Abstract

BackgroundNut butter-based Ready to Use Supplemental Foods (RUSF) are an effective way to add nutrients and calories to diets of malnourished and food insecure populations. The RUSF formulations have been further modified to add micronutrients including iron and folic acid needed during pregnancy and lactation. Because docosahexaenoic acid (DHA, C22:6 n-3) enhances fetal development and birth outcomes, it has been suggested that perhaps RUSF formulations for pregnancy should also include this Omega 3 fatty acid. The goal of the present study was to gain an understanding of Zambian women’s knowledge of nutritional needs in pregnancy through structured focus group discussions, and to formulate and determine the acceptability of a RUSF with DHA.MethodsStructured focus group sessions were conducted among women attending an antenatal clinic at the University Teaching Hospitals in Lusaka, Zambia. Dietary and nutrition knowledge was surveyed through structured dialogue that was recorded by audio and transcribed verbatim. An RUSF containing 400 mg DHA from fish oil in 50 g RUSF was designed and assessed for fatty acid content and product stability. Participants then sampled the RUSF-DHA, provided feedback on taste, and were surveyed about willingness to consume the novel formula using a standardized hedonic instrument.ResultsThe participants’ knowledge of foods recommended for use in pregnancy included fruits, vegetables, meat, and fish. Most women reported eating fish at least once per week, although the specific type of fish varied. Most did not have prior knowledge of the importance of consuming fish during pregnancy or that some fish types were more nutritional than others as they included omega 3 fatty acids. The participants were uniformly accepting of the RUSF-DHA for the purpose of enhancing birth and developmental outcomes, but were critical of the aroma in hedonic testing.ConclusionsWomen were committed to consuming a healthy diet that would impact the outcome of pregnancy, and were receptive to advice on the importance of consuming foods such as fish as a source of DHA. The RUSF-DHA formulation was acceptable due to the potential benefits for the developing infant, however, the fishy odor may be limiting for long-term daily use.

Highlights

  • Given the high rate of malnutrition and stunting in Zambia and the value of Ready to Use Supplemental Foods (RUSF) for use in addressing some of the nutritional problems of women and their infants, we developed an RUSF with fish oil to supply the docosahexaenoic acid (DHA) crucial to fetal and infant brain growth

  • Employing focus group discussions surrounding nutrition and health, as well as hedonic testing of the RUSF-DHA, the current study presents findings on nutrition knowledge for pregnancy and the acceptability the peanut butter-based RUSF with fish oil to pregnant women in Zambia

  • We developed and evaluated acceptability of a lipid based-RUSF formulation that contained fish oil to provide a source of DHA

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Summary

Introduction

Because docosahexaenoic acid (DHA, C22:6 n-3) enhances fetal development and birth outcomes, it has been suggested that perhaps RUSF formulations for pregnancy should include this Omega 3 fatty acid. The goal of the present study was to gain an understanding of Zambian women’s knowledge of nutritional needs in pregnancy through structured focus group discussions, and to formulate and determine the acceptability of a RUSF with DHA. 10% of women aged 15–49 are underweight (BMI < 18.5 kg/m2), ) and 14.3% of women in Zambia are living with HIV. Due to the high rates of both malnutrition and HIV infection in Zambia, it is essential that nutrition be optimized to maximize development, growth, and the ability to resist and fight infectious disease [2, 3]

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