Animal-source foods as a food-based approach to address nutrient deficiencies and functional outcomes: a study among Kenyan schoolchildren.

Abstract

AbstractThe importance of micronutrients in growth, cognitive development and combating infection is becoming more evident. The main approaches to ameliorating micronutrient deficiencies have been non-food-based approaches. This chapter describes a randomized, controlled, school feeding study that tested for a causal link between animal-source food intake and micronutrient nutrition, growth, cognitive and behavioural outcomes. Twelve rural Kenyan primary schools were randomized to one of four groups. Standard I children received the local plant-based dish githeri (maize, beans and greens) as a school snack with added meat, milk or fat (the latter to equalize the energy content). Control children received no feedings but participated in data collection. Outcome measures at baseline and longitudinally were 24-hour food intake recall, anthropometry, cognitive function, physical activity and behaviours during school free play. The meat group showed the steepest rate of increase in Raven's Progressive Matrices scores and in zone-wide school end-of-term total and arithmetic test scores. The meat group showed the greatest increase in percentage time in high levels of physical activity, initiative and leadership behaviours compared with all other groups. For growth, in the milk group only younger and stunted children showed a greater rate of gain in height. The meat group showed near doubling of upper mid-arm muscle area and the milk group a smaller increase. Serum vitamin B12 showed significant improvement. This is the first randomized controlled feeding study to show the effect of meat-versus milk-versus plant-based snacks on children's functional outcomes. Food-based approaches, particularly utilizing animal-source foods, offer potentially sustainable solutions to multiple deficiencies.