Peanut butter, a staple of the American lunchbox, was first processed as a protein substitute. Now, medical researchers at Washington University in St. Louis, Missouri, have found that peanut butter may be a key in helping to solve the problem of malnutrition in the developing world.

Peanut butter is a good source of protein, vitamin E and other nutrients. In fact, more than a hundred years ago, an American physician encouraged the owner of a food products company to process peanut butter as a nutritious substitute for people with poor teeth who couldn't chew meat. A few years later, peanut butter was on its way to becoming a favorite American food.

But it has also been a part of various diets all over the world. Africans have ground peanuts into stews, and the Chinese have crushed peanuts into creamy sauces for centuries. Now, it's being looked at as a way to fight dietary deficiencies.

In the southeastern African nation of Malawi, one in eight children die from malnutrition. There's no drought or war that's causing the problem. It's simply poverty in the nation of eleven million people, where most people still live in mud huts.

Washington University pediatrician Mark Manary went to Malawi for the first time almost ten years ago on a faculty exchange program. "At any time of the year," he said, "you can have 50 or 100 kids who are in the hospital simply because they don't have enough to eat. And in fact, in the big picture, 67 percent of all children in this country of 11 million people, are chronically malnourished."

Dr. Manary is very interested in nutrition, and in Malawi, he had plenty of opportunity to study ways to fight malnutrition. "Once they had been, kind of, turned around and were discharged to home, our results were very disappointing," he continued. Only 25 percent or so actually recovered at home, another 10 percent died at home, and about 20 percent had to come back to the hospital because they were ill from their malnutrition again."

Last year, Dr. Manary helped oversee a new home-based program to keep children from relapsing after their initial treatment. Some families received enough corn to ensure there were no food shortages. Other children were given a peanut butter food.

As Dr. Manary says, the results were striking. "The regimen that involved a peanut butter food was associated with a 93 percent full recovery. They gained their entire weight deficit back. Now, when I talk about, when I say, peanut butter food, that's basically peanut butter that we've added vitamins and minerals, some vegetable oil, some sugar, and milk powder."

The problems begin for children at about one year of age, when breast milk no longer provides all the nutrients needed. By the time kids are weaned at about age two, many are severely undernourished. That's when they show up in hospitals.

With last year's success of the peanut butter food as a treatment for malnutrition, Dr. Manary and his colleagues hope to expand the effort this year. Dr. Manary said, "We'd like to use it at some mission hospitals, at rural health centers run by the government, at district hospitals and get a broader experience with using it in the therapeutic feeding of children. But we also have a whole agenda for prevention because as we talk about improving treatment, obviously, the best thing would be if these kids were never malnourished in the first place."

The product only costs about 30 cents per child, per day, and the results have been encouraging. And he says, so far there have been no problems with peanut allergies. "We were concerned about that before, and we gave every child a test feeding under our observation in the hospital," he said. "And our project has fed over 500 kids in 2001, and nobody had a peanut allergy, not one of those kids."

Washington University pediatrician Mark Manary says that also might be true in other parts of the developing world where food allergies are much less common.

Four months ago, peanut butter became an important source of nutrition in another part of the world: for malnourished Afghani children and adults. It was a part of the daily 2,200-calorie rations that the U.S. Air Force dropped on Afghanistan a few weeks before the fall of the Taleban.

Actualities and material provided by Washington University, St. Louis, Missouri