in the form of either liquid paste, powder, 
granules, grit, flakes or in ot her solid form  that are  high energy, fortified with vitamins and minerals and 
supplied in a ready to eat form and suitable for the treatment of children with severe acute malnutrition . 
The foods are  produced and packaged by grinding and mixing protein, car bohydrate, lipid and vitamins and 
minerals  to allow the protein and carbohydrate components of the food to be embedded in the lipid matrix  with 
the size of the particles being  less than 200 micrometres  in order for the mixture to maintain its consistency DUS 908: 2012  
©UNBS 2012  – All rights reserved  3 
 and not readily separate . Therapeutic foods are designed and manufactured to ensure that the foods have a 
long shelf -life, are micro -organism contamination resistant  and are ready to eat straight from the packaging.  
5 Requirements  
5.1 General quality requ irements  
Nutrient -concentrated foods for therapeutic uses shall:  
a) have acceptable flavour and odour ; 
b) be soft or crushable;  
c) be easy for young children ;  
d) be free from objectionable matter ; and 
e) be free from rancid, musty or any other foreign taste characteri stic of spoilage . 
5.2 Composition requirements  
5.2.1 Proteins source  
At least half of the proteins contained in the foods shall come from animal source.  
5.2.2 Vitamins and mineral salts  
Added mineral salts and vitamins shall conform to the CAC/GL 10 -1979  
The added minerals shall be water -soluble and shall not form insoluble components when mixed together. 
The food shall have a mineral composition that will not alter the acid base metabolism of children with severe 
acute malnutrition. In particular, it shal l have a moderate positive non -metabolizable base sufficient  to 
eliminate the risk of metabolic acidosis. The non -metabolizable base can be approximated by the formula: 
estimated absorbed millimoles (sodium + potassium + calcium + magnesium) - (phosphorus + chloride ). The 
mineral mix recommended for F100 by WHO is an example of a mineral mix with a suitable positive non -
metabolizable base.  
5.2.3 Nutrient composition  
Nutrient -concentrated foods for therapeutic uses shall conform to the requirements in Table 1. 
Table 1 — Nutritional composition for Nutrient -concentrated foods for therapeutic uses   
Characteristic  Requirement  
Min Max 
Moisture, % by mass   2.5 
Energy, Kcal/100 g  520 550 
Proteins, % total energy  10 12 
Lipids % total energy  45  60 
Sodium , mg/100 g   290 
Potassium, mg/100 g  1,110  1,400  
Calcium, mg/100 g  300 600 DUS 908: 2012  
4 ©UNBS 2012  – All rights reserved  
 Phosphorus (excluding phytate), mg/100 g  300 600 
Magnesium , mg/100 g  80 140 
Iron, mg/100 g  10 14 
Zinc, mg/100 g  11 14 
Copper , mg/100 g  1.4 1.8 
Selenium , μg/100g  20 40 
Iodine, μg/100 g  70 140 
Vitamin A, mg/100 g  0.8 1.1 
Vitamin D, μg/100 g  15 20 
Vitamin E, mg/100 g  20  
Vitamin K μg/100 g  15 30 
Vitamin B1, mg/100 g  0.5  
Vitamin B2, mg/100 g  1.6  
Vitamin C, mg/100 g  50  
Vitamin B6, mg/100 g  0.6  
Vitamin B12, μg/100 g  1.6  
Folic acid , μg/100 g  200  
Niacin , mg/100 g  5  
Pantothenic acid , mg/100 g  3  
Biotin , μg/100 g  60  
n-6 fatty acids % of total energy  3 10 
n-3 fatty acids % of total energy  0.3 2.5 
 
5.3 Anti-nutritional factors  
Nutrie nt-concentrated foods for therapeutic uses shall be free from anti -nutritional factors  in amounts that may 
present hazards to the health or compromise nutrient absorption properties of the food .  
6 Food additives  
Food additives may be used in accordance wi th US 45.  
7 Contaminants  
7.1 Pesticide and veterinary drug residues  
Nutrient -concentrated foods for therapeutic uses shall not contain pesticide and veterinary drug residues in 
amount s that may present a hazard to health. In particular the product shall c onform to the maximum residue 
limits for pesticides  and veterinary drugs  established by Codex Alimentarius commission for similar 
commodities.  DUS 908: 2012  
©UNBS 2012  – All rights reserved  5 
 7.2 Heavy metal and other contaminants  
Nutrient -concentrated foods for therapeutic uses shall conform to the maxi mum limits for heavy metal and 
other contaminants specified in US 7 38. 
7.3 Mycotoxins  
Nutrient -concentrated foods for therapeutic uses shall not contain mycotoxins in amount that may present 
hazard to health. In particular the product shall conform to the maximum limits for aflatoxin specified in Table 
2. 
Table 2— Maximum limits for aflatoxin in nutrient concentrated foods for therapeutic foods  
S. No.  Parameter  Limit  Method of Test  
i) Total aflatoxin , micrograms per kilogram, maximum  5 US ISO 16050  
 
8 Management systems  
Producers of nutrient -concentrated foods for therapeutic uses shall implement a food safety management 
systems based on HACCP2 principles. ISO 220003 is an example of a food safety management systems 
based on HACCP principles.  
9 Hygiene  
The nutrient -concentrated foods for therapeutic uses shall be prepared and packaged in the premises built 
and maintained under hygienic condition in accordance with US 28.  
Nutrient -concentrated foods for therapeutic uses shall co nform to the microbiological  limits given in Table 3. 
Table 3 — Microbiological limits for nutrient -concentrated foods  for therapeutic uses  
Microorganism(s)  Limit  Method of test  
Total plate count, cfu/g, max. 104 US ISO 4833  
Total coliform bacteria, cfu/g, max. < 1  US ISO 4832  
Salmonella sp, in 25 g,  max. Negative  US ISO 6579  
Clostridium perfringens , in 1g , max. Negative  US ISO 7937  
Yeast  and moulds , cfu/g,  max. 100 US EAS 217  
Pathogenic Staphylococci, cfu/g, max. Negative  US ISO 6888 -3 
Listeria  monocytogenes , in 25 g , max. negative  ISO 11290 -1 
                                                      
2 HACCP= Haz ard Analysis and Critical Control Point system.  
3 ISO 22000, Food safety management system requirements, Published by ISO (International Organisation for 
Standardisation)  DUS 908: 2012  
6 ©UNBS 2012  – All rights reserved  
 10 Packaging  
The nutrient -concentrated foods for therapeutic uses shall be pack aged in moisture -proof and dry containers 
of food grade material in such a way as to protect it from deterioration and contamination.  Pack size shall 
allow  for single dose use.  
11 Labelling  
11.1 General food labeling  
Nutrient -concentrated foods for therapeutic uses shall be labelled in accordance with US 7.  
In addition, the following information shall be legibly and indelibly marked on the container:  
(a) The n ame of the product shall be declared as “ nutrient -concentrated food for therapeutic uses ” 
(b) Protein  source  shall be declared in close proximity to the name of the product with the qualifier 
“Protein  source......  
(c) Direction of use shall be declared on the label.  
11.2 Nutrition and health labeling and claims  
Labels for n utrient -concentrated foods for therapeutic uses shall include nutrition information in accordance 
with US 500. Nutrition and health claims may be made in accordance with US 508 and 566.  
12 Methods of sampling and test  
Nutrient -concentrated foods for therapeutic uses shall be sampled in accordance with the appropriate 
methods of sampling. Test s shall be conducted in accordance with appropriate methods where indicated in an 
appropriate clause or other  international standard methods.  DUS 908: 2012  
©UNBS 2012  – All rights reserved  7 
 Bibliography  
[1] Community -based management of severe acute malnutrition. A Joint Statement by the World Health 
Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition 
and the Unite d Nations Children’s Fund. World Health Organization/World Food Programme/United 
Nations System Standing Committee on Nutrition/The United Nations Children’s Fund, 2007.  
.  
UNBS 2012 – All rights reserved   
 Certification marking  
Products that conform to Uganda standards may be marked with Uganda National Bureau of Standards 
(UNBS) Certification Mark shown in the figure below.  
The use of the UNBS Certification Mark is governed by the Standards Act, and the Regulations made 
thereunder. This mark can be used only by those licensed under the c ertification mark scheme operated by 
the Uganda National Bureau of Standards and in conjunction with the relevant Uganda Standard. The 
presence of this mark on a product or in relation to a product is an assurance that the goods comply with the 
requirement s of that standard under a system of supervision, control and testing in accordance with the 
certification mark scheme of the Uganda National Bureau of Standards. UNBS marked products are 
continually checked by UNBS for conformity to that standard.  
Furthe r particulars of the terms and conditions of licensing may be obtained from the Director, Uganda 
National Bureau of Standards.  
 
 DUS 908: 2012    
 
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