Episode 14: Edesia Nutrition
I'm Zachary Cartwight. This is Water In Food.
We are able to be a part of bringing children back from the brink of starvation, back to healthy growth and development and a chance at a future and a chance at a life.
Our products were made to treat and prevent malnutrition especially young children ages six months to five years.
We have a two year shelf life on all of the products.
Thank you guys for joining today. I'm really happy to have you here. Why don't you both say hello?
Hi. Hi Zachary. How you doing?
I'm well, and yourself?
I'm doing well. Thank you. My name is Rami Kawsara and I have been with Edesia for six years. It will be six years in August and I'm the quality and regulatory manager. At Edesia I do quality and we make sure that the product from start to finish is good and I'm ready to go before it leaves our organization.
And Rami I understand that you were just promoted; is that correct? Did you just have a title change?
That's correct. I was the quality control supervisor and now I'm the quality and regulatory manager at Edesia.
Thank you very much.
You are welcome. And Maria, what about you? How long have you been there and what's your role?
Sure. My name is Maria Kasparian and I'm the executive director at Edesia. I've been with the Edesia since we got started in February 2009. And so that's over 12 years now. I was the first employee working with the founder, Navyn Salem, and we started the two of us in her home with ideas and visions and grant writing and partnership, thoughts. And now today, 12 years later, I've played a lot of different roles along the way and feel lucky to still be here and be the executive director of this wonderful organization.
And Maria I was wondering if you could talk a little bit more about the story behind how Edesia was started?
Sure. So our founder, Navyn, her father's family hails from Tanzania. They were there for several generations and so she always had a personal connection to the continent of Africa and a certain sensitivity to particular needs and poverty alleviation and wanting to do something, give something back to her father's Homeland. She also had a fascination and interest in business and the ability of a business to do good and this concept of social enterprise. So this idea that a business, whether for-profit or nonprofit, can be used to create a social good, create a product that's needed while at the same time creating meaningful jobs and opportunities for individuals. So, honestly, that was the first core concept.
And then in doing research, in visiting Tanzania, meeting with nonprofits doing work there, came to realize that nutrition was a gap area that really wasn't being focused on enough in the development space. So kind of marrying that idea of nutritional needs and too many children, way too many children's still suffering from acute malnutrition and starvation that being the need and then this passion for social enterprise, Edesia was born of that. The idea of forming a nonprofit that could manufacture specialized foods to treat and prevent malnutrition in places like Tanzania and beyond.
So once the passion was there, what was the next step? Who did you reach out to? Or how did you go about starting the company?
Sure. Well, we had a lot to learn as the two of us back in February 2009. And one of the first organizations we reached out to was Nutriset, which is the French company that originally invented this range of products along with some other partners in the late 1990s. So they are one of the four leading experts, of course, in ready to use therapeutic foods as they are known. The brand name that's best well known is called Plumpy'Nut. They developed those and then piloted them with various organizations in the field over the early 2000s. By the mid-2000s, it was accepted widely by the powers that be in nutrition. So the World Health Organization, the Standing Committee on Nutrition, UNICEF, the World Food Program, that these types of products were the best case standard of care for children with severe acute malnutrition to rehabilitate them and cure them.
So at that point, Nutriset started licensing out their technology to other suppliers, primarily in developing countries where these products are used. So they first had a partner in Niger, Niamey. They then had a partner in Ethiopia, so Hilina Foods and STA, and then from there, there's about a dozen. So there are partners in Burkina Faso, Guinea, Nigeria, Sudan, Madagascar, India, Haiti, and a partner in the United States, which is Edesia. So we reached out to them to form that kind of licensee relationship and also to access technology transfer and training from them to understand how to best make these products. Because though they are not complex in terms of the number of ingredients necessarily, there is a lot of technology that goes into making sure that these products are shelf-stable, that they are nutritionally perfect for these very specific important needs, and that they're microbiologically safe for this vulnerable population that they're serving.
And Rami I was wondering if you could talk a little bit more about the products themselves and really who the target consumers are today.
Sure. So as Maria mentioned our products were made to treat and prevent malnutrition, especially young children ages six months to five years, those who are most at risk of malnutrition and most in need of treatments. Additionally, we have products that are specialized, ready to eat food for vulnerable populations, such as pregnant and lactating moms, people living with HIV. So our partners such as UNICEF, WFP, and USAID, partner with them to distribute basically the products that we make.
And Maria you mentioned that these products are only composed of just a few ingredients. Can you talk a little bit more about those ingredients and what really makes your products unique? How are you hitting that long shelf life that you mentioned before?
So the core ingredients of our range of products are peanuts, soy, vegetable oils, milk, both milk powder and whey, vitamins, and minerals. Those are the main ingredients. So in different balances, of course, according to different formulations. One of the things that makes the product unique is in the name itself, ready to eat therapeutic or ready to eat supplementary foods. They're ready to eat because they're shelf-stable. They don't require any reconstitution with water. They don't require any cooking. That does mean that the packaging and preparation is important for the shelf life. So they're packaged in a metalized polyester that has very low oxygen transfer and is opaque. They are also nitrogen flushed and we also have very specific standards around things like water activity, which I know we're going to talk more about today.
Yeah. We're headed that direction, but I want to understand by using the nitrogen flushing and by using the correct packaging and the correct water activity, what type of shelf life are you seeing for these products? How long does that last?
Yeah, so we have a two year shelf life on all of the products and that's under pretty hot humid conditions. So two years is 30 degrees Celsius or below, which is about 86 degrees Fahrenheit. We also do shelf stability studies on all the products at both 30 and 40 degrees Celsius to see how they do. But two years is basically what we're looking at for shelf life.
And you mentioned... Go ahead.
No, I was just going to say, they've got a long journey to make. I mean, Rami mentioned our partners. We are the beginning of the journey. We're always working with partners like UNICEF, the World Food Program, USAID. And then there nonprofit and government health system partners. So the journey only begins here in Rhode Island. It continues far across the world and the shelf life is really critical because the journey itself may take several months and then it's often going to have to make a journey to a remote clinic somewhere where they also need to know that that supply can last for a long period of time.
And you mentioned the term ready to use therapeutic products is this the same as a meal replacement product or a supplement or is this something completely different?
So it's a little bit different. It's not really considered as a meal replacement. They're considered as therapeutic and supplementary foods, depending on which food you're talking about. If you're talking about Plumpy'Nut, which is a ready to use therapeutic food, it's more like a medical food in some countries it's considered as essential medicine in some countries it's considered as a food. We kind of are the line between food and pharma. So during a treatment period, so a child that has severe acute malnutrition, their body does need very intensive rehabilitation before they can eat other foods again. So during a treatment, they will be eating about three of these 92 gram packets per day, for an average of about seven weeks. Obviously, this varies a little bit by context and the health situation of the child. But during that time, this is meeting all of their caloric and nutritional needs in addition to water and or breast milk, depending on what is available.
Whereas the rest of our products, which are either supplementary or complementary, they're looked at as supplements or compliments to whatever is already available in the diet. So something like a Plumpy'Doz or a Nutributter, maybe one per day, in addition to the staple foods that are available. So with a porridge or with rice or context-specific depending what's available in the community and they are adding some nutrition density, they're adding some protein, fat calories that are probably lacking in the diet.
And Rami, I want to ask you a question about the packaging, because I understand that the packaging relates to the extent of malnutrition and that helps to make sure that the right product is being consumed. Can you talk a little bit about the packaging and how you came up with the color of the packaging for each of your products.
Sure. So our packaging basically matches the MUAC tape and it's basically a tape that is used to measure the extent of malnutrition. So they usually use it to measure the mid upper arm circumference. So basically when you have that, it will show you if it needs Plummpy'Doz or like if it needs Plumpy'Nut or RUSF, which is type of some of our products. So if it's in the red area, it will be a severe malnutrition. If it's the orange zone, it will be moderate malnutrition. And then in the green area for like the babies that need like some supplements with the breastfeeding from their mom.
Yeah. I really like how straightforward you've made that and how you've related it to the tape and to the extent of malnutrition. That makes a lot of sense.
Just so to clarify, it's a global standard now, so it's not only Edesia, it's something that actually took a good amount of time for the global community to harmonize on. But you're absolutely right. It helps for sure with diagnosis and clarity in the field to know that red is severe acute malnutrition and yellow and orange is moderate acute malnutrition, and then green is the healthy range, but some kind of supplement or compliment might be needed if there's a food insecurity challenge.
Yeah. Thank you for clarifying that. When did that happen? When did everyone agree that yes, these were the colors and this is the way that we're going to move forward?
Good question. It's been more than five years now. I want to say it's like seven, eight years ago. And it was a big effort, not just with the colors, but also to harmonize the packaging so that everyone's package has, no matter what producer all over the world, there's about 25 to 30 global producers and that anyone who's making RUTF has to have a FIC red band across the package and as an example, but that is harmonized and it happened probably around seven years ago now.
And I want to dive back into kind of the food science of these products and now gets a water activity that we mentioned earlier. And Rami, I was wondering if you could tell us when water activity became an essential measurement for these products.
So before 2015, the regulations were set to be concerned with the upper limit for water activity. And initially, there was no lower limit and the upper limit had to be lower than 0.6 to control microbial growth. In 2015, the food technologist at USAID introduced a lower limit as well, because they started to get concerned about the increased levels of oxidations when going below the 0.2. So we understand that water activity is one of the most used criteria for quality as you're aware and food safety. And there is a direct connection between water activity and shelf stability and obviously retaining vitamins and minerals.
Yeah, I think that lipid oxidation is kind of a tricky thing because as you get really low in water activity, you can actually have an increased lipid oxidation rate. And I'm not sure that everyone always realizes that. So would you say that your range of water activity is maybe 0.2 to 0.5 or-
0.2 to 0.5. We always make sure it does not exceed the 0.6 because we don't want any microbial growth. And obviously, we don't want also to go below the 0.2 and we have seen some of that in the winter when there is seasonal fluctuation that we see the water activity goes below the 0.2.
And what types of instruments have you used to measure what activity. Are you using a handheld device, a benchtop device? What does that process look like?
We used to use the handheld device and we moved away from that. And we now have the 4TE benchtop device and it's provided by METER Group. Device: https://www.metergroup.com/meter_products/aqualab-4te-water-activity-meter/
And why make that upgrade? Why go from handheld to benchtop?
So when originally that when we were doing the handheld device, we received a customer complaint and we had some issues c the water activity and to improve the accuracy of the results we moved away and we started using the benchtop one, which is a 0.003 accuracy. And the turn around time also on it is much quicker than the other one.
And with that quicker turnaround time, when are you looking at water activity? Is this something that you look at in process or for finished products or during shelf life testing? When are you using that instrument?
So we do the analysis once per shift and three times every day to ensure that obviously, we have control over the products and water activity.
And I want to turn back to you, Maria now that we kind of have a better understanding of your products and who they're going to, I'm wondering if you're doing anything for the domestic market here in the US.
Yeah. Great question. That is something newer for us. Since day one, people have always asked us, well, that's great that you're helping malnourished people and kids abroad, but we have problems here too in the US what are you doing here? And for many years, we said we're not, we're really focused internationally where there are more acute needs. But that said, there are certain needs in the US and over the last few years, we came to realize that we were well positioned to also help meet some of those needs. Namely in a few areas so one of the needs is in regards to peanut allergies in the United States and we have a new product it's called MeWe Baby. And it's a healthy snack that is a good peanut introduction for young children. So we realized kind of the research and pediatric advice around introduction of allergens was really turned on its head a few years back.
So the advice of avoiding allergens for long periods of time, or until a child was older, really switched. And now the advice is that allergens like peanuts should be introduced earlier at four to six months and then at regular intervals to actually help decrease significantly the incidents of peanut allergy. So in light of that, we realized, well, one thing we're really experts at is making peanut based products for young kids. That's what we do. And there weren't a lot of products like that available in the domestic market. Now, there are a few, one of which is ours. So we developed a product like that for kids. And they're different flavor and it's a flavored peanut butter that's also a consistency. That's easy to swallow safely for a young child. And so that's for one. Additionally, to that, there are different nutritional needs in the US whether that's you want a healthy fortified snack on the go that has protein and also fortified with vitamins and minerals and, or you need nutritional support because you're recovering from a health condition or you're not growing fast enough as a child.
So things like boost or ensure those kinds of drinks are available in the United States, for sure. But there aren't a lot of other options if you're looking for alternatives. So we created an option, both for kids and for adults that are similar nutritionally in terms of filling that kind of need, but in a completely different format. So they're peanut spreads that are flavored. You've got snickerdoodle or chocolate brownie or fun, different fun flavors and also lower sugar than many of those drinks. But another alternative for people that are looking for that kind of supplement. So we have started selling these products on the market here in the US and we also have donated them through food banks and other channels carrying through our mission really is to treat and prevent malnutrition for vulnerable populations. So that fit for purpose type of nutrition work still carries through to what we do domestically.
So just to clarify, the MeWe product is for a kid nutrition, but also adults. And then you're also working for an early peanut introduction in babies; is that correct?
Yeah, that is correct. And then the other aspect of it is that we want to use the commercial products in the US to also help spread awareness and raise funds for the work that we do internationally, because the needs are large. And especially with the COVID-19 pandemic, the needs did not decrease. They increased significantly. So we want to look at different things we can do to raise awareness and raise funds for those who are most vulnerable and who can really be helped by nutritional supplements. So that's the other aspect of why the United States.
And how has Edesia been able to deal with the impacts of COVID? How has this impacted your company, especially with things like logistics and supply chain?
It hasn't been an easy year for anyone. And we are part of that. It has not been an easy year, but I'm proud to say we have been able to endure and overcome most of that. We were able to stay up and running throughout the entire pandemic. We consider ourselves and we are considered as an essential business as someone who is manufacturing foods and foods that are often life-saving foods. So we did stay open, but we had to modify a lot of things. We shortened our shifts. We segregated shifts. We put in cleaning and extra cleaning and sanitation shifts in between to help prevent spread or potential spread at Edesia. In terms of supply chain we increased all of our safety stocks of raw materials, because for risks, there were a lot more risks of interrupted supply.
We didn't know if any of our suppliers would be shut down. So we had to increase all of those safety stocks. You mentioned logistics and trucking that as well was higher risk. Again, we had to add more time because we didn't know when there would be delays. And there were some times delays. Costs also went up. So those are things we had to account for and work with. But all in all, we got our way through 2020 and into 2021 and we are feeling more hopeful and more resilient. And that we have been able to normalize kind of in a new normal, which is still cautious and it's still extra careful, but we've adapted our systems so that we can still function and we can still do the work that we do and make sure that supplies are not interrupted where they're needed all over the world.
And Rami what were some of the impacts that you've seen on your side from your perspective and in quality, how has COVID impacted your position and looking at these products and getting them out the door?
As Maria mentioned, from quality standpoint, we had to increase our sanitation activities, segregate the shifts and make sure that people maintain social distancing. It was hard because a lot of the supply chain got disturbed. So sometimes we had some delays with testing the product because every batch we make we need to ensure that we send some samples to the lab to be tested to clear the batch and then can be sent. So we had a lot of delays in terms of testing, but we were able to maintain our supplies. It was challenging, but we were able to do it.
Well. I'm glad that you guys have been able to kind of push forward and make the shifts that you need to. I think the work that you do is really impactful and I'm really happy to have you guys here today. My last question for each of you I'll start with you, Rami, is why do you love coming to work every day? What makes you proud to be a part of Edesia?
That's actually a great question. First diversity. There are 27 spoken languages at Edesia, which is an amazing thing. Here at Edesia you feel a sense of belonging. The management team also ensures to recruit from the refugee population. So we also ship the products that we make all over the world. So to countries where many of the staff members are from, I have seen our products back when I was in Syria and I have seen the change that they make. My job provides me with a sense of purpose as it is not just a job for me it is more like a mission that has a meaningful purpose.
And Maria, same question. Why do you love coming to work with this company every day and what makes you part or proud to be a part of your team?
So many things, but above all the ability to be able to work with a team of people who are passionate and mission-driven, as Rami was saying. People that have a common mission and something that's bigger than ourselves. We know we have pictures all over Edesia of children from all over the world and from the US and to see those faces and to know that we are able to be a part of bringing children back from the brink of starvation, back to healthy growth and development and a chance at a future and a chance at a life that just puts everything else in the world back in perspective and makes you realize that all those tests are worth it. All those challenges are worth it, everything that just takes headaches are worth it. Everything's worth it because you are with a team helping to create life opportunities for kids that wouldn't have them otherwise.
So to me, that's just the best thing in the world. And post COVID I would invite listeners, anyone, who's interested to come to our facility. We are an open facility. We invite people to come in, learn more about what we do. We do educational tours, Rami will show you the lab. And we like to educate because it starts with like, we really believe it's a small world and everything matters. And every single person educate yourself, spread awareness, donate when you can, volunteer when you can, reach out to Congress when you can, like anything really does make a difference. And I think that's what seeing all the kids' faces does for me. And knowing that these foods are life-changing and life-saving and that we can all be a part of it no matter where we are, the world, as I said, is small and very interconnected. And that's an amazing thing.
Well, I'll definitely be signing up for a tour someday. So I hope to be there-
... see the lab Rami and-
... both of you. So I just want to say, thank you guys so much. I love learning about new products and in companies like yours and it makes me proud to know that a small part of your process is water activity and helping to ensure the safety and quality of these products. So Rami and Maria, thank you again for being on this episode.
Thank you very much for inviting us too.
All right see you guys.
I'm Zachary Cartwright. This is Water In Food. Find this podcast on Apple iTunes, Spotify or wherever you listen to podcasts.