Effect of nutritional supplement formula on catch-up growth in young children with nonorganic faltering growth: a prospective multicenter study

Optimization of dabi teff-field pea based energy and protein dense novel complementary food with improved sensory acceptability using D-optimal mixture design

Protein-energy malnutrition is unacceptably high among children in developing countries due to inadequate required nutrients and poor quality of complementary foods characterized by low protein and energy density and often monotonous. Thus, this research was aimed at examining the potential of including dabi teff, the underutilized/forgotten crop into pre-processed local food crops viz., germinated maize, roasted barley, roasted field pea, dehulled oats and linseed to develop energy and protein-dense optimized novel complementary food with improved sensory acceptability. Nutrisurvey software was employed to define ranges and they were constrained at 20-35% dabi teff, 0-30% field pea and 5-20% maize, while the rest were set constant at 25% barley, 15% oats and 5% linseed. Eleven experimental runs were generated from the six mixture components using D-optimal mixture design, Stat-Ease Design Expert ® software version 11. A 5-point Hedonic scale was used to evaluate the sensory attributes. 'Scheffe' regression was used to fit and test model adequacy and numerical multi-response optimization was performed to identify optimal points using the Design expert. Field pea and linseed contained significantly higher (P < 0.05) protein at 20.95% and 20.57%. The newly formulated products contained significantly higher protein (1.4-1.6 times) and protein density (1.31-1.56 times) as compared to the control and fulfilled the recommended standard. The optimal was identified at 34.66% dabi teff, 25% barley, 15% oats, 15.34% field pea, 5% linseed and 5% maize flour ratios with response values at overall optimization to be 5.57% moisture, 15.74% protein, 5.09% fat, 2.26% ash, 2.88% fiber, 73.05% carbohydrate, 380.43 kcal/100 g energy and 4.12 sensory acceptability score and it contained an energy density of 1.27 kcal/g and protein density of 4.14 g/100kacl. These findings showed that optimized dabi teff-field pea based novel complementary food can be used as a sustainable food-based strategy to combat protein-energy malnutrition among children in developing countries.

Oral Nutritional Supplementation Improves Growth in Children at Malnutrition Risk and with Picky Eating Behaviors

The problem of poor nutrition with impaired growth persists in young children worldwide, including in India, where wasting occurs in 20% of urban children (<5 years). Exacerbating this problem, some children are described by their parent as a picky eater with behaviors such as eating limited food and unwillingness to try new foods. Timely intervention can help prevent nutritional decline and promote growth recovery; oral nutritional supplements (ONS) and dietary counseling (DC) are commonly used. The present study aimed to determine the effects of ONS along with DC on growth in comparison with the effects of DC only. Enrolled children (N = 321) were >24 to ≤48 months old, at malnutrition risk (weight-for-height percentile 3rd to 15th), and described as a picky eater by their parent. Enrollees were randomized to one of the three groups (N = 107 per group): ONS1 + DC; ONS2 + DC; and DC only. From day 1 to day 90, study findings showed significant increases in weight-for-height percentile for ONS1 + DC and for ONS2 + DC interventions, as compared to DC only (p = 0.0086 for both). There was no significant difference between the two ONS groups. Anthropometric measurements (weight and body mass index) also increased significantly over time for the two ONS groups (versus DC only, p < 0.05), while ONS1 + DC significantly improved mid-upper-arm circumference (p < 0.05 versus DC only), as well. ONS groups showed a trend toward greater height gain when compared to DC only group, but the differences were not significant within the study interval. For young Indian children with nutritional risk and picky eating behaviors, our findings showed that a 90-day nutritional intervention with either ONS1 or ONS2, along with DC, promoted catch-up growth more effectively than did DC alone.