Acceptability trial of local Indonesian snack (SISTIK) enriched with chicken liver and eggshell powder as a potential food to increase micronutrient intakes among women of reproductive age

Abstract

Background Addressing stunting is a key global nutrition goal for 2025, with Indonesia among the top five countries grappling with high stunting rates in children. Chronic micronutrient deficiencies in women and young children in Indonesia have been associated with poor foetal and infant growth. To tackle this issue, we developed micronutrient-enriched crackers (MEC) incorporating nutrient-rich chicken liver and powdered eggshells. These crackers, known locally as 'sistik,' may provide a sustainable solution to boost micronutrient intakes. Our study among Indonesian women aimed to gauge their acceptability of MEC, which have the potential to enhance maternal micronutrient status and thus combat stunting during early childhood. Methods We conducted a two-phase acceptability trial involving 81 women aged 19-35 years in Ujung Berung Sub-district, Bandung City, Indonesia. Each phase was a single-blinded trial; only the researcher was aware of product assignment. The first phase entailed a test feeding session in a local community house which participants sampled both MEC and standard wheat crackers (SWC) on one day. Participants assessed each product using a 7-point cued facial response scale, evaluating colour, smell, flavour, and texture. In the second phase, all participants received a 14-day supply (75 g/day) of either MEC (n=41) or SWC (n=40) to consume at home under real-life conditions. Adherence was determined by weighing unconsumed products. Results The test MEC food received favourable ratings from participants on a 7-point scale, with no significant differences in liking scores between MEC and SWC regarding colour, smell, flavour, and texture. Mean (SD) daily adherence was 51 (21) g/d, with no significant difference between groups. Conclusions This study provides valuable insights for stakeholders and policymakers regarding the potential options for MEC as a food or as daily snacks to increase the intakes and status of micronutrients among adult women. Registration ClinicalTrials.gov (NCT04564222, 25th September 2020).