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Analysis of nutritional adequacy of local foods for meeting dietary requirements of children aged 6-23 months in rural central Tanzania.

ABSTRACT: Under nutrition remains a serious problem among children in Sub-Saharan Africa. Analysing how diets composed of local foods could achieve nutritional goals for infants and young children in low-income settings is essential. The objective of this study was to analyse how local foods can be used rationally and to what extent these foods can be supplemented to achieve nutrient requirements for children aged 6 - 23 months in resource-poor settings.A cross-sectional study was carried out to estimate dietary intakes of 400 children aged 6-23 months using a 12-h weighed dietary record, 24-h dietary recalls, and 7-days food records. Anthropometric measurements on each subject were also taken. Analyses were done to establish the level of nutrient intake, and nutritional status of the study population using Microsoft Excel 2013 and ProPAN software version 2.0.The results showed that the prevalence of stunting, wasting and underweight for children aged 6-23 months was 30-41%, 1.5-3% and 4-9%, respectively. In addition, the results showed that diets that were consumed by the subjects comprised of local foods met vitamin A, vitamin C, protein and energy requirements for children aged 6-23 months. However, the extent of deficit in iron, zinc and calcium in baseline diets was large and difficult to meet under the existing feeding practices.The study shows that local foods in the study area have a potential to achieve recommended dietary intakes of some essential nutrients, and that interventions are needed to meet the required amount of iron, zinc and calcium for children aged 6-23 months. The interventions we propose here may encourage changes in traditional feeding habits and practices of the target population. Possible intervention options are (1) supplementation of local foods with nutrient-dense foods that are not normally consumed in the locality (2) providing new avenues for increasing the production and wide consumption of local nutrient-dense foods, or optimizing the way local diets are constituted so as to achieve nutrient recommendations for infants and young children.

SUBMITTER: Raymond J

PROVIDER: S-EPMC5559821 | biostudies-other | 2017

REPOSITORIES: biostudies-other

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Project description:BACKGROUND:Animal source foods provide high-quality protein and essential micronutrients within the human diet and are of particular significance for the health and development of children. Despite the availability of domestic livestock in rural households of Ethiopia, the diets of children are often monotonous and mainly cereal-based with low energy and nutrient density. OBJECTIVE:Explore barriers and facilitators for the consumption of animal source foods among 6-23 months old children from the rural communities of Northern Ethiopia. METHODS:A community-based exploratory qualitative study design was conducted in July through September 2018. A total of eight focus group discussions (56 individuals) and twenty-four qualitative interviews were conducted with mothers who are lactating, fathers, health extension workers, nutrition, and agriculture experts. Purposive sampling technique was used to include study participants based on their potential relevance in delivering a wealth of information. Thematic analysis strategies, a method for identifying, analyzing, and reporting themes within data, were used to code and grouped into related families and synthesize the qualitative data. RESULTS:Consumption of animal source foods among 6-23 months old children was very low and the home-reared livestock and their products were mainly used for market purposes. Animal products are consumed during special societal occasions since they are considered as luxury food rather than an essential part of daily children's diet. Lack of nutrition knowledge, high cost of animal source foods, mothers' workload to herd livestock, low household income, low milk production, the poor linkage between health and agriculture sectors, and social norms and beliefs were identified as common barriers. While the presence of nutrition experts, cooking demonstrations, in-kind credit programs, livestock ownership, and government-led stunting reduction programs were the facilitators for the consumption of animal source foods in the study communities. CONCLUSIONS:Reduced consumption of animal source foods inadvertently impacted dietary diversity of 6-23 months old children from the study communities. Thus, strengthening social and behavior change communication to promote the consumption of animal source foods, creating opportunities for women to own small livestock for household consumption and provide nutrition education on dietary restriction of animal source foods during religious periods among 6-23 months old children in the rural communities of Northern Ethiopia are recommended.

Project description:IntroductionChildhood undernutrition is a major public health problem especially in low and middle-income countries (LMIC). The prevalence of early introduction of complementary feeding, low meal frequency, and low dietary diversity are frequent in LMICs. The effect of inappropriate complementary feeding practices on the nutritional status of children is not well documented in East African countries including Tanzania. Therefore, this study aimed at determining the effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Tanzania.MethodologyA retrospective cohort study was done using the Pasua and Majengo cohorts of mother-child pairs in urban Moshi who were enrolled from 2002 to 2017. About 3355 mother-child pairs were included in the analysis. Appropriate complementary feeding practices were assessed using WHO IYFP indicators such as age at introduction of solid, semi-solid, or soft foods, minimum dietary diversity, and minimum meal frequency. Nutritional status (stunting, wasting, and underweight) was determined. Multilevel modeling was applied to obtain the effect of inappropriate complementary feeding practices on the nutritional status of children and to account for the clustering effect of mothers and children and the correlation of repeated measures within each child.ResultsMajority of the children (91.2%) were given soft/semi-solid/solid foods before six months of age, 40.3percent had low meal frequency, and 74percent had low dietary diversity. Early introduction of complementary food at age 0-1 month was statistically significantly associated with higher risks of wasting and underweight (ARR 2.9, 95%CI 1.3-6.3; and ARR 2.6, 95% CI 1.3-5.1 respectively). Children with low minimum meal frequency had higher risks of stunting, wasting, and underweight (ARR 2.9, 95%CI 2.3-3.6; ARR 1.9, 95%CI 1.5-2.5 and ARR 1.9, 95%CI 1.5-2.4 respectively). Children with low minimum dietary diversity were more likely to be stunted than is the case with their peers who received the minimum dietary diversity (ARR 1.3, 95% CI 1.01-1.6).ConclusionThere were a high proportion of children, which were fed inappropriately; Inappropriate complementary feeding practices predisposed children to undernutrition. Our study supports the introduction of complementary feeding, providing minimum dietary diversity, and minimum feeding frequency at six months of age as important in improving the nutritional status of the children.

Project description:BackgroundAging is a process associated with physiological changes such as in body composition, energy expenditure and physical activity. Data on energy and nutrient intake adequacy among elderly is important for disease prevention, health maintenance and program development.MethodsThis descriptive cross-sectional study was designed to determine the energy requirements and adequacy of energy and nutrient intakes of older persons living in private households in a rural Filipino community. Study participants were generally-healthy, ambulatory, and community living elderly aged 60-100 y (n = 98), 88 of whom provided dietary information in three nonconsecutive 24-hour food-recall interviews.ResultsThere was a decrease in both physical activity and food intake with increasing years. Based on total energy expenditure and controlling for age, gender and socio-economic status, the average energy requirement for near-old (>or= 60 to < 65 y) males was 2074 kcal/d, with lower requirements, 1919 and 1699 kcal/d for the young-old (>or= 65 to < 75 y) and the old-old (>or= 75 y), respectively. Among females, the average energy requirements for the 3 age categories were 1712, 1662, and 1398 kcal/d, respectively. Actual energy intakes, however, were only approximately 65% adequate for all subjects as compared to energy expenditure. Protein, fat, and micronutrients (vitamins A and C, thiamin, riboflavin, iron and calcium) intakes were only approximately 24-51% of the recommended daily intake. Among this population, there was a weight decrease of 100 g (p = 0.012) and a BMI decrease of 0.04 kg/m2 (p = 0.003) for every 1% decrease in total caloric intake as percentage of the total energy expenditure requirements.ConclusionThese community living elderly suffer from lack of both macronutrient intake as compared with energy requirements, and micronutrient intake as compared with the standard dietary recommendations. Their energy intakes are ~65% of the amounts required based on their total energy expenditure. Though their intakes decrease with increasing age, so do their energy expenditure, making their relative insufficiency of food intake stable with age.

Project description:Background:A trial in Burkina Faso compared the cost-effectiveness of 4 specialized nutritious foods (SNFs) used to prevent stunting and wasting in children aged 6-23 mo. Objectives:This article explores differences in SNF use that may have influenced effectiveness, specifically in relation to consumption by the recipient child and by any other person (i.e., sharing), other diversion from the recipient child, preparation, storage, and hygiene. Methods:Subsamples from a geographically clustered, longitudinal trial with random assignment to Corn Soy Blend Plus with oil (CSB+ w/oil), Corn Soy Whey Blend with oil (CSWB w/oil), Super Cereal Plus (SC+), or ready-to-use supplementary food (RUSF) were selected for in-depth interviews, in-home observations, and focus group discussions. Results:Sharing was common in all arms, with the highest reported in SC+ (73%) and highest observed in CSWB w/oil (36%). Some reported giving the ration away (highest in SC+ at 17%) or using it for other purposes (highest in CSWB w/oil at 17%). The recipient child was observed consuming the ration in 49% of households on average (38-60% by arm in CSB+ w/oil and RUSF, respectively). Qualitative reports of bitterness and spoilage emerged in the CSWB w/oil arm. Most observed households (excluding RUSF) did not prepare porridge daily as instructed (35-46% by arm). Household water samples showed either high-risk or unsafe contamination with Escherichia coli (72-78% by arm). Low percentages were observed handwashing (both child and server) before consuming the porridge. Conclusions:The SNFs were not prepared or served as intended and diversion from the recipient was common. Storage conditions may have resulted in spoilage of the ration containing whey before reaching recipients. This article provides context about factors that may have influenced the effectiveness of these SNFs. Programming and household use of SNFs are as important as their nutrient composition. This trial was registered at clinicaltrials.gov as NCT02071563.

Project description:BackgroundThere is a variety of specialized nutritious foods available for use in programs targeting undernutrition, but evidence supporting the choice of product is limited.ObjectivesWe compared the cost-effectiveness of 4 specialized nutritious foods to prevent stunting and wasting in children aged 6-23 mo in Burkina Faso.MethodsFour geographic regions were randomly assigned to 1 of 4 intervention arms: Corn-Soy Blend Plus (CSB+) programmed with separate fortified vegetable oil (the reference food), Corn-Soy-Whey Blend (CSWB; a new formulation) with oil, SuperCereal Plus (SC+), and ready-to-use supplementary food (RUSF). We compared the effects of each intervention arm on growth (length-for-age z score (LAZ), weight-for-length z score (WLZ), end-line stunting (LAZ < -2), and total monthly measurements of wasting (WLZ < -2). Rations were ∼500 kcal/d, distributed monthly. Children were enrolled in the blanket supplementary feeding program at age ∼6 mo and measured monthly for ∼18 mo. Average costs per child reached were linked with effectiveness to compare the cost-effectiveness of each arm with CSB+ with oil.ResultsIn our sample of 6112 children (CSB+, n = 1519; CSWB, n = 1503; SC+, n = 1564; RUSF, n = 1526), none of the foods prevented declines in growth. Children in the SC+ and RUSF arms were not significantly different than those in the CSB+ with oil arm. Children in the CSWB with oil arm experienced higher end-line (measurement at age 22.9-23.9 mo) stunting (OR: 2.07; 95% CI: 1.46, 2.94) and more months of wasting (incidence rate ratio: 1.29; 95% CI: 1.09, 1.51). CSB+ with oil was the least-expensive ration in all costing scenarios ($113-131 2018 US dollars/enrolled child) and similar in effectiveness to SC+ and RUSF, and thus the most cost-effective product for the defined purposes.ConclusionsCSB+ with oil was the most cost-effective ration in the prevention of wasting and stunting in this trial. This trial was registered at clinicaltrials.gov as NCT02071563.

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Analysis of nutritional adequacy of local foods for meeting dietary requirements of children aged 6-23 months in rural central Tanzania.

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