Complementary Meals Research Articles

A Review of Infant and Young Child Feeding Practices and Their Challenges in India.

This review focuses on infant and young child feeding (IYCF) practices in India, aiming to offer information on its trends, challenges, and opportunities for improvement. The overview starts by exploring the importance of IYCF practices and their results on child health, growth, and development. It delves into cultural norms, conventional practices, and local variations that impact feeding behaviors, acknowledging the range of nutritional habits across communities. The role of healthcare systems and community interventions in promoting the most desirable feeding practices is mentioned, addressing issues consisting of different breastfeeding practices, well-timed introduction of complementary meals, and micronutrient supplementation.By making thisassessment, the goal of this review is to make healthcare professionals, policymakers, and researchers aware of the current trends of IYCF and its demanding situations, and regions for development in India. It gives an understanding of the improvement of strategies and interventions that can make contributions to the increase and improvement of infant and young child nutrients, thereby nurturing the Upcoming generations.

Compositional Analysis of Complementary Foods Given by Mothers to Children Aged 6-23 Months in Giginyu Nassarawa Local Government Area, Kano State, Nigeria

Under nutrition among young children is high and poor complementary foods have been implicated. The objective of this study was to investigate compositional analysis of complementary foods given by mothers to children aged 6-23 months in Giginyu Nassarawa Local Government Area, Kano State, Nigeria using appropriate standard methods and compare with a commercial complementary food (control). Energy density was designated low if < 0.8 kcal and contribution of meals to daily requirements (RDA) of protein, calcium and zinc for young children determined. The moisture, protein, ash, energy density, calcium, zinc, and phytate contents of the complementary meals (100g wet basis) ranged from 64.32-83.7%, 0.74-6.29%, 0.04-1.41%, 0.37-1.17 kcal/ml, 0.82-27.00 mg/100g, 0.022-0.277mg/100g and 0.05-1.68%, respectively. The soybean based meal, ‘SB’ was significantly higher (p<0.01) than other meals including the control, in protein, ash, energy, calcium, zinc and phytate contents. All other meals met above 50% of the RDA for protein except CMS1 (33%), SMMG (42.1%), PS (19.7%) and MSMP (32.8%). Except SB and CMS2 that contributed above 20-37% of RDA for calcium and zinc, the rest of the complementary meals were very low in calcium and zinc content.The moisture contents of common complementary meals offered to older infants in Giginyu LGA, Kano State are quite high which affected the energy density of the meals. Except for pap/sugar and custard based meals, the meals had appreciable levels of protein contents. However, there was low calcium and zinc (micronutrients) contents of most of the meals with about 400 mls daily consumption.

Effect of Blending Ratio and Extrusion Operating Conditions on Nutritional Quality and Functional and Sensory Acceptability of Teff‐Bulla‐Based Complementary Food: A Response Surface Methodology Approach

The purpose of this study was to identify possible locally accessible cereals, tubers, and legumes for use in the extrusion of teff, bulla, and haricot beans to prepare inexpensive supplemental foods. This study used central composite rotatable design (CCRD) to assess the effects of specific processing parameters on response variables such as proximate composition and physical, functional, and sensory qualities of produced complementary food. The processing parameters included haricot bean blending ratios (BR) (10–30%), feed moisture content (FMC) (15–21%), and barrel temperature (BT) (120–160°C). The proximate composition of the complementary food ranged from 9.25 to 12.36% moisture content, 7.82 to 14.04% protein, 2.1 to 3.28% ash, 1.13 to 3.93% fiber, 1.17 to 3.12% fat, 65.40 to 78.25% carbohydrate, and 338.42 to 354.86 kcal/100 g energy. The predominant minerals and antinutritional factors ranged from 2.40 to 10.37 mg/100 g, 58.70 to 146.26 mg/100 g, 0.8 to 4.74 mg/100 g, 113.21 to 325.00 mg/100 g, and 16.54 to 44.62 mg/100 g for Fe, Ca, Zn, phytate, and tannin, respectively. The blending ratio and extrusion parameters demonstrated significant (p < 0.05) linear, quadratic, and interaction impacts on the physical and functional responses, according to analysis of variance (ANOVA). Mothers and caregivers largely approved all the trial porridges. The best blending and extrusion parameters, according to numerical optimization, were a BR of 28.2837%, FMC of 15.0007%, and BT of 120.001°C. The predicted responses for optimization were water solubility index (WSI) (32.4462 g/g), water absorption index (WAI) (3.69849%), viscosity (2016.47cP), protein (14.046%), and energy (348.034 kcal/100 g) with a desirability value of 0.856. This research leads us to believe that producing complementary meals with excellent nutritional value for developing nations may be achieved by evidence‐based selection of locally accessible plant‐based components.

Complementary Feeding: Food Group Diversity and Probability of Nutrient Adequacy among 6-12-Month-Old Infants in Southern Thailand

Objective: To determine complementary food intake, food group diversity and nutritional adequacy of 6-12-month-old infants in southern Thailand.Material and Methods: A total of 120 healthy infants, aged 6-12 months, were enrolled: from December 2020 to November 2021. A 24-hour food record was used to assess the type, amount and frequency of food intake in each infant. The infants’ food intake was classified into seven food groups. Macronutrient and micronutrient intakes were analysed using the INMUCAL software program; the standard program for the calculation of nutrients in Thai food.Results: Of the 120 infants, 10 (8.3%) received breast and/or formula feeding without complementary food; 30 (25%) received 1, 66 (55%) received 2, and 14 (11.7%) 3-4 received complementary meals a day. The 4 most common supplementary foods given to the infants were rice mixed with vitamin A-rich fruits or vegetables, meat, eggs, or other fruits (mostly bananas). Infants who received 1 complementary meal, with 1-3 food groups a day, had significantly higher percentages of micronutrient inadequacies (iron, magnesium, selenium and vitamin E) than those receiving at least 2 complementary meals; with at least 4 food groups a day.Conclusion: Infants in southern Thailand who were fed <4 food groups with <2 complementary meals a day were at risk of micronutrient inadequacies; such as iron, magnesium, selenium and vitamin E. Therefore, infants aged 6-7 months should be given a minimum meal frequency (MMF) of 2 meals, with a minimum dietary diversity (MDD) of 4 food groups per day.

A synthetic lure for Anopheles gambiae (Diptera: Culicidae) based on the attractive plant Parthenium hysterophorus.

Sugar is the sole diet for male mosquitoes and a complementary meal for females. Searching for natural sources of sugar is mediated by semiochemicals. Floral nectars, extra floral nectaries, damaged tissues of plants and rotten fruits are the most common sources of sugar in nature. I provide laboratory evidence of the high attraction of Parthenium hysterophorus L., a weed that grows in tropical climates, to Anopheles gambiae Giles. This study has tried to identify the chemicals which might be involved in the chemical attraction of A. gambiae to this plant. Using quantitative GC-MS analysis, α-pinene, camphene, 1-octen-3-ol, β-pinene, cis-β-ocimene, bornyl acetate, α-caryophyllene, hexadecanoic acid, and α-linolenic acid were identified as the main constituents of P. hysterophorus volatiles. Successive olfactory assays helped a better understanding of the more attractive chemicals of P. hysterophorus to A. gambiae which was the basis for testing a possible synthetic blend. Olfactory experiments proved this synthetic blend to be as attractive as Parthenium intact plants for A. gambiae. A minimal blend, consisting of only α-pinene, camphene, and cis-β-ocimene, was also produced and laboratory experiments indicated its relative attraction for A. gambiae. This blend can be tested in the attractive toxic sugar bait stations for sampling, surveillance, or control programs of mosquitoes in tropical Africa, where A. gambiae sensu stricto transfer malaria among residents.

Assessment of nutrient adequacy of complementary foods for infants and young children in Morogoro, Tanzania

Women sustain household health by operationalizing and maximizing nutrition through food preparation. Thus, information and the women's knowledge on nutrient adequacy of meals prepared at home is crucial for the design, implementation and performance of nutrition interventions. However, there is limited evidence on the adequacy of homemade complementary meals for children below two years in Tanzania. This study aimed to assess the dietary quality of the prepared complementary foods provided to infants and children. A cross-sectional survey was used to collect demographic and nutritional information. A total of 119 breastfeeding children aged 6 to 22 months were recruited. The dietary intake patterns were assessed using a seven-day food frequency questionnaire, and a 3-day 24 h recall. The dietary diversity score and Food consumption score evaluated dietary patterns. Food consumed by 27 children in a day (24 h) was weighed and recorded and samples were collected for nutrient analysis. Nutrient adequacy ratios were obtained by comparing FAO/WHO recommended intakes. Results revealed that 15% of the children had poor food consumption patterns. The median dietary diversity score of the children was four out of eight food groups. For most households, median adequacy ratios for energy, fat and micronutrient contributed from complementary foods were less than one. Although breastfeeding was present and supported at home, the nutrient densities of complementary meals were inadequate to achieve the WHO/FAO recommended nutrient intakes. Promotion of community food fortification and diversification programs, along with nutrition education, health and sanitation are necessary as they can improve the intake of critical micronutrients and nutrition status.

Formulation and nutritional properties of qualea-bird-meat-based complementary foods for children (6–23 months) in Tanzania using a linear programming technique

BackgroundLong-standing mitigation strategies have been used to address the issue of malnutrition in children, especially undernutrition in developing countries including Tanzania, however, the problem still exists. Development of instant complementary formulae based on readily available local foods using robust mathematical models, to fight malnutrition seems to be one of the best options. PurposeThe purpose of this study was to develop and evaluate the nutritional content of instant supplemental food formulations based on qualea bird's meat for infants between the ages of 6 and 23 months using a linear programming model. Basic procedureFour complementary meal formulations based on bird meat were developed using a linear programming model: control, only bird meat (CtrQM); green banana mixed with bird meat (BanQ); Irish potato mixed with bird meat (PotQ); and rice mixed with the meat (RicQ). The formulations were cooked separately at 98 °C for 45–55 min and extruded to create instant dry products and analyzed using standard methods for proximate composition, minerals, and vitamin A. Main findingThe proximate composition parameters, minerals and vitamin A contents (in DM) were substantially enhanced and differed significantly (p < 0.05) between the formulations. PotQ had a higher moisture content (8.9 g/100 g), protein (16.7 g/100 g), crude fat (1.8 g/100 g), ash (5.4 g/100 g) and crude fibre (2.9 g/100 g) than lower values in other formulations. Furthermore, calcium was the most abundant mineral (832.5 mg/kg) whereas zinc was the least abundant mineral (38.5 mg/100 g). The variation in mineral contents among formulations was also significant (p < 0.05). Additionally, RicQ had significantly (p < 0.05) highest retinol (26.5 mg/kg) and beta-carotene (4.9 μg/g) while the lowest values were observed in the control sample with values of 3.3 mg/kg and 1.6 μg/g respectively. ConclusionIn a view of the findings, a linear programming model optimized and enhanced the proximate composition, mineral, and vitamin A qualities of the qualea birds' meat-based instant complementary formulation that seems to meet the RDAs for infants aged 6 to 23 months. Therefore, the application of the model in product formulation to combat malnutrition in the country is highly recommended.

Gender Discrimination in Infant and Young Child Feeding Practices in India: Evidence from NFHS-4

Undernutrition among children continues to be a serious issue. The study examines the prevalence of the gender gap in the infant and young child feeding (IYCF) practices in India based on recent National Family and Health Survey Data, 2015 (NFHS-4). A binary logistic regression model has been used to determine the factors responsible for achieving exclusive breastfeeding, minimum dietary diversity and minimum meal frequency of the index child, that is, youngest child in the households. A separate regression model was run for both boys and girls. Girls faced discrimination not only in terms of exclusive breastfeeding but also in terms of receiving the required number of complementary meals. Logistic regression results indicate that the birth order of the children and the sex composition of the siblings are the important determinants of IYCF practices. Girls are more deprived in terms of receiving exclusive breastfeeding and other age-appropriate protein-rich food items when born in a household with more than two older daughters. Media exposure, mother’s autonomy and access to health and nutrition-related education are prominent factors in determining IYCF practices. The results suggest that there is a need to improve gender sensitisation in terms of feeding practices within the households.

Complementary feeding with traditional and baby led weaning (BLW) methods - assessment of selected aspects of infant's diet

Background: Infant nutrition is a topic of constant debate between parents and doctors. The recommendations themselves have been modified several times over the past 6 decades. Baby Led Weaning (BLW) method is gaining more and more popularity in infant nutrition during the period of expanding the infant menu. The main aim of the study was to evaluate selected aspects of dietary expansion in a group of their children, taking into account dietary expansion with the use of the traditional method and the BLW method. Material and method: An exploratory cross-sectional study was conducted in December 2021-January 2022 among a randomly selected sample of 523 mothers of children in infancy aged up to 12 months. Data for the study were collected anonymously using the CAWI method. The information collected from 500 women was considered for the final data analysis taking into account the inclusion and exclusion criteria. Results: 66.6% of the women surveyed (N=333) stated that their child is or was fed breast milk during the first six months. The child's diet was most often expanded with complementary meals after 6 months of age. This answer was indicated by 58.8% of respondents (N=294). 85.6% of the surveyed women (N=428) first introduced or intend to introduce vegetables to their diet. 13% of the respondents (N=65) introduced or planned to introduce vegetables and fruit at the same time. In the studied group of mothers the BLW method was not known or not used by 7 mothers (1.4%), 343 mothers used or intended to use the BLW method (68.6%), whereas 150 women knew the BLW method (30.0%), but did not use it or did not intend to use it during the expansion of their child's diet. Conclusions: The majority of mothers surveyed used the BLW method during the expansion of their children's diet, accepting the principle that it is the child who decides whether and how much to eat, and the parent who decides what and when the child eats.

A mixture design approach to developing a cereal-based complementary meal for better nutritional quality

Adequate nutrition is imperative during infancy and childhood because a short period of malnutrition could have a long-term effect on growth, development and health in the adult life. A mixture design approach was deployed to optimize the composition of a complementary food produced from available food ingredients – for better nutritional quality. A complementary meal was formulated from a mix of yellow maize, sorghum, millet, soybean, groundnut, crayfish and fish. The complementary food was analyzed for nutritional composition and anti-nutritional factors alongside traditional ogi (a fermented maize porridge popularly used as food for children) and another commercially available baby food. Quadratic models were able to explain the moisture and protein content of the complementary food with a R2 of 0.8177 and 0.7284, respectively. Special cubic models were able to explain the ash, fat and crude fibre content of the complementary food with R2 of 0.9022, 0.8352, and 0.8228, respectively. Multi-response optimization was deployed to obtain an optimised complementary meal. The multi-response optimization was set to minimize moisture while it maximized the ash, protein, crude fibre, and fat of the flour blend. The optimized complementary meal had higher ash, fat, fibre and protein content compared to ogi. A 100 g portion of the complementary meal contained 20.26 g crude protein, 8.13 g fat, 55.75 g carbohydrates and yielded up to 377.21 kcal of energy while a 100 g portion of the ogi contained 5.71 g crude protein, 1.04 g fat, 83.86 g carbohydrates and energy yield of 367.64 kcal. The mineral contents of the optimized blend per 100 g portion included potassium (406.10 mg), calcium (50.80 mg), iron (1.04 mg), and zinc (7.53 mg). The optimised complementary meal also had higher protein, ash, crude fibre and fat when compared to the commercially available baby food. Compared to ogi, utilization of this complementary meal for children could offer affordable food with adequate nutrients.

Evaluation of the ecoefficiency of greenhouse gases generation in the provision of complementary meals in a public hospital

The present study aimed to assess Ecoefficiency (EE) related to the emission of Greenhouse Gases (GHG) from the transport of the inputs used to provide complementary meals at a large university hospital in Brazil. For EE calculations, the annual energy supply in kilocalories of the inputs used and the estimated GHG emissions were considered, considering the distance in kilometers between the place of origin of each product and the destination city in southern Brazil. 31 products were used and selected for complementary meals distributed in the groups of: dairy products, cookies, drinks, supplements, and enteral diets for adults and pediatrics. The results showed that EE was directly related to the origin of the products, especially in enteral diets. The application of the Spearman correlation coefficient showed a strong negative correlation of -0.8119 [CI (95%) -0.9023; -0.6531] between the variables distance in kilometers and eco-efficiency and also when comparing GHG emissions with kilocalories. The health sector must play its role in relation to environmental impacts also in the assessment of GHG emissions in the context of nutritional therapy.

Translation of EU Food Law and Nutrient Reference Values Into Practice: the German Dietary Scheme for the First Year of Life.

European dietary regulations affect national dietary guidelines for child nutrition. The update of the German Dietary Scheme for the first year of life is used to examine the translation of European nutrient references into food-based guidelines while maintaining traditional habits. Within the Dietary Scheme, intake of energy and nutrients was calculated in the complementary feeding period for each of the 3 daily recommended complementary meals (a vegetable-potato-meat meal, a milk-cereal meal, a cereal-fruit meal) in addition to the daily liquid-milk servings (breast milk or follow-on formula). Pureed-home-made complementary meals were assumed. The adequacy of nutrient intake was evaluated by comparison with the European Food Safety Authority (EFSA) Dietary Reference Values. Macronutrient content of meals was compared to the European complementary food directive. Daily intake of most nutrients following the scheme was well in line with EFSA values, whereas the commonly 'critical' nutrients iron and iodine remained far below EFSA values. Substituting breast milk or whole cow's milk with follow-on formula had only a small impact on nutrient supply. Although the different nutrient profiles of meals were not fully in line with European regulations, they add up to an overall balanced daily diet. Taken together, European dietary reference values for energy and nutrients can mostly be met by the modular system of the Dietary Scheme as a total diet concept for infant nutrition in Germany. The different proposed meals generally agree with EU regulations for complementary food.

PENGARUH SUBSTITUSI AMPAS TAHU DAN PENAMBAHAN PISANG AMBON PADA SNACK BARKEDELAI UNTUK OLAHRAGAWAN (ASPEK DAYA TERIMA, EKONOMI DAN KANDUNGAN GIZI) &lt;br&gt;&lt;i&gt;Effect of Bean Curd Substitution and Addition of Ambonese Banana on Soybean Snack bar Formula for Athletes (Acceptability, Economic Value, and Nutritional Aspects)&lt;/br&gt;&lt;/i&gt;

Degradation of sport performance in Indonesian athletes was recorded in Sea Games 2017 and FIFA rank in 2015. Some of athletes’ main problem are lack of stamina and endurance. These problem are caused by insuffi cient carbohydrate and energy intake. In addition, selection of tofu curd waste and banana are purposed to provide adequate potasium intake. This study was aimed to reveal the eff ect of bean curd waste and the addition of Ambonese bananas to the acceptability, nutritional value and economic value of the formulated snack bars.The used design was true experiment with completely randomized design. This study employed untrained panelists including athletes with weight restrictions (gymnastics and sports combat with weight classes) as many as 30 people.The percentage of bean curd waste substitution was P1: 12%; P2: 16%; P3: 25%, and 10% added banana. Statistical test results Friedman confi rmed a signifi cant diff erence in the level of preference on the texture and taste aspects between control and other formula. The results of the acceptability, nutritional value and economic value ranking obtained the optimum value in formula two (P2).Nutritional value for 100 grams of snack bar P2 (cohydrate: 41.6 g; fi ber: 8.7 g; potassium: 514 mg) has been able to contribute at least 10% of the daily energy needs of athletes. Laboratory test results for fi ber and potassium can meet 16.7% and 10.9% of the daily needs of athletes. Hence, formulated snack bar can be claimed to be high in fi ber and potassium products. The most aff ordable price of the formulated product was 7,000 IDR per 125 g which is more economical than the commercial soybean-based snack bar. Therefore, the formulated snack bar can be recommended as a complementary meal of athlete with weight restrictions.

TAS2R38 bitter taste genotype is associated with complementary feeding behavior in infants

BackgroundGenetically mediated sensitivity to bitter taste has been associated with food preferences and eating behavior in adults and children. The aim of this study was to assess the association between TAS2R38 bitter taste genotype and the first complementary food acceptance in infants.Parents of healthy, breastfed, term-born infants were instructed, at discharge from the nursery, to feed their baby with a first complementary meal of 150 mL at 4 to 6 months of age. They recorded the day when the child ate the whole meal in a questionnaire. Additional data included food composition, breastfeeding duration, feeding practices, and growth at 6 months. Infants’ TAS2R38 genotypes were determined at birth, and infants were classified as “bitter-insensitive” (genotype AVI/AVI) and “bitter-sensitive” (genotypes AVI/PAV or PAV/PAV).ResultsOne hundred seventy-six infants and their mothers were enrolled; completed data were available for 131/176 (74.4%) infants (gestational age 39.3 ± 1.1 weeks, birth weight 3390 ± 430 g). Bitter-insensitive were 45/131 (34.3%), and bitter-sensitive were 86/131 (65.6%). Thirty-one percent of bitter-insensitive infants consumed the whole complementary meal at first attempt, versus 13% of bitter-sensitive ones (p = 0.006). This difference was significant independently of confounding variables such as sex, breastfeeding, or foods used in the meal. Growth at 6 months did not differ between the two groups.ConclusionsDifferences in TAS2R38 bitter taste gene were associated with acceptance of the first complementary food in infants, suggesting a possible involvement in eating behavior at weaning.

Individual and household risk factors of severe acute malnutrition among under-five children in Mao, Chad: a matched case-control study

BackgroundSevere acute malnutrition (SAM) is one of the leading causes of morbidity and mortality in Chad. The reasons behind persistently high prevalence of SAM in the Kanem region are still poorly understood, leaving national and international partners without clearly identified drivers to address. Current knowledge of SAM determinants in this context is largely based on very limited data. The aim of this study was thus to investigate individual and household-level risk factors for SAM among under-five children in Mao health district.MethodsA matched case-control study was conducted on 411 (137 cases and 274 controls) children aged 6–59 months with their caretakers from mid-February to August 2017. Data were collected by using a structured interviewer administered questionnaire, anthropometric measurements and through direct observations of household environment. Controls were matched to their cases on place of residence and on age (± 3 months). Data were double-entered, processed and analysed using Epi Info 7.2.0.1. Conditional logistic regression was used to analyse the association of independent variables with SAM. For multivariable analysis, two models were constructed to investigate risk factors for SAM, at individual and household level. A stepwise backwards elimination approach with a significance level of p = 0.05 was used to build the final models.ResultsAt the individual level, SAM was significantly associated with diarrhoea [AOR (95% CI) = 10.7 (4.2–27.3)], fever [AOR (95% CI) = 8.4 (3.1–22.8)], vomiting [AOR (95% CI) = 7.6 (3.0–19.7)], being stunted [AOR (95% CI) = 5.3 (1.7–16.3)], and type of complementary meal [AOR (95% CI) = 4.4 (1.0–19.6)]. At the household level, SAM was significantly associated with undernourished caretaker [AOR (95% CI) = 2.6 (1.2–5.5)], caretaker’s hand washing habits [AOR (95% CI) = 1.9 (1.2–3.1)], absence of toilet [AOR (95% CI) = 1.9 (1.1–3.6)], caretaker’s marriage status [AOR (95% CI) = 7.7 (2.0–30.1)], and low household food diversity [AOR (95% CI) = 1.8 (1.0–3.1)].ConclusionThe present study identified the need to address both treatment and prevention of infections in children through an integrated approach. Well-organized efforts to improve child feeding practices, household hygiene and sanitation conditions, women’s nutritional status, along with increasing household food diversity are likely to lead to improved nutritional status of children in this setting.

Adherence to complementary feeding guidelines among caregivers of children aged 6-23 months in Lamwo district, rural Uganda.

IntroductionMalnutrition contributes to half of all deaths among children under-five years in developing countries such as Uganda. Optimal complementary feeding is one of the crucial interventions that could prevent these deaths. This study measured adherence to complementary feeding guidelines and its associated factors among caregivers of children aged 6-23 months in Lamwo district, rural Uganda.MethodsA household cross-sectional study was used to collect data on adherence to complementary feeding among 349 caregivers. A composite variable with 9 indicators of complementary feeding was used to measure adherence. Univariable and multivariable logistic regression was used for statistical analysis using STATA software.ResultsA household cross-sectional study was used to collect data on adherence to complementary feeding among 349 caregivers. A composite variable with 9 indicators of complementary feeding was used to measure adherence. Univariable and multivariable logistic regression was used for statistical analysis using STATA software.nearly all (97.7%, 341/349) children had ever been breastfed. Complementary feeding was initiated at six months for 47.0% (164/349) of the children. The number of complementary meals ranged from 1-4 meals per day with a mean of 3 meals per day (SD = 0.8). About half (55.8%, 195/349) of the children were given less than the recommended amount of food. Overall only 40.1% (140/349) of all study respondents were adherent to complementary feeding guidelines. The odds of adherence to complementary feeding were higher among caregivers with children aged 6-8 months (AOR = 4.68, 95% CI: 1.91-11.48), children whose fathers had attained 8 or more years of formal education (AOR = 2.27, 95% CI: 1.22-4.19), caregivers with two children under five years (AOR = 5.46, 95% CI: 1.46-20.36), those living in the poorest households (AOR = 3.00, 95% CI: 1.37-6.57) and those who showed willingness to recommend initiation of complementary feeding at six months to another mother (AOR = 1.34 95% CI: 1.06-1.70).ConclusionAdherence to complementary feeding guidelines was very low in this rural African setting indicating an urgent need for interventions such as health education to improve adherence with consequent reduction in rates of under nutrition. These interventions should target caregivers with older children, fathers with less than 8 years of formal education and those living in the wealthiest households.

Food-based modification of LC-PUFA concentration in complementary food did not affect plasma vitamin E concentration in infants

Backgroundω-3 Long-chain polyunsaturated fatty acids (ω-3 LC-PUFA) are essential for an optimal development of infants. An increased dietary intake of ω-3 PUFA may also be associated with a decrease in the vitamin E content in the blood of healthy infants because these fatty acids have more isolated double bonds compared to ω-6 PUFA and are therefore more susceptible to lipid peroxidation. MethodsThe present analysis is part of a randomised, food-based trial examining the influence of a 4–6-month intervention with an increased content of ω-3 PUFA (sources: rapeseed oil or salmon) of complementary meals on vitamin E concentration in plasma. From the introduction of complementary feeding at the age of 4–6months until the age of 10months, healthy infants born at term received vegetable–potato–meat meals either with α-linolenic acid (ALA)-rich rapeseed oil (intervention group rapeseed oil, IG-R), salmon in combination with corn oil (intervention group fish, IG-F) to provide docosahexaenoic acid (DHA), or with linoleic acid-rich corn oil (control group, CG). Blood plasma was obtained at the 4th month ±14days (age of infants at baseline) and at the 10th month ±14 days (age of infants after 6months of intervention) and analysed using HPLC (vitamin E and malondialdehyde (MDA)) and GC (fatty acids). Vitamin E (tocopherol profile) and MDA were measured in plasma samples and fatty acids were determined in plasma glycerophospholipids. ResultsComplete data on vitamin E and fatty acid concentrations were available for 155 participants. Compared to CG, IG-F and IG-R had higher weekly α-tocopherol equivalents (α-TE) intake (p<0.05) and α-TE/PUFA ratio (p<0.05 (‘baby’ meals), p<0.001 (‘junior’ meals)) by intake of complementary meals. At baseline and after intervention, no significant differences in vitamin E and MDA concentrations between IG-R, IG-F, and CG were found in plasma. In all three groups, the α-tocopherol levels decreased after intervention (p<0.001). With regard to ω-3 PUFA, no differences at baseline existed. After intervention, infants of IG-F showed higher contents of eicosapentaenoic acid (EPA), DHA and total ω-3 PUFA in plasma than CG, while the IG-R had higher levels of ALA compared to CG. ConclusionsThe α-tocopherol supply decreased along with decreasing fat supply in the complementary feeding period compared to breast milk and formula milk feeding period. The increase of ω-3 PUFA intake by complementary food (rapeseed oil or salmon) did not affect the vitamin E concentration in blood plasma of infants compared to conventional complementary feeding with corn oil. Clinical Trial Registrationwww.clinicaltrials.gov, identifier: NCT01487889, title: Polyunsaturated fatty acids in child nutrition—a German multimodal optimisation study (PINGU).

Determinants of Child Malnutrition and Infant and Young Child Feeding Approaches in Cambodia.

Women's diets often decrease with regard to amounts per meal and day as well as diversity if a household's access to food is limited. The result is a monotonous diet that, in particular, negatively affects women's nutritional status during pregnancy and lactation and, thus, the infant. The infant's diet is of utmost importance, as it needs to meet the nutrient requirements especially during the first 2 years of life, a critical window for the child's healthy development. In Cambodia, infant and young child feeding (IYCF) practices are poor. Preparation of a special complementary meal in addition to breast milk feeds for children aged 6-23 months is often not a common habit. Instead, children eat watery, plain rice porridges that do not meet the nutrient requirements at this young age. A lack of adequate caring practices such as responsive feeding exacerbates the risk of malnutrition. Caregivers are often unaware of the importance of nutrition during the first 2 years of life regarding its effects on children's growth. In 2012, a randomized controlled trial (RCT) was started in two provinces of northern Cambodia: Oddar Meanchey and Preah Vihear. To contribute to reducing child mortality by addressing malnutrition among children 6-23 months of age, the Food and Agriculture Organization of the United Nations (FAO) implemented a nutrition-sensitive agriculture project with nutrition-specific actions, i.e. a nutrition education intervention was embedded in a food security project. Wealth, a child's age, and maternal education were identified as determinants of a child's dietary diversity. The older the child and/or the wealthier the household, the more diverse the child's diet. Maternal education was positively associated with the child's dietary diversity. Household dietary diversity was significantly associated with child dietary diversity in a model including group, child's age, maternal education, and wealth as confounders. The RCT also showed that a 2- to 3-month nutrition education programme carried out by government and community health volunteers as well as local NGOs addressing caregivers with a child between 5 and 18 months of age has great potential to improve IYCF practices. Since no impact on average height-for-age Z-scores could be demonstrated in this RCT, we suggest for Cambodia that (1) more emphasis be put on animal-source food and other protein sources in nutrition education, (2) nutrition education be implemented in the community through trained government and community members including peers as trainers, (3) sessions on family nutrition be included in the curriculum and the continuation of breastfeeding be emphasized, and (4) nutrition education be institutionalized, including continuous in-service training for sustainability.

Feeding practices and nutrient content of complementary meals in rural central Tanzania: implications for dietary adequacy and nutritional status.

BackgroundStunting and micronutrient deficiencies are significant health problems among infants and young children in rural Tanzania. Objective of the study was to assess feeding practices, nutrient content of complementary meals, and their implications for dietary adequacy and nutritional status.MethodsA cross-sectional study was conducted in six randomly selected villages in Mpwapwa District, Tanzania during the post-harvest season. Information on feeding practices, dietary consumption and anthropometric measurements of all infants below the age of one year were collected. Forty samples of common meals were collected and analysed for proximate composition, iron, zinc and calcium. Results were expressed per 100 g dry weight.ResultsEnergy, protein and fat content in porridge ranged from 40.67–63.92 kcal, 0.54–1.74 % and 0.30-2.12 %, respectively. Iron, zinc and calcium contents (mg/100 g) in porridge were 0.11–2.81, 0.10–3.23, and 25.43-125.55, respectively. Median portion sizes were small (porridge: 150–350 g; legumes and meats: 39–90 g). Very few children (6.67 %) consumed animal-source foods. Low meal frequency, low nutrient content, small portion size and limited variety reduced the contribution of meals to daily nutritional needs.ConclusionsFindings of the study highlight inadequate feeding practices, low nutritional quality of meals and high prevalence of stunting. Feasible strategies are needed to address the dietary inadequacies and chronic malnutrition of rural infants.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-015-0489-2) contains supplementary material, which is available to authorized users.

Home-made and commercial complementary meals in German infants: results of the DONALD study.

Infant complementary food can be home-made or bought as ready-to-eat commercial products. The nutrient composition of commercial products is regularised in a European Commission guideline, whereas the preparation of home-made complementary meals is the responsibility of caregivers. In the present study, the composition of commercial and home-made complementary meals as eaten by healthy German infants was compared. Of 8226 complementary meals (74% commercial and 26% home-made) recorded in 1083, 3-day weighed dietary records from 396 participants (6-12 months old) of the German DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) study were analysed. Median energy density (kcal 100 g(-1)) was highest in commercial and home-made cereal-milk meals (89 kcal 100 g(-1)). In home-made savoury and cereal-fruit meals, the energy density was significantly higher compared to their commercial counterparts. Median protein contents were highest in savoury and cereal-milk meals (>2.5 g 100 g(-1)) and dairy-fruit meals (2-4 g 100 g(-1)). Added sugars were found in less than a quarter of meals. Highest median sodium contents were found not only in commercial savoury meals (median 38 mg 100 g(-1)) and vegetable meals (32 mg 100 g(-1)), but also in home-made cereal-milk meals (36 mg 100 g(-1)). Both median fat and iron contents were higher in home-made meals compared to commercial savoury and cereal-fruit meals. With the exception of the higher sodium content in commercial savoury meals for older infants, the lower fat content in commercial savoury and cereal-fruit meals, and the added sugar content in some commercial dairy-fruit meals, a comparison of commercial and home-made complementary meals did not reveal any serious inadequacy.