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Lee GO, Caulfield LE, Paredes-Olortegui M, Penataro-Yori P, Salas MS, Kosek MN. Nutrient intakes from complementary foods are associated with cardiometabolic biomarkers among undernourished Peruvian children. J Nutr Sci 2023; 12:e80. [PMID: 37528831 PMCID: PMC10388437 DOI: 10.1017/jns.2023.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 08/03/2023] Open
Abstract
Relatively little is known about how the diet of chronically undernourished children may impact cardiometabolic biomarkers. The objective of this exploratory study was to characterise relationships between dietary patterns and the cardiometabolic profile of 153 3-5-year-old Peruvian children with a high prevalence of chronic undernutrition. We collected monthly dietary recalls from children when they were 9-24 months old. At 3-5 years, additional dietary recalls were collected, and blood pressure, height, weight, subscapular skinfolds and fasting plasma glucose, insulin and lipid profiles were assessed. Nutrient intakes were expressed as average density per 100 kcals (i) from 9 to 24 months and (ii) at follow-up. The treelet transform and sparse reduced rank regress'ion (RRR) were used to summarize nutrient intake data. Linear regression models were then used to compare these factors to cardiometabolic outcomes and anthropometry. Linear regression models adjusting for subscapular skinfold-for-age Z-scores (SSFZ) were then used to test whether observed relationships were mediated by body composition. 26 % of children were stunted at 3-5 years old. Both treelet transform and sparse RRR-derived child dietary factors are related to protein intake and associated with total cholesterol and SSFZ. Associations between dietary factors and insulin were attenuated after adjusting for SSFZ, suggesting that body composition mediated these relationships. Dietary factors in early childhood, influenced by protein intake, are associated with cholesterol profiles, fasting glucose and body fat in a chronically undernourished population.
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Key Words
- Cardiometabolic biomarkers
- Complementary foods
- HAZ, height-for-age Z-score, based on the WHO reference standard
- HDL-c, high-density lipoprotein cholesterol
- HDLZ, sd of mean HDL-c, based on the distribution of the sample
- HOMA-IR, homeostatic model assessment-insulin resistance
- INZ, sd of insulin, based on the distribution of the sample
- LDC-c, low-density lipoprotein cholesterol
- MAPZ, sd of mean arterial blood pressure, based on the distribution of the sample
- MFP, meat, fish or poultry
- Nutrient intake
- PCA, principal components analysis
- Peru
- RRR, reduced rank regression
- Stunting
- TC, total cholesterol
- TG, triglycerides
- TGZ, sd of triglycerides, based on the distribution of the sample
- WAZ, weight-for-age Z-score, based on the WHO reference standard
- WHZ, weight-for-height Z-score, based on the WHO reference standard
- vLDL-c, very low-density lipoprotein cholesterol
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Affiliation(s)
- Gwenyth O. Lee
- Rutgers Global Health Institute and Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, NJ, USA
| | - Laura E. Caulfield
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Pablo Penataro-Yori
- University of Virginia Division of Infectious Diseases and International Health, Charlottesville, VA, USA
| | | | - Margaret N. Kosek
- University of Virginia Division of Infectious Diseases and International Health, Charlottesville, VA, USA
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Ferreira SS, Marchioni DML, Wall CR, Gerritsen S, Teixeira JA, Grant CC, Morton SMB, Gontijo de Castro T. Prevalence and maternal determinants of early and late introduction of complementary foods: results from the Growing Up in New Zealand cohort study. Br J Nutr 2023; 129:491-502. [PMID: 35403582 DOI: 10.1017/S000711452200112X] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A nationally generalisable cohort (n 5770) was used to determine the prevalence of non-timely (early/late) introduction of complementary food and core food groups and associations with maternal sociodemographic and health behaviours in New Zealand (NZ). Variables describing maternal characteristics and infant food introduction were sourced, respectively, from interviews completed antenatally and during late infancy. The NZ Infant Feeding Guidelines were used to define early (≤ 4 months) and late (≥ 7 months) introduction. Associations were examined using multivariable multinomial regression, presented as adjusted relative risk ratios and 95 % confidence intervals (RRR; 95% CI). Complementary food introduction was early for 40·2 % and late for 3·2 %. The prevalence of early food group introduction were fruit/vegetables (23·8 %), breads/cereals (36·3 %), iron-rich foods (34·1 %) and of late were meat/meat alternatives (45·9 %), dairy products (46·2 %) and fruits/vegetables (9·9 %). Compared with infants with timely food introduction, risk of early food introduction was increased for infants: breastfed < 6months (2·52; 2·19-2·90), whose mothers were < 30 years old (1·69; 1·46-1·94), had a diploma/trade certificate v. tertiary education (1·39; 1·1-1·70), of Māori v. European ethnicity (1·40; 1·12-1·75) or smoked during pregnancy (1·88; 1·44-2·46). Risk of late food introduction decreased for infants breastfed < 6 months (0·47; 0.27-0·80) and increased for infants whose mothers had secondary v. tertiary education (2·04; 1·16-3·60) were of Asian v. European ethnicity (2·22; 1·35, 3·63) or did not attend childbirth preparation classes (2·23; 1·24-4·01). Non-timely food introduction, specifically early food introduction, is prevalent in NZ. Interventions to improve food introduction timeliness should be ethnic-specific and support longer breast-feeding.
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Lin X, Wu X, Li X, Zhang D, Zheng Q, Xu J, Lu S. Infant exposure to trace elements in breast milk, infant formulas and complementary foods from southern China. Sci Total Environ 2022; 838:156597. [PMID: 35690194 DOI: 10.1016/j.scitotenv.2022.156597] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
Excessive intake of essential trace elements or exposure to potentially toxic elements above certain thresholds may cause adverse health effects in humans. To date, there is scarce evidence concerning Chinese infant exposure to trace elements and the associated risks. In this study, we collected 61 breast milk, 54 infant formula and 90 complementary food samples from southern China to investigate the levels of cobalt (Co), chromium (Cr), copper (Cu), selenium (Se), zinc (Zn), arsenic (As), cadmium (Cd), nickel (Ni) and lead (Pb). The concentrations of these elements in the breast milk samples ranged from under the limit of detection (<LOD)-0.65, <LOD-65.5, 107-1040, 6.17-27.9, 820-10,160, <LOD-2.96, <LOD-0.52, <LOD-230, and <LOD-19.1 μg/L, respectively. In infant formula samples, the concentrations of these elements ranged from 2.77 to 7.56, 27.5-205, 188-4321, 69.7-322, 40,793-84,405, 2.47-12.2, 0.15-3.57, <LOD-505 and 2.19-26.5 μg/kg, respectively, while the concentrations detected in complementary food samples ranged from <LOD-23.7, <LOD-224, <LOD-3705, <LOD-219, 15,335-100,905, <LOD-159, <LOD-66.6, <LOD-502 and <LOD-25.6 μg/kg, respectively. The results showed that the levels of Cr, Cu and Se in 14.8-55.6 % of the infant formula and complementary food samples were lower than the reference values set by Codex Alimentarius or Chinese National Standards, while the levels of Zn in commercial food samples exceeded the corresponding reference values in 9.3-27.8 % of cases; these results suggest a potential risk via the consumption of commercial infant foods. To the best of our knowledge, this is the first study that has comprehensively assessed whether exposure to trace elements via food intake poses potential health risks to Chinese infants.
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Affiliation(s)
- Xiaoying Lin
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou 510275, China
| | - Xiaoling Wu
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou 510275, China
| | - Xiangyu Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou 510275, China
| | - Duo Zhang
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou 510275, China
| | - Quanzhi Zheng
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou 510275, China
| | - Jiayi Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou 510275, China
| | - Shaoyou Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou 510275, China.
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Bassetti E, Zehner E, Mayhew SH, Nasser N, Mulder A, Badham J, Sweet L, Crossley R, Pries AM. Nutrient profiles of commercially produced complementary foods available in Cambodia, Indonesia and the Philippines. Public Health Nutr 2022; 25:1-11. [PMID: 35786427 PMCID: PMC9991791 DOI: 10.1017/s1368980022001483] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/06/2022] [Accepted: 06/10/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the nutritional suitability of commercially produced complementary foods (CPCF) marketed in three South-East Asian contexts. DESIGN Based on label information declared on the products, nutrient composition and content of CPCF were assessed against the WHO Europe nutrient profile model (NPM). The proportion of CPCF that would require a 'high sugar' warning was also determined. SETTING Khsach Kandal district, Cambodia; Bandung City, Indonesia; and National Capital Region, Philippines. PARTICIPANTS CPCF products purchased in Cambodia (n 68) and Philippines (n 211) in 2020, and Indonesia (n 211) in 2017. RESULTS Only 4·4 % of products in Cambodia, 10·0 % of products in Indonesia and 37·0 % of products in the Philippines fully complied with relevant WHO Europe NPM nutrient composition requirements. Sixteen per cent of CPCF in Cambodia, 27·0 % in Indonesia and 58·8 % in the Philippines contained total sugar content levels that would require a 'high sugar' warning. CONCLUSIONS Most of the analysed CPCF were not nutritionally suitable to be promoted for older infants and young children based on their nutrient profiles, with many containing high levels of sugar and sodium. Therefore, it is crucial to introduce new policies, regulations and standards to limit the promotion of inappropriate CPCF in the South-East Asia region.
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Affiliation(s)
- Eleonora Bassetti
- Helen Keller International, New York, NY, USA
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Susannah H Mayhew
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Nadine Nasser
- Access to Nutrition Initiative, Utrecht, Netherlands
| | | | | | - Lara Sweet
- JB Consultancy, Johannesburg, South Africa
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Koplin JJ, Soriano VX, Peters RL. Real-World LEAP Implementation. Curr Allergy Asthma Rep 2022; 22:61-66. [PMID: 35394609 PMCID: PMC8990270 DOI: 10.1007/s11882-022-01032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2022] [Indexed: 11/29/2022]
Abstract
Purpose of Review In 2015, findings from the Learning Early About Peanut allergy (LEAP) trial provided the first convincing evidence that peanut allergy may be preventable through early peanut introduction into the infant diet. Here we discuss implementation of the LEAP study findings around the world and emerging evidence of the impacts on infant feeding and food allergy. Recent Findings The LEAP findings led to rapid changes in allergy prevention guidelines internationally to recommend early peanut introduction. There is now emerging evidence that this has been followed by a substantial increase in early peanut introduction to infants. Studies investigating the impact of these changes in infant feeding practices on the prevalence of peanut allergy are underway. Summary The LEAP trial represented a significant step forwards in food allergy prevention and new research over the past 5 years has provided insights into how best to implement this intervention in the real world.
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Affiliation(s)
- Jennifer J Koplin
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia. .,Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
| | - Victoria X Soriano
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
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Mehta S, Huey SL, Ghugre PS, Potdar RD, Venkatramanan S, Krisher JT, Ruth CJ, Chopra HV, Thorat A, Thakker V, Johnson L, Powis L, Raveendran Y, Haas JD, Finkelstein JL, Udipi SA. A randomized trial of iron- and zinc-biofortified pearl millet-based complementary feeding in children aged 12 to 18 months living in urban slums. Clin Nutr 2022; 41:937-947. [PMID: 35299084 DOI: 10.1016/j.clnu.2022.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS Biofortification of staple crops with higher levels of micronutrients via traditional breeding methods is a sustainable strategy and can possibly complement fortification and other interventions to target micronutrient deficiencies in low resource settings, particularly among vulnerable populations such as children. We aimed to determine if iron- and zinc-biofortified pearl millet (FeZnPM, Dhanashakti, ICTP-8203Fe)-based complementary feeding improves nutritional status, including iron biomarkers and growth, in children living in urban slums of Mumbai. METHODS We conducted a randomized controlled trial of FeZnPM among 223 children aged 12-18 months who were not severely anemic at baseline (hemoglobin ≥9.0 g/dL). Children were randomized to receive either FeZnPM or conventional non-biofortified pearl millet (CPM) daily for 9 months. Iron status (hemoglobin, serum ferritin), plasma zinc, and anthropometric indicators (length, weight, mid-upper arm circumference, triceps and subscapular skinfolds) were evaluated at enrollment and throughout the trial. World Health Organization (WHO) anthropometric z-scores were calculated using WHO growth standards. Primary outcomes were hemoglobin and serum ferritin concentrations, and growth, defined as WHO z-scores. An intent to treat approach was used for analyses. We used the Hodges-Lehmann-Sen test to assess the change in primary outcomes between baseline and the last visit and report corresponding 95% confidence intervals. RESULTS At baseline, 67.7% of children were anemic (hemoglobin <11.0 g/dL) and 59.6% were iron deficient (serum ferritin <12.0 μg/L). FeZnPM did not significantly increase iron biomarkers or improve growth, compared to CPM. In subgroup analyses, FeZnPM improved hemoglobin concentrations in male children, and in children with iron deficiency or iron depletion (serum ferritin <25.0 μg/L) at baseline, relative to CPM. CONCLUSIONS Daily consumption of FeZnPM-based complementary foods did not significantly impact iron and zinc status or growth in children living in Mumbai's urban slums. However, the intervention significantly improved hemoglobin concentrations among male children and among individuals who were iron-deficient or iron-depleted at baseline. TRIAL REGISTRATION This trial is registered with Clinicaltrials.gov (ID: NCT02233764), and Clinical Trials Registry of India (ID: REF/2014/10/007731).
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Affiliation(s)
- Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA; Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, NY, USA.
| | - Samantha L Huey
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Padmini S Ghugre
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | | | | | - Jesse T Krisher
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | | | - Harsha V Chopra
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | - Aparna Thorat
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | - Varsha Thakker
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
| | - Lynn Johnson
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, USA
| | - Laura Powis
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | | | - Jere D Haas
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | | | - Shobha A Udipi
- Department of Nutrition and Food Science, SNDT Women's University, Mumbai, India
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Brunet G, Vidal L, Bove I, Girona A, Iragola V, Ceriani F, Rodríguez R, Martínez A, Fuletti D, Ares G. The social representations of complementary feeding. Appetite 2021; 165:105324. [PMID: 34029670 DOI: 10.1016/j.appet.2021.105324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
The social representations of complementary feeding are expected to shape parents' decisions and to provide justification or legitimization for their practices. The aims of the present work were: i) to explore the social representations of complementary feeding in parents and health professionals, ii) to evaluate if the onset of complementary feeding modify social representations in parents, and iii) to compare the representations of parents and pediatricians. Three groups of participants were considered: 170 parents of children who had not started complementary feeding (1-4 months old), 170 parents of children who had started complementary feeding (7-10 months old) and 212 pediatricians. Parents were recruited in health facilities in Montevideo (Uruguay), whereas pediatricians were recruited at the National Pediatrics Conference. Participants were asked to complete a word association task with "the first meals of a baby". All the responses provided by participants were grouped into categories using content analysis. The structure of the social representations was assessed considering the frequency of mention and the average rank of appearance of the categories. Results showed that the social representations of complementary feeding for both parents and pediatricians were extremely narrow and mainly focused on specific foods: puree and a small set of vegetables and fruits. None of the categories showed high frequency of mention and low rank of appearance, indicating that the structure of the social representations did not include any element in the first periphery. According to the theory of social representations, results from the present work suggest that the social representations of complementary feeding for Uruguayan parents and pediatricians are deeply rooted and resistant to change.
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Affiliation(s)
- Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200, Montevideo, Uruguay.
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 S/n, CP 91000, Pando, Canelones, Uruguay
| | - Isabel Bove
- UNICEF Uruguay, Bulevar General Artigas 1659, CP 11600, Montevideo, Uruguay
| | - Alejandra Girona
- Departamento de Nutrición Básica, Escuela de Nutrición, Universidad de la República, Av. Américo Ricaldoni S/n, CP 11600, Montevideo, Uruguay; Red Uruguaya de Apoyo a la Nutrición y Desarrollo Infantil, Pedro Vidal 2145, CP 11600, Montevideo, Uruguay
| | - Valentina Iragola
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200, Montevideo, Uruguay
| | - Florencia Ceriani
- Red Uruguaya de Apoyo a la Nutrición y Desarrollo Infantil, Pedro Vidal 2145, CP 11600, Montevideo, Uruguay
| | - Raquel Rodríguez
- Departamento de Nutrición Básica, Escuela de Nutrición, Universidad de la República, Av. Américo Ricaldoni S/n, CP 11600, Montevideo, Uruguay; Red Uruguaya de Apoyo a la Nutrición y Desarrollo Infantil, Pedro Vidal 2145, CP 11600, Montevideo, Uruguay
| | - Andrea Martínez
- Red Uruguaya de Apoyo a la Nutrición y Desarrollo Infantil, Pedro Vidal 2145, CP 11600, Montevideo, Uruguay
| | - Darío Fuletti
- UNICEF Uruguay, Bulevar General Artigas 1659, CP 11600, Montevideo, Uruguay
| | - Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 S/n, CP 91000, Pando, Canelones, Uruguay
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Vidal L, Bove I, Brunet G, Girona A, Alcaire F, Antúnez L, Ares G. Are the recommendations of paediatricians about complementary feeding aligned with current guidelines in Uruguay? Public Health Nutr 2021; 24:1-10. [PMID: 33413708 DOI: 10.1017/s1368980020005352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore Uruguayan paediatricians' personal recommendations about complementary feeding and to assess if they are aligned with current guidelines and scientific evidence. DESIGN A questionnaire composed of open-ended questions was used to explore foods recommended to start complementary feeding, foods regarded as the most important during the first meals, recommendations for delayed introduction of foods and foods that should be avoided. Reasons underlying the recommendations were also explored. SETTING Montevideo, the capital city of Uruguay (Latin America). PARTICIPANTS A total of 212 paediatricians were recruited during a National Pediatrics Conference, organised by the Uruguayan Society of Pediatrics. RESULTS The recommendations about complementary feeding provided by paediatricians to parents and caregivers in Uruguay seemed not to be fully aligned with the guidelines provided by the Ministry of Health. Paediatricians recommend a rigid food introduction sequence, characterised by the early introduction of soft pureed vegetables and fruits, followed by meat and the delayed introduction of allergenic foods. Food diversity and the concept of ultra-processed were not frequently identified in the responses. CONCLUSIONS Results stress the importance of developing educational and communication approaches targeted at paediatricians to contribute to the uptake of updated recommendations regarding complementary feeding.
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Affiliation(s)
- Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000Pando, Canelones, Uruguay
| | | | - Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, Montevideo, Uruguay
| | - Alejandra Girona
- Departamento de Nutrición Básica, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000Pando, Canelones, Uruguay
| | - Lucía Antúnez
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000Pando, Canelones, Uruguay
| | - Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000Pando, Canelones, Uruguay
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Buzigi E, Pillay K, Siwela M. Child acceptability of a novel provitamin A carotenoid, iron and zinc-rich complementary food blend prepared from pumpkin and common bean in Uganda: a randomised control trial. BMC Pediatr 2020; 20:412. [PMID: 32873263 PMCID: PMC7461249 DOI: 10.1186/s12887-020-02326-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Ugandan children are fed homemade complementary foods (CFs) which are usually deficient in vitamin A, iron and zinc. Novel homemade CFs rich in vitamin A, iron and zinc need to be developed, and assessed for their acceptability among target children. OBJECTIVE Homemade provitamin A carotenoids (PVACs), iron and zinc-rich complementary food (CF), common bean pumpkin blend (BPB) formulated from pumpkin (Sweet cream) and common bean (Obwelu) and PVAC-rich pumpkin blend (PB) from Sweet cream were prepared by expert peer mothers. This study compared child acceptability of BPB and PB (control). METHODS The crossover acceptability study randomly assigned Ugandan children 6 to 24 months old to either receive 100 g of BPB (n = 35) or 100 g of PB (n = 35) on day one. After a washout period of one day, children crossed over to receive either BPB (n = 35) or PB (n = 35). The amount of CF consumed, duration of consumption, and micronutrient intake were assessed. The CF was acceptable if children consumed ≥50 g (50%) of served food (100 g). A paired t-test was used to determine the mean differences within participants between BPB and PB. The level of statistical significant difference was set at a probability value of 5% (p = 0.05). RESULTS The mean consumption of BPB and PB was 53.9 g and 54.4 g, respectively. The mean duration for consumption of BPB and PB was 20.6 and 20.3 min, respectively. There was no significant difference in the amounts consumed, and duration of consumption in BPB and PB (p > 0.05). The mean intake of vitamin A was significantly higher (p < 0.00001) in PB (152.5 μgRAE) compared to BPB (100.9 μgRAE). The mean iron intake was significantly higher in BPB (1.1 mg) (p < 0.00001) compared to PB (0.3 mg). Furthermore, zinc intake was significantly higher (p < 0.00001) in BPB (0.58 mg) compared to PB (0.13 mg). CONCLUSION A homemade complementary food, BPB, made from locally available common bean and pumpkin is rich in PVACs, iron and zinc and is acceptable to children in the age range of complementary feeding in Uganda. TRIAL REGISTRATION Pan African Clinical Trials Registry www.pactr.org as PACTR202002576768667 . Retrospectively registered. Date of registration: 29/January/2020.
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Affiliation(s)
- Edward Buzigi
- Department of Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa.
- Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Westville Campus, J Block 4th Floor, Durban, 4041, South Africa.
- Department of Human Nutrition & Home Economics, Kyambogo University, P.O. Box 1 Kyambogo, Kampala, Uganda.
| | - Kirthee Pillay
- Department of Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa
| | - Muthulisi Siwela
- Department of Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa
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Stiller CK, Golembiewski SKE, Golembiewski M, Mondal S, Biesalski HK, Scherbaum V. Maternal nutritional status and child feeding practices: a retrospective study in Santal communities, Birbhum District, West Bengal, India. Int Breastfeed J 2020; 15:50. [PMID: 32471456 PMCID: PMC7257594 DOI: 10.1186/s13006-020-00262-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 03/17/2020] [Indexed: 11/24/2022] Open
Abstract
Background In West Bengal, according to the National Family Health Survey (NFHS-4) 2015-16, undernutrition and anemia are particularly common among scheduled tribe women and children. The purpose of this research is to assess the nutritional status of Adivasi mothers and child feeding patterns, relevant for clinical practice and the design of future preventive actions. These baseline characteristics were obtained in the scope of a feeding trial aimed at improving the hemoglobin concentration of the index child (6–39 months). Methods In February 2015, the baseline survey was conducted in 21 tribal villages. In total, 288 mothers and 307 children were recruited for their hemoglobin levels (HemoCue Hb201+), as well as anthropometric indices height/length, weight and MUAC. By questionnaire-based interview aspects on child feeding practices, childcare, family scheduling, and prenatal care were elucidated. Results The majority of mothers belong to the Santal tribe (93.8%). Nearly half of mothers suffered from underweight including severe forms (BMI < 18.5: 49.4%), and the majority of mothers were anemic (Hb < 12 g/dl: 86.2%). Similarly, undernutrition was highly prevalent among the index children. Ever breastfeeding was almost universal in the study area (99.6%), with all infants aged < 12 months at the time of the interview still being breastfed. The majority of children were breastfed within the first hour after birth (75.7%), still every third child (32.2%) was deprived of colostrum. Merely 32.9% of infants were exclusively breastfed for 6 months (180 days) according to the recommendations of the WHO/UNICEF. When relating to the proposed complementary feeding (CF) indicator then 89.6% of children have received CF (mainly family foods/biscuits/plain rice) during the first 6 to 8 months, and 46.8% of children aged 6 to 23 months fulfilled the minimum acceptable diet (2 to 3 meals per day and ≥ 4 food groups per day), corresponding to 58.1% among children aged 12 to 23 months versa 25% among infants aged 6 to 11 months. Conclusion The maternal nutritional status was poor and showed interrelations with the nutritional status of the index child. Inadequate feeding and caring practices were common. In particular the younger age group (< 12 months) was found at risk of being offered inadequate CF, which needs to be tackled by future programs. Trial registration The trial was retrospectively registered at the German Clinical Trials Register on the 1st July 2019 (DRKS00017388).
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Affiliation(s)
- Caroline Katharina Stiller
- Institute of Nutritional Sciences, University of Hohenheim, Garbenstr. 30, 70599, Stuttgart, Germany. .,Shining Eyes -medical aid for children and socioeconomic village development in India e.V., Flein, Germany.
| | - Silvia Konstanze Ellen Golembiewski
- Shining Eyes -medical aid for children and socioeconomic village development in India e.V., Flein, Germany. .,Institute of Household and Consumer Economics (530A), University of Hohenheim, Stuttgart, Germany.
| | - Monika Golembiewski
- Shining Eyes -medical aid for children and socioeconomic village development in India e.V., Flein, Germany
| | - Srikanta Mondal
- Bolpur Manab Jamin, South Jambuni, Birbhum District, Bolpur, West Bengal, India
| | - Hans Konrad Biesalski
- Institute of Nutritional Sciences, University of Hohenheim, Garbenstr. 30, 70599, Stuttgart, Germany
| | - Veronika Scherbaum
- Institute of Nutritional Sciences, University of Hohenheim, Garbenstr. 30, 70599, Stuttgart, Germany
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Kalid M, Osman F, Sulaiman M, Dykes F, Erlandsson K. Infant and young child nutritional status and their caregivers' feeding knowledge and hygiene practices in internally displaced person camps, Somalia. BMC Nutr 2020; 5:59. [PMID: 32153972 PMCID: PMC7050725 DOI: 10.1186/s40795-019-0325-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 11/13/2019] [Indexed: 11/21/2022] Open
Abstract
Background In an attempt to design an educational programme targeting caregivers of children aged 6 to 59 months in internally displaced persons camps in Somalia, the objective of this study was twofold. First, to explore the nutritional situation of all children aged 6–59 months enrolled in a nutrition programme provided by Save the Children in 2017 in internally displaced persons camps. Second, to identify gaps in the caregivers’ hygiene and feeding practices. Methods In a study of 1655 households, 1655 caregivers for 2370 children aged 6 to 59 months enrolled in a nutrition programme provided by Save the Children answered an adapted questionnaire on hygiene and feeding practices. At the same time, based on standard criteria in the questionnaire, naturalistic observations of caregivers’ hygiene practices were conducted. Every child in the study was measured with anthropometric Mid-Upper-Arm Circumference measurements for the classification of Moderate Acute Malnutrition, Severe Acute Malnutrition and Global Acute Malnutrition. Descriptive statistics were used for analysis. Results 1) There was Severe (12.1%) and Global Acute (19.9%) Malnutrition among children included in the nutrition programme, more frequently in the 6–24 month age group compared to the 25–59 month age group (p < 0.01). 2). The practices in the households were below what could generally be considered hygienic. 3) There was poor caregivers’ knowledge of breastfeeding benefits and complementary foods. Conclusion Child malnutrition might derive from gaps in the caregiver’s knowledge, attitudes, and practices regarding hygiene and infant feeding. An awareness of these gaps can be helpful in designing future educational programmes that target caregivers, particularly in at-risk population groups.
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Affiliation(s)
- Mohamed Kalid
- 1Save the Children International, Somalia and Dalarna University, School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Fatumo Osman
- 2School of Education, Health and Social Studies, Dalarna University, Högskolegatan 2, 791 31 Falun, Sweden
| | - Munshi Sulaiman
- Research Evaluation, Monitoring, Learning and Monitoring (REALM) Save the Children International, Somalia Country Office, Nairobi, Kenya
| | - Fiona Dykes
- 4Fiona Dykes, Maternal and Infant Nutrition and Nurture Unit (MAINN), School of Community Health and Midwifery, University of Central Lancashire, Preston, Lancashire PR1 2HE UK
| | - Kerstin Erlandsson
- 2School of Education, Health and Social Studies, Dalarna University, Högskolegatan 2, 791 31 Falun, Sweden
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Ajala LO, Dafallah OB, Obasi NA, Fasuan TO, Ogundapo SS. Mineral compositions of infant complementary foods in relation to dietary daily intake and synergistic/antagonistic interrelationships. Int J Food Sci Nutr 2020; 71:804-814. [PMID: 32153222 DOI: 10.1080/09637486.2020.1738353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study investigated the levels of selected essential elements in a brand of industrially prepared complementary foods in the UK for infants aged 4+, 7+, and 10+ months in order to ascertain their nutritional standards relative to the mineral reference daily intakes and interrelationships. Estimated daily intake of minerals was calculated from elemental contribution from the complementary foods and breast milk. The results showed remarkable significant differences (p < .05) in the concentration levels of the elements in the complementary foods. There were no significant differences (p > .05) between the estimated daily intakes compared to the standard values stipulated by the regulatory bodies. Although, the results showed that specific interrelationships were generally justified by the elemental contents, there were few differences with respect to the overall elemental profile. The results of the study support the recommendation of the use of semi-pureed meals by infants as complementary foods. However, the results of mineral interrelationships implicated imbalances and thus recommend fortification of the infants' complementary foods with iron, calcium, and zinc.
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Affiliation(s)
| | | | - Nwogo Ajuka Obasi
- Department of Medical Biochemistry, Alex Ekwueme Federal University, Ikwo, Nigeria
| | | | - Segun Solomon Ogundapo
- Department of Science Laboratory Technology, Akanu Ibiam Federal Polytechnic, Unwana, Nigeria
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Abstract
OBJECTIVE The present study compared the age of first solid foods in a cohort of preterm infants with term infants and identified factors influencing timing of solid food introduction. DESIGN Structured interviews on infant feeding practices, growth and medical status at term equivalence and at 3, 6, 9 and 12 months corrected postnatal age. The age of solid food introduction was compared between term and preterm infants, and the influence of maternal, infant and milk feeding factors was assessed. SETTING This prospective longitudinal study recruited primary carers of preterm and term infants from a regional metropolitan referral hospital in eastern Australia. PARTICIPANTS One hundred and fifty infants (preterm, n 85; term, n 65). RESULTS When corrected for prematurity, preterm infants received solid foods before the recommended age for the introduction of solid foods for term infants. Median introduction of solid foods for preterm infants was 14 weeks corrected age (range 12-17 weeks). This was significantly less than 19 weeks (range 17-21 weeks) for term infants (P < 0·001). Lower maternal education and male gender were associated with earlier introduction of solid foods among preterm infants. CONCLUSIONS Preterm infants are introduced to solid foods earlier than recommended for term infants, taking account of their corrected age. Further research is needed to assess any risk or benefit associated with this pattern and thus to develop clear evidence-based feeding guidelines for preterm infants.
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Chouraqui JP, Delmas B, Le Bris M, Bellaiche M, Jung C, Hanh T. Physicians advice, parental practice and adherence to doctor's advice: an original survey on infant feeding. BMC Pediatr 2019; 19:313. [PMID: 31484507 PMCID: PMC6724317 DOI: 10.1186/s12887-019-1697-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/27/2019] [Indexed: 12/27/2022] Open
Abstract
Abstract Background: Despite several years of guidance on infant feeding, there has been only a slight change in consumer compliance. Therefore, this study aimed to analyse parents feeding practices, explore physicians’ advice about infant feeding and subsequent parent’s adherence to advice. Methods A multicentric cross-sectional qualitative and descriptive self-report online study was conducted in volunteers to participate in the study. Results Fifty-four physicians (paediatricians and general practitioners) and 600 parents of infants were recruited. Of the infants, 20.2% presented at inclusion with at least one type of functional gastrointestinal disorder. The breastfeeding prevalence was quite low (37.3%). The main initial deviance from guidelines said they observed in infant feeding was the early use of cow’s milk. More than two-thirds of infants older than 8 months were drinking cow’s milk. The introduction of solid foods was globally in line with recommendations. Most physicians gave advice about the different aspects of infant feeding but were seeking more information, as did the parents. A discrepancy between the physicians’ statements and the parents’ perceptions was observed. However the majority (95.4%) of parents reported that they followed totally or partially the advice received, especially by abandoning subsequently the use of cow’s milk in favour of a formula. The main reason for not adhering to the advice was that they did not consider it suitable for their infant and they preferred to rely on their feelings or recommendations from familiars. Conclusions This survey provides good insights into parents’ infant feeding practices together with the advice given by their doctor. The gap between practices and current guidelines is notable only for breast-feeding and use of formula. Despite several guidelines professionals and parents seek nutrition information. It highlights the need to deliver consistent, relevant, and less confusing messages about infant feeding. Electronic supplementary material The online version of this article (10.1186/s12887-019-1697-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jean-Pierre Chouraqui
- Paediatric Nutrition and Gastroenterology, Division of Pediatrics, Woman, Mother and Child Department, Centre Hospitalier Universitaire Vaudois (CHUV), 21 rue du Bugnon, 1011, Lausanne, Switzerland.
| | - Bérénice Delmas
- Nestlé, Département Médical et Nutrition Infantile, 7 Boulevard Pierre Carle, BP 900, Noisiel, France
| | - Marine Le Bris
- Nestlé, Département Médical et Nutrition Infantile, 7 Boulevard Pierre Carle, BP 900, Noisiel, France
| | - Marc Bellaiche
- Service de Gastroentérologie, Mucoviscidose et Nutrition Pédiatriques, Hôpital Robert Debré, 48 Boulevard Serurier, 75935, Paris, France
| | - Camille Jung
- Centre de Recherche Clinique, CHI Creteil, 40 Avenue de Verdun, 94000, Creteil, France
| | - Thierry Hanh
- Nestlé, Département Médical et Nutrition Infantile, 7 Boulevard Pierre Carle, BP 900, Noisiel, France
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Forsido SF, Kiyak N, Belachew T, Hensel O. Complementary feeding practices, dietary diversity, and nutrient composition of complementary foods of children 6-24 months old in Jimma Zone, Southwest Ethiopia. J Health Popul Nutr 2019; 38:14. [PMID: 31159861 PMCID: PMC6547550 DOI: 10.1186/s41043-019-0172-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 05/07/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Mothers and caregivers typically feed infants according to their culture, purchase power and level of awareness with no due diligence to nutritional quality of the diet. Scientific evidence on nutritional adequacy of predominant complementary foods is critical for planning and prioritising interventions. The purpose of the current study was to evaluate the quality of complementary foods and the optimality of complementary feeding practices in Southwest Ethiopia. METHODS In this cross-sectional study, a stratified multistage sampling procedure was used to sample 433 children, 6-24 months old. A semi-structured questionnaire was used to collect demographic, socio-economic and dietary data. Dietary diversity score was measured using a 24-h dietary recall. Six customary complementary food types were assayed for proximate composition, energy and mineral density using standard methods. Adequacy of the complementary foods in nutrients for complementary feeding purposes was assessed as a ratio between actual composition and recommended composition of complementary foods. RESULTS Only 16.1% of the children get the minimum dietary diversity. The children were reported to be fed with cereals & grains (68.8%), discretionary calories (53.6%), protein-rich foods (44.6%), oils and fat (40.5%), vegetables (38.5%), dairy products (17.9%) and fruits (28.1%). The sampled foods contained 4.3-24.4%, 0.9-8.5%, 8.2-11.9%, 27.9-162.6 Kcal/100 g, 168.4-250.4 mg/100 g, 1.8-4.1 mg/100 g and 22.5-42.4 mg/100 g of total carbohydrate, crude fat, protein, energy content, calcium, zinc and iron, respectively. All the complementary food samples predominantly fed to children were not composed of adequate protein, fat, carbohydrate, energy and calcium as recommended for complementary feeding purposes. However, most of the complementary foods are composed of adequate iron and zinc. CONCLUSIONS The nutrient density and diversity of complementary foods of 6-24-month-old children in the study area were found to be sub-optimal. Upgrading the nutritional composition of the starchy complementary foods should be of highest priority to improve nutrition of the infants and young children.
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Affiliation(s)
- Sirawdink Fikreyesus Forsido
- Department of Agricultural and Biosystems Engineering, Faculty of Organic Agricultural Sciences, University of Kassel, Witzenhausen, Germany
- Department of Post-Harvest Management, College of Agriculture and Veterinary Medicine, Jimma University, Jimma, Ethiopia
| | - Nejat Kiyak
- Department of Agricultural and Biosystems Engineering, Faculty of Organic Agricultural Sciences, University of Kassel, Witzenhausen, Germany
| | - Tefera Belachew
- Department of Population and Family Health, Nutrition Unit, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Oliver Hensel
- Department of Post-Harvest Management, College of Agriculture and Veterinary Medicine, Jimma University, Jimma, Ethiopia
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Fonseca ML, Cruz DM, Acosta Rojas DC, Páez Crespo J, Stevenson PR. Influence of Arthropod and Fruit Abundance on the Dietary Composition of Highland Colombian Woolly Monkeys (Lagothrix lagotricha lugens). Folia Primatol (Basel) 2019; 90:240-257. [PMID: 31067556 DOI: 10.1159/000497239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 01/24/2019] [Indexed: 11/19/2022]
Abstract
The woolly monkey's (Lagothrix lagotricha) diet consists primarily of fruits, and for some populations fruit availability predicts its frequency in the diet. Woolly monkeys also eat new leaves, flowers, seeds and arthropods, but it is unclear whether arthropods are consumed in proportion to their environmental availability. We tested the hypothesis that arthropod consumption by woolly monkeys depends on availability. We studied a group of woolly monkeys for 10 months in 2013-2014, in Cueva de los Guácharos National Park, Colombia, in order to test the hypothesis that arthropod consumption by woolly monkeys depends on availability. We carried out surveys of plant phenology each month for 10 months to estimate fruit productivity, and every 2 months we also surveyed 3 canopy substrates (leaves, mosses and bromeliads) to quantify variation in arthropod biomass. During this time, we also quantified the diet of a woolly monkey group. The items most consumed were fruits (60%), followed by arthropods (24%), leaves (13%) and miscellaneous other items (3%). Arthropod biomass in the canopy did not vary considerably over the 10 months (0.014-0.037 g/g substrate) but was lower at the end of the second rainy season. A positive correlation was found between availability and entomophagy, but only when arthropods were relatively abundant. We did not find a relationship between arthropod and fruit feeding frequencies. Our results indicate that arthropods are prevalent in the diet of the woolly monkeys due to their abundance in Andean forest canopies.
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Affiliation(s)
- Manuel L Fonseca
- Laboratorio de Ecología de Bosques Tropicales y Primatología, Universidad de los Andes, Bogotá, Colombia,
| | - Diana M Cruz
- Laboratorio de Ecología de Bosques Tropicales y Primatología, Universidad de los Andes, Bogotá, Colombia
| | - Diana C Acosta Rojas
- Laboratorio de Ecología de Bosques Tropicales y Primatología, Universidad de los Andes, Bogotá, Colombia
| | - Johanna Páez Crespo
- Laboratorio de Ecología de Bosques Tropicales y Primatología, Universidad de los Andes, Bogotá, Colombia.,Primate Molecular Ecology and Evolution Laboratory, Anthropology Department, University of Texas at Austin, Austin, Texas, USA
| | - Pablo R Stevenson
- Laboratorio de Ecología de Bosques Tropicales y Primatología, Universidad de los Andes, Bogotá, Colombia
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Walia K, Kapoor A, Farber JM. Qualitative Microbiological Risk Assessment of Moringa oleifera Leaf Powder To Be Used To Treat Undernutrition in Infants and Children in Cambodia and India: A Review. J Food Prot 2019; 82:513-521. [PMID: 30810376 DOI: 10.4315/0362-028x.jfp-18-252] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This qualitative risk assessment (QRA) was conducted to estimate the microbiological risk associated with the consumption of Moringa oleifera leaf powder (MLP) by infants and children ages 6 to 23 months to prevent or treat undernutrition in Siem Reap, Cambodia, and Madhya Pradesh, India. This QRA follows the Codex Alimentarius Commission principles and guidelines for risk assessment and takes into account all known microbial hazards that are associated with MLP. A comprehensive literature search was carried out for foodborne pathogens isolated from MLP and other dried foods of similar consistency, such as dried herbs and spices and flour. From this literature search, the following pathogens were identified and considered for this microbiological QRA: Bacillus cereus, Escherichia coli, Campylobacter spp., Clostridium perfringens, Cronobacter spp., Listeria monocytogenes, Salmonella spp., and Staphylococcus aureus. Results suggest that when cereal slurry (porridge) fortified with MLP is boiled (a rolling boil for 5 min) prior to consumption, the food safety risk to undernourished infants and children of B. cereus, C. perfringens type A, Cronobacter, enterohemorrhagic E. coli, L. monocytogenes, Salmonella spp., and S. aureus is low to moderate, with only a moderate to serious risk posed by C. perfringens type C. However, when the fortified porridge is not boiled before consumption, the food safety risk is increased for all of the evaluated pathogens. Overall, the QRA suggests that MLP presents a risk to undernourished infants and children. However, this risk can be mitigated when the powder is stored under the appropriate conditions to ensure there is no ingress of moisture and then processed in a hygienic manner to reduce contamination and/or cross-contamination by following hazard analysis critical control point or similar procedures (even in a home setting) including a heat treatment, i.e., boiling, to further reduce microbial hazards.
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Affiliation(s)
- Kavita Walia
- Canadian Research Institute for Food Safety, Department of Food Science, University of Guelph, Guelph, Ontario, Canada N1G 2W1
| | - Ansdeep Kapoor
- Canadian Research Institute for Food Safety, Department of Food Science, University of Guelph, Guelph, Ontario, Canada N1G 2W1
| | - Jeffrey M Farber
- Canadian Research Institute for Food Safety, Department of Food Science, University of Guelph, Guelph, Ontario, Canada N1G 2W1
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Abstract
BACKGROUND Rural infant growth failure has been highlighted as a priority for action in China's national nutrition and child development policies. The aim of this paper was to evaluate the effect of community-based intervention project on child feeding, child health care and child growth. METHODS From 2001 to 2005, UNICEF and China's Ministry of Health worked together to develop holistic strategies for child health care. All the interventions were implemented through the three-tier (county-township-village) rural health care network.In this study, 34 counties were included in both surveys in 2001 and 2005. Among these 34 counties, nine were subjected to the intervention and 25 counties were used as controls. In nine intervention counties, leaflets containing information of supplemental feeding of infants and young children were printed and distributed to women during hospital delivery or visit to newborn by village doctors. Two cross-sectional surveys were both conducted from July to early September in 2001 and 2005. We calculated Z-scores of height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ), with the new WHO growth standard. HAZ < - 2 was defined as stunting, WAZ < - 2 was defined as underweight, and WHZ < - 2 was defined as wasting. RESULTS Following the four-year study period, the parents in the intervention group showed significantly better infant and young child feeding practices and behaviors of child care than did their control group counterparts. In addition, all three anthropometric indicators in 2005 in the intervention group were better than in the control, with stunting 4.9% lower (p < 0.001), underweight 2.2% lower (p < 0.001), and wasting 1.0% lower (p < 0.05). CONCLUSIONS We concluded that the health care education intervention embed in government had the potential to be successfully promoted in rural western China.
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Affiliation(s)
- Weifeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University College of Medicine, P.O. Box 46, No.76 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Yuan Xing
- Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, 710054, People's Republic of China
| | - Miaomiao Pang
- Shaanxi Provincial Corps Hospital of Chinese People's Armed Police Force, Xi'an, Shaanxi, 710054, People's Republic of China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Hong Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University College of Medicine, P.O. Box 46, No.76 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China.
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Newton S, Owusu-Agyei S, Asante KP, Amoaful E, Mahama E, Tchum SK, Ali M, Adjei K, Davis CR, Tanumihardjo SA. Vitamin A status and body pool size of infants before and after consuming fortified home-based complementary foods. ACTA ACUST UNITED AC 2016; 74:10. [PMID: 26955479 PMCID: PMC4780150 DOI: 10.1186/s13690-016-0121-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/13/2016] [Indexed: 11/26/2022]
Abstract
Background Home fortification using sachets of micronutrient powder (e.g. “Sprinkles”) is a food-based approach offering an alternative to high dose vitamin A (VA) supplements for infants. The primary objective was to investigate the impact of VA-home fortification on infant VA pool size. The secondary objective was to compare VA status of infants assessed by the modified relative dose response (MRDR) test before and the 13C-retinol isotope dilution (13C-RID) test in the same infants after vitamin A supplementation. Methods A randomized-controlled trial was conducted in 7–9 month old infants in Ghana. Eligible children were randomly allocated to receive a daily sachet of “Sprinkles” with or without VA for 5 months added to complementary foods. The MRDR test indirectly determined VA liver reserves at baseline and the 13C-RID determined VA body pool at follow-up in the same cohort of children. Results At baseline, the MRDR values (95 % CI) for infants were comparable in the intervention and control groups: normal at 0·032 (SD 0·018) (0·025–0·038) and 0·031 (SD 0·018) (0·024–0·038), respectively. After intervention, total body stores (TBS) and liver retinol concentrations did not differ between intervention and control groups; TBS were 436 (SD 303) and 434 (SD 186) μmol, respectively, and estimated liver concentrations were 0·82 (SD 0·53) and 0·79 (SD 0·36) μmol/g liver, indicating adequate reserves in all children. Conclusions Both the MRDR and 3C-RID tests confirmed that the infants had adequate VA status before and after home fortification of their complementary foods. These tests offered more information than serum retinol concentrations alone, which predicted VA deficiency using current suggested cutoffs not corrected for inflammation status.
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Affiliation(s)
- Sam Newton
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Esi Amoaful
- Nutrition Department, Ghana Health Service, Accra, Ghana
| | - Emmanuel Mahama
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Samuel Kofi Tchum
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Martha Ali
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Kwame Adjei
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Brong Ahafo Region Ghana
| | - Christopher R Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI USA
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI USA
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Doub AE, Moding KJ, Stifter CA. Infant and maternal predictors of early life feeding decisions. The timing of solid food introduction. Appetite 2015; 92:261-8. [PMID: 26025089 PMCID: PMC4499500 DOI: 10.1016/j.appet.2015.05.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 04/26/2015] [Accepted: 05/22/2015] [Indexed: 11/22/2022]
Abstract
There is limited research on the maternal and infant characteristics associated with the timing of solid food introduction. The current study examined how maternal feeding style and infant temperament independently and interactively predicted the age at which infants were introduced to solid food. Data from 115 predominately white, middle-class mothers were collected when infants were 4 and 6 months of age. The timing of solid food introduction was positively correlated with mothers' age, education, breastfeeding at 4 months, self-reported responsiveness to infants' hunger and satiety cues, and negatively correlated with mothers' pre-pregnancy body mass index (BMI), beliefs about feeding infants solid food prior to 6 months of age, and infants' temperamental motor reactivity. When controlling for maternal age, education, pre-pregnancy BMI, and milk feeding method at 4 months, the timing of solid food introduction was negatively predicted by mothers' beliefs about feeding solid food prior to 6 months of age. Exploratory interaction analyses suggested that infant temperament marginally moderated maternal feeding style in predicting the timing of solid food introduction.
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Affiliation(s)
- Allison E. Doub
- 315 Health and Human Development-East Building, The Pennsylvania State University, University Park, PA 16802, United States
| | - Kameron J. Moding
- 315 Health and Human Development-East Building, The Pennsylvania State University, University Park, PA 16802, United States
| | - Cynthia A. Stifter
- 308 Health & Human Development-East Building, The Pennsylvania State University, University Park PA 16802, United States
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Rodriguez-Oliveros MG, Bisogni CA, Frongillo EA. Knowledge about food classification systems and value attributes provides insight for understanding complementary food choices in Mexican working mothers. Appetite 2014; 83:144-152. [PMID: 25149201 DOI: 10.1016/j.appet.2014.08.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 07/18/2014] [Accepted: 08/17/2014] [Indexed: 11/29/2022]
Abstract
Knowledge about mothers' perceptions of food classification and values about complementary feeding is necessary for designing educational and food supply interventions targeted to young children. To determine classification, attributes, and consumption/preparation routines of key complementary foods, 44 mothers of children < 2 y of age in 14 manufacturing businesses were studied. Using 31 key foods, we conducted free-listings, pile-sort, and food attributes exercises. Hierarchical clustering showed that mothers identified nine classes of key foods, including milk derivatives, complements, junk food, infant products, chicken parts, and other meats. From multidimensional scaling, mothers used three primary classification systems: food groups, food introduction stages, and food processing. Secondary classification systems were healthy-junk, heavy-light, hot-cold, good-bad fat, and main dish-complement. Child health and nutrition, particularly vitamin content, were salient attributes. Fruits and vegetables were preferred for initiating complementary feeding on the second month of age. Consumption of guava, mango, and legumes, however, was associated with digestive problems (empacho). Red meats were viewed as cold-type, heavy, and hard, not suitable for young children, but right for toddlers. Chicken liver was considered nutritious but dirty and bitter. Egg and fish were viewed as a vitamin source but potentially allergenic. Mothers valued vitamin content, flavor, and convenience of processed foods, but some were suspicious about expiration date, chemical and excessive sugar content and overall safety of these foods. Mothers' perceptions and values may differ from those of nutritionists and program designers, and should be addressed when promoting opportune introduction of complementary foods in social programs.
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Affiliation(s)
- Maria Guadalupe Rodriguez-Oliveros
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad 655, Colonia Santa Maria Ahuacatitlan, Cuernavaca, Morelos, CP 62100, Mexico
| | - Carole A Bisogni
- Division of Nutritional Sciences, Cornell University, 1303B MVR Hall, Ithaca, NY 14853-4401, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Room 529, Columbia, SC 29208, USA.
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Abstract
Exclusive breastfeeding provides optimal nutrition for infants until they are six months of age. After six months, infants require complementary foods to meet their nutritional needs. This is when weaning begins. Weaning is the gradual process of introducing complementary foods to an infant's diet while continuing to breastfeed. There is no universally accepted or scientifically proven time when all breastfeeding must stop. The timing and process of weaning need to be individualized by mother and child. Weaning might be abrupt or gradual, take weeks or several months, be child-led or mother-led. Physicians need to guide and support mothers through the weaning process. This document replaces a previous Canadian Paediatric Society position statement on weaning published in 2004.
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Ijarotimi OS, Keshinro OO. Protein quality, hematological properties and nutritional status of albino rats fed complementary foods with fermented popcorn, African locust bean, and bambara groundnut flour blends. Nutr Res Pract 2012. [PMID: 23198016 PMCID: PMC3506868 DOI: 10.4162/nrp.2012.6.5.381] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The objective of this study was to determine protein quality and hematological properties of infant diets formulated from local food materials. The food materials were obtained locally, fermented, and milled into flour. The flours were mixed as 70% popcorn and 30% African locust bean (FPA), 70% popcorn and 30% bambara groundnut (FPB), and 70% popcorn, 20% bambara groundnut, and 10% African locust bean (FPAB). Proximate analysis, protein quality, hematological properties, and anthropometric measurements of the animals fed with the formulations were investigated. The protein contents of the formulated diets were significantly higher than that of Cerelac (a commercial preparation) (15.75 ± 0.01 g/100 g) and ogi (traditional complementary food) (6.52 ± 0.31 g/100 g). The energy value of FPAB (464.94 ± 1.22 kcal) was higher than those of FPA (441.41 ± 3.05 kcal) and FPB (441.48 ± 3.05 kcal). The biological value (BV) of FPAB (60.20%) was the highest followed by FPB (44.24%) and FPA (41.15%); however, BV of the diets was higher than that of ogi (10.03%) but lower than that of Cerelac (70.43%). Net protein utilization (NPU) of the formulations was 41.16-60.20%, whereas true protein digestibility was 41.05-60.05%. Metabolizable energy (232.98 kcal) and digestible energy (83.69 kcal) of FPAB were the highest, whereas that of FPA had the lowest values. The protein digestibility values corrected for amino acid score of the diets (0.22-0.44) were lower than that of Cerelac (0.52), but higher than that of ogi (0.21). The growth patterns and hematological properties (packed cell volume, red blood cells, hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, and mean corpuscular volume) of the formulated diets were higher than those of ogi, but lower than those of Cerelac. In conclusion, we established that the FPAB food sample was rated best in terms of protein quality over the other formulated diets. Therefore, a FPAB blend may be used as a substitute for ogi.
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Affiliation(s)
- Oluwole Steve Ijarotimi
- Department of Food Science and Technology (Human Nutrition Division), Federal University of Technology, Akure, Ondo State, Nigeria
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Lakshmi Devi N, Shobha S, Alavi S, Kalpana K, Soumya M. Utilization of extrusion technology for the development of millet based complementary foods. J Food Sci Technol 2012; 51:2845-50. [PMID: 25328236 DOI: 10.1007/s13197-012-0789-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 07/01/2012] [Accepted: 07/22/2012] [Indexed: 10/28/2022]
Abstract
Millet based complementary foods were developed using sorghum (Sorghum vulgare), rice (Oryza Sativa), besan (Cicer arietinum; Bengal gram dhal flour), legume mix (Green gram and roasted Bengal gram; Phaseolus aureus Roxb and Cicer arietinum) and soybean (Glycine max Merr) with a lab scale twin screw extruder. The extrudates were subjected to acceptability studies initially and at the end of the storage period i.e. 3 months at laboratory level by panel of judges using a 5-point hedonic scale. Physico-chemical characteristics like bulk density, piece density and expansion ratio were measured and proximate principles were assessed. Soy and legume mix were found to have low bulk density as well as high expansion ratio. The developed extrudates were made into fine powder and sieved through a 60 mm mesh. Malted ragi flour at 15 % level was added to the powdered extrudates to develop the complementary mixes with low bulk density. Raw formulas without malt and with malt; extruded mixes without malt and with malt were studied for viscosity. The developed mixes were made into porridge and fed to the infants and the opinions about the acceptability of mixes were collected from the mothers. The complementary mixes with malted ragi showed reduced viscosity and formed good, smooth slurry and well accepted both by children and their mothers. Extruded soy and legume mixes with addition of 15 % malt were found to have satisfactory functional characteristics and nutritive value and can be explored for bulk preparation.
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Affiliation(s)
- N Lakshmi Devi
- Department of Foods and Nutrition, Post-Graduate and Research Centre, Acharya N.G. Ranga Agricultural University, Rajendra Nagar, 500079 Hyderabad, India
| | - S Shobha
- Department of Foods and Nutrition, Post-Graduate and Research Centre, Acharya N.G. Ranga Agricultural University, Rajendra Nagar, 500079 Hyderabad, India
| | - Sajid Alavi
- Department of Grain Science and Industry, Kansas State University, Manhattan, KS USA
| | - K Kalpana
- Department of Foods and Nutrition, Post-Graduate and Research Centre, Acharya N.G. Ranga Agricultural University, Rajendra Nagar, 500079 Hyderabad, India
| | - M Soumya
- Department of Foods and Nutrition, Post-Graduate and Research Centre, Acharya N.G. Ranga Agricultural University, Rajendra Nagar, 500079 Hyderabad, India
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