The MFFAPP Tanzania Efficacy Study Protocol: Newly Formulated, Extruded, Fortified Blended Foods for Food Aid

Soy Protein is an Efficacious Alternative to Whey Protein in Sorghum–Soy Fortified Blended Foods in Rats

Background

Previously we found that extruded corn–soy blend (CSB) and sorghum–soy blend (SSB) fortified blended foods (FBFs) containing whey protein concentrate (WPC) were equally nutritious food aid products. WPC provides high-quality protein; however, it is the most expensive ingredient in these FBFs.

Objectives

The primary objective of this study was to determine if soy protein can serve as an alternative to WPC and the secondary objective was to evaluate different sucrose amounts in the FBFs.

Methods

Nine extruded FBFs were formulated: 1 CSB and 1 SSB, both containing 9.5% WPC and 15% sucrose, served as comparison FBFs. Three additional CSB and 4 SSB FBFs were formulated containing no WPC, but with increased soy flour to meet protein requirements and varying sucrose concentrations. The sucrose content ranged from 0% to 10% for the CSBs and 0% to 15% for the SSBs. Male weanling Sprague Dawley rats were individually housed and divided into 10 diet groups (n = 9–10) which consumed either AIN-93G or a dry FBF for 28 d. At study conclusion, blood, livers, and body composition data were collected. Results were analyzed using 1-factor ANOVA with Tukey's test.

Results

Outcomes were not significantly different between the SSB groups, with the exception of significantly higher protein efficiency for the WPC-containing group. Among the CSB groups, caloric and protein efficiencies were significantly higher for the WPC-containing CSB group. There were no significant differences in hemoglobin or hepatic iron concentrations between FBF groups, but hepatic iron concentrations were significantly higher in all FBF groups than in the AIN-93G group. Groups consuming diets with ≤10% sucrose had significantly higher bone mineral density than groups consuming diets with 15% sucrose.

Conclusions

These results suggest that extruded SSB, but not necessarily CSB, FBFs with soy protein and 5%–10% added sucrose are efficacious and cost-effective alternatives to WPC-containing FBFs.

Nutrient Cost-Effectiveness of Fortified Blended Food Aid Products

BACKGROUND

Sorghum-Soy Blend (SSB) and Sorghum-Cowpea Blend (SCB) fortified blended food aid porridge products were developed as alternatives to Corn-Soy Blend Plus (CSB+) and Super Cereal Plus (SC+), the most widely used fortified blended food aid products. However, the cost and nutrient cost-effectiveness of these products procured from different geographical areas have not been determined.

OBJECTIVE

The objective of this study is to determine the nutrient cost-effectiveness of SSB and SCB compared to existing fortified blended foods.

METHODS

Nutritional data as well as ingredient, processing, and transportation cost for SSB, SCB, and existing fortified blended foods were compiled. Using the omega value, the ratio of the fortified blended food's Nutrient Value Score to the total cost of the fortified blended food divided by an identical ratio of a different fortified blended food or the same fortified blended food produced in a different country and the nutrient cost-effectiveness of each of the fortified blended foods procured in the United States and several African countries were determined.

RESULTS

Both CSB+ and SC+ are less expensive than SSB and SCB, but they also have lower Nutrient Value Scores of 7.7 and 8.6, respectively. However, the omega values of CSB+ and SC+ are all above 1 when compared to SSB and SCB, suggesting that the existing fortified blended foods are more nutrient cost-effective.

CONCLUSIONS

Comparing the nutrient cost-effectiveness of various food aid products could provide valuable information to food aid agencies prior to making procurement decisions.

Sensory Shelf Life Estimation of Novel Fortified Blended Foods Under Accelerated and Real-Time Storage Conditions

Fortified blended foods (FBFs), a staple of food aid around the world, must maintain desirable characteristics for long periods of storage. This study estimated the shelf life of FBFs, including a traditional FBF (nonextruded corn soy blend plus [CSB+]) and 13 novel extrusion cooked FBFs. All products were stored under accelerated and real-time environments (real time = 30 °C and 65% relative humidity [RH], accelerated = 50 °C and 70% RH based on a Q₁₀ factor of 2). Products were made into porridges and evaluated by a descriptive sensory panel for five times in each shelf life condition. Rancid and painty sensory characteristics were key determining factors for shelf life. Real-time (RT) and accelerated shelf life (ASL) testing agreed that most novel extrusion cooked FBFs had shelf lives of at least 2 years, which is comparable to current CSB+. However, ASL testing failed to predict RT shelf life of two novel FBFs, which were estimated by RT testing to have a 2+ year shelf life. The results indicated that novel extrusion cooked FBFs have high potential for use as alternative complementary food and maintain quality for long storage periods. It is essential to conduct RT testing parallel with ASLT testing, especially for new products, to obtain a more precise estimation of products' shelf life. PRACTICAL APPLICATION: These findings show that extrusion cooked novel fortified blended foods made with extrusion generally can last up to or exceeding 24 months at ambient conditions as measured either real-time or under accelerated conditions. This is plenty of time for storage, shipping, distribution, and home storage of such products by recipients. Thus, there should be no concerns about shelf life of these products for international distribution.

Determination of the Sensory Characteristics of Traditional and Novel Fortified Blended Foods Used in Supplementary Feeding Programs

Despite the wide use of traditional non-extruded fortified blended foods (FBFs), such as corn soy blend plus (CSB+), in supplementary feeding programs, there is limited evidence of its effectiveness on improving nutritional outcomes and little information on actual sensory properties. Fifteen novel extruded FBFs were developed with variations in processing and ingredients in order to improve the quality of food aid products based on the Food Aid Quality Review (FAQR) recommendations. Descriptive sensory analysis was performed to determine the effects of the processing parameters and ingredients on the sensory properties of traditional and novel FBFs. The extrusion process affected the aroma and flavor of the tested products. Novel FBFs from the extrusion process had more pronounced toasted characteristics, probably because of the high temperature used during extrusion. The ingredient composition of the FBFs also had a significant impact on the sensory properties of the products. The addition of sugar to novel FBFs leads to a significant increase in sweetness, which could improve acceptance. The level of lipids in binary blends appeared to be mainly responsible for the bitterness of the product. In addition, legumes, which were a primary ingredient, contributed to the beany characteristics of the products. The higher amounts of legume used in the formulations led to beany characteristics that could be perceived from the products and could be a negative trait depending on consumers' prior use of legume-based products.

Complementary Feeding of Sorghum-Based and Corn-Based Fortified Blended Foods Results in Similar Iron, Vitamin A, and Anthropometric Outcomes in the MFFAPP Tanzania Efficacy Study

BACKGROUND

Fortified blended foods (FBFs) are micronutrient-fortified food aid products containing cereals and pulses. It has been suggested to reformulate FBFs to include whey protein concentrate, use alternative commodities (e.g., sorghum and cowpea), and utilize processing methods such as extrusion to produce them. The Micronutrient Fortified Food Aid Pilot Project (MFFAPP) efficacy study was designed to test the efficacy of complementary feeding of newly formulated FBFs.

OBJECTIVES

The aim of this study was to test the effectiveness of 5 newly formulated FBFs in combating iron deficiency anemia and vitamin A deficiency compared with traditionally prepared corn-soy blend plus (CSB+) and no intervention. A secondary aim was to determine the impact on underweight, stunting, wasting, and middle-upper arm circumference.

METHODS

A 20-wk, partially randomized cluster study was completed. Two age groups (aged 6-23 and 24-53 mo) with hemoglobin status <10.3 g/dL, and weight-for-height z scores >-3 were enrolled and assigned to diet groups. Biochemical and anthropometric measurements were collected at 0, 10, and 20 wk.

RESULTS

Both hemoglobin concentrations and anemia ORs were significantly improved in all intervention groups except for CSB+ and the no-intervention groups at week 20. Only extruded corn-soy blend 14 and the no-intervention age groups failed to significantly decrease vitamin A deficiency risk (P < 0.04). There were no consistent significant differences among groups in anthropometric outcomes.

CONCLUSIONS

FBFs reformulated with sorghum, cowpea, corn, and soy significantly improved anemia and vitamin A deficiency ORs compared with week 0 and with no intervention. Although newly formulated FBFs did not significantly improve vitamin A deficiency or anemia compared with CSB+, CSB+ was the only FBF not to significantly improve these outcomes over the study duration. Our findings suggest that newly formulated sorghum- and cowpea-based FBFs are equally efficacious in improving these micronutrient outcomes. However, further FBF refinement is warranted. This trial was registered at clinicaltrials.gov as NCT02847962.

Novel Formulated Fortified Blended Foods Result in Improved Protein Efficiency and Hepatic Iron Concentrations Compared with Corn-Soy Blend Plus in Broiler Chickens

BACKGROUND

Corn- and soybean-based fortified blended foods (FBFs) have been the primary food aid product provided by the United States. Sorghum and cowpea have been suggested as alternative FBF commodities because they are drought-tolerant, grown in food aid-receiving areas, and not genetically modified. Extrusion processing has also been suggested to improve the quality of these FBFs.

OBJECTIVES

The aim of this study was to determine the protein quality and iron and vitamin A bioavailability of novel FBFs in broiler chickens.

METHODS

Whey protein concentrate (WPC)-containing FBFs corn-soy blend 14, sorghum-soy, and sorghum-cowpea (SC); a soy protein isolate (SPI)-containing SC FBF (SC+SPI); 2 reformulated, overprocessed SC FBFs (O-SC+WPC, O-SC+SPI); and a nonextruded WPC-containing SC FBF were developed. Nonextruded corn-soy blend plus (CSB+), a currently used FBF, and a gamebird starter/grower diet were used as comparison diets. In the prepared FBF study, 9 groups of 8-d-old broiler chicks (n = 10) consumed prepared FBFs for 21 d. In the dry study, 8 groups of 4-d-old broiler chicks (n = 24; control: n = 23) consumed dry FBFs for 14 d. Results were analyzed by 1-factor ANOVA with least-significant-difference test.

RESULTS

In the prepared study, novel formulated FBFs significantly increased caloric and protein efficiency and nonsignificantly increased body weight gain, despite similar food intake compared with CSB+. In the dry study, novel formulated FBFs, except for O-SC+SPI, significantly increased food intake, caloric efficiency, and protein efficiency and nonsignificantly increased body-weight gain compared with CSB+. Novel formulated FBFs nonsignificantly and significantly increased hepatic iron concentrations compared with all FBFs in the prepared and dry studies, respectively.

CONCLUSION

Novel formulated FBFs, apart from O-SC+SPI, resulted in improved protein efficiencies and hepatic iron concentrations compared with CSB+, suggesting that they are of higher nutritional quality.

Novel Fortified Blended Foods: Preference Testing with Infants and Young Children in Tanzania and Descriptive Sensory Analysis

The preference of porridge made from extruded fortified blended foods (FBFs) compared to a current nonextruded product (corn soy blend plus [CSB+]) among infants and young children was studied in Mwanza region, Tanzania. Five extruded, fortified blends were chosen as novel FBFs in this study: (i) corn soy blend 14 (CSB14), (ii) white sorghumFontanelle 4525 soy blend (SSB), (iii) white sorghumFontanelle 4525 cowpea blend (WSC1), (iv) white sorghum738Y cowpea blend (WSC2), and (v) red sorghum217X Burgundy cowpea blend (RSC). Paired preference testing between CSB+ and each novel FBF was conducted using approximately 600 children for each pair. Results showed that infants and young children prefer CSB14 and SSB over CSB+. Children did not show a preference between CSB+ and any of the 3 sorghum cowpea blends (WSC1, WSC2, and RSC) probably because of a distinct beany flavor from cowpea that they were not familiar with. This study indicated that novel FBFs have potential to be used successfully as supplementary food with higher or comparable preference compared to FBFs currently used in food aid programs.

PRACTICAL APPLICATION

Successful novel fortified blended foods (FBFs) can be developed with appropriate nutrition and sensory appeal from indigenous and alternative food sources. Development of such foods requires an understanding not only of the nutritional composition, but also how ingredients impact sensory properties and how they can influence preferences. From this research, novel FBFs from sorghum and cowpea were shown to be equally or preferentially preferred and should be successful. Such information is important for creating new standards and alternative formulations for FBFs.

Bioavailable Iron and Vitamin A in Newly Formulated, Extruded Corn, Soybean, Sorghum, and Cowpea Fortified-Blended Foods in the In Vitro Digestion/Caco-2 Cell Model

BACKGROUND

Fortified-blended foods (FBFs), particularly corn-soybean blend (CSB), are food aid products distributed in developing countries. The US Agency for International Development food aid quality review recommended developing extruded FBFs with the use of alternative commodities such as sorghum.

OBJECTIVE

The objective of the study was to determine bioavailable iron and vitamin A content from newly developed extruded corn, soybean, sorghum, and cowpea FBFs compared with the nonextruded traditional food aid FBFs, corn-soy blend 13 (CSB13) and corn-soy blend plus (CSB+).

METHODS

Eleven extruded FBFs-sorghum-cowpea (n = 7), sorghum-soy (n = 3), and corn-soy (n = 1)-along with 2 nonextruded FBFs-CSB13 and CSB+, and Cerelac (Nestlé), a commercially available fortified infant food, were prepared. Bioavailable iron and vitamin A contents were assessed by using the in vitro digestion/Caco-2 cell model. Dry FBFs, aqueous fractions, and Caco-2 cell pellet vitamin A contents were analyzed by HPLC. Dry FBF and aqueous fraction iron contents were measured by atomic absorptiometry, and bioavailable iron was assessed by measuring Caco-2 ferritin contents via ELISA.

RESULTS

Iron and vitamin A concentrations in Cerelac and dry FBFs ranged from 8.0 to 31.8 mg/100 g and 0.3 to 1.67 mg/100 g, respectively. All of the extruded FBFs contained 4- to 7-fold significantly higher (P < 0.05) aqueous fraction iron concentrations compared with CSB13 and CSB+. However, there were no significant differences in Caco-2 cell ferritin and vitamin A concentrations between extruded FBFs, nonextruded FBFs, and or the basal salt solution negative control.

CONCLUSION

Results support the theory that the consumption of newly developed extruded sorghum-cowpea, sorghum-soy, and corn-soy FBFs would result in iron and vitamin A concentrations comparable to traditional nonextruded CSB13 and CSB+ FBFs.