Nutrient Sources in the Diets of Rural Tanzanian Children 9‐24 Months and Local Pathways to Nutrient Adequacy

Abstract

As part of the MAL‐ED study, a cohort of 231 children living near Haydom, TZ was followed twice weekly to characterize morbidity, diet, growth and development. From 9‐24 mo, a 24‐hr recall was administered monthly to quantify food, energy and nutrient intakes. Here we identify foods and beverages contributing to energy, macro‐ and micronutrient intakes, and evaluate local pathways to improve child dietary intakes. On average, energy, carbohydrate, and protein intakes are sufficient according to WHO guidelines, but fat and selected micronutrient intakes (vit C, vit A, iron, zinc, calcium) are low. The two most important foods in the diet of children 9‐15 months are stiff maize porridge and milk, contributing to energy (45% porridge; 25% milk), carbohydrate (55% porridge; 11% milk), protein (31% porridge, 41% milk), and fat intakes (20% porridge; 59% milk). Top sources of micronutrients are vegetable broths (vit C: okra relish, cabbage, pumpkin or moringa leaf broth), milk (vit A: 67%; calcium: 90%; zinc: 30%), and stiff maize porridge (iron: 60%; zinc: 41%). Porridge and milk continue to be important from 16‐24 mo, but sources of vit A and vit C expand due to increased diet diversity. Days with adequate nutrient intakes were related to the type of food mixed into a child's porridge. Adequate intakes of iron and zinc were more likely to include beans, pumpkin, or a meat mixed into their porridge, or for zinc to include millet rather than maize porridge. Adequate vitamin A intake days were more likely to include porridge with a vegetable (sweet potato, pumpkin) or a leafy broth, and adequate vitamin C intake days included oranges or sweet potatoes.[MAL‐ED is funded by BMGF, NIH/FIC/FNIH]