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The use of Ready-to-Use Therapeutic Foods (RUTFs) is not a sustainable strategy to treat child moderate acute malnutrition due to its high cost and unfamiliarity. An integrated multidisciplinary approach called "Pappa di Parma" was used to develop, characterize and introduce alternative sustainable and energy-dense meals against malnutrition. Six formulations were developed by using basic accessible technologies and locally available ingredients (Tanzania), a daily portion of which meets RUTFs macronutrient requirements and most micronutrients RNI. Quality characterization, rheological properties and shelf-stability of formulae were assessed under different storage conditions disclosing the suitability and stability of no-water formulae in all tested storage conditions for almost under three months. Moreover, the cultural acceptance and the economical sustainability through the implementation in Tanzania were also evaluated. Overall, this study confirmed the "Pappa di Parma" approach as a valid starting point to sustainable alternatives to RUTFs, tailored to specific agricultural and socio-economic contexts. • Sustainable formulae to treat infant moderate acute malnutrition were developed. • Only basic accessible technologies and locally available ingredients were used. • A daily portion meets RUTFs macronutrient requirements and most micronutrients RNI. • Technological traits proved the quality and stability of no-water formulae for 90 days. • Cultural acceptance was also evaluated in the local context. [ABSTRACT FROM AUTHOR]