Abstract
The study assessed the potential for use of millets in mid-day school meal programs for better nutritional outcomes of children in a peri-urban region of Karnataka, India, where children conventionally consumed a fortified rice-based mid-day meal. For a three-month period, millet-based mid-day meals were fed to 1500 adolescent children at two schools, of which 136 were studied as the intervention group and were compared with 107 other children in two other schools that did not receive the intervention. The intervention design was equivalent to the parallel group, two-arm, superiority trial with a 1:1 allocation ratio. The end line allocation ratio was 1.27:1 due to attrition. It was found that there was statistically significant improvement in stunting (p = 0.000) and the body mass index (p = 0.003) in the intervention group and not in the control group (p = 0.351 and p = 0.511, respectively). The sensory evaluation revealed that all the millet-based menu items had high acceptability, with the highest scores for the following three items: finger millet idli, a steam cooked fermented savory cake; little and pearl millet bisi belle bath, a millet-lentil hot meal; and upma, a pearl and little millet-vegetable meal. These results suggest significant potential for millets to replace or supplement rice in school feeding programs for improved nutritional outcomes of children.
Highlights
India has one of the world’s highest demographics of children suffering from various types of malnutrition, which is double that in Sub-Saharan Africa [1]
The studied children depended on mid-day meals since 38% and 49% of the children in the intervention and control groups, respectively, went to school without eating breakfast
This study, undertaken in the peri-urban area in Karnataka state of India, demonstrated three important pieces of evidence: (1) that the introduction of millet-based meals in school feeding programs can significantly improve the nutritional outcome of school going children compared to fortified rice-based meals; (2) that these meals can be enjoyed by the children; (3) that it can be cost effective if millets are given government pricing support as as rice
Summary
India has one of the world’s highest demographics of children suffering from various types of malnutrition, which is double that in Sub-Saharan Africa [1]. A total of 44% of children under the age of five are underweight, while 72% of infants have anaemia [2]. The rate of undernutrition from lack of micronutrients, especially iron deficiency anaemia, is high in India. National Family Health Survey [3], more than half the women (55%) have iron deficiency anaemia. Underweight, wasting, and stunting are prevalent in children under five These figures hint at serious long-term consequences for human capital development and the productivity potential of the nation. They imply the denial of basic human rights of children, such as access to food
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