Lipids in complementary foods.
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Dietary Fats↗
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Iron and zinc intake from complementary foods: some issues from Pakistan.
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Anemia, Iron-Deficiency↗
The adequacy of micronutrients in complementary foods.
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Developing Countries↗
[Complementary food to breastfed infants. Introduction can wait until the age of six months but not longer].
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Breast Feeding↗
[In spite of the WHO's recommendation: the last work not yet said about breast feeding and complementary foods].
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Breast Feeding↗
Zinc and iron nutrition in Chilean children fed fortified milk provided by the Complementary National Food Program.
OBJECTIVE: Chilean infants are at risk for isolated zinc and iron deficiencies because of a low consumption of animal products in low socioeconomic sectors. In 1999, the National Complementary Food Program of Chile manufactured a new milk (2 kg of powdered milk/mo) fortified with iron (Fe; 10 mg/L), zinc (Zn; 5 mg/L), and copper (0.5 mg/L) to be provided to infants until age 18 mo and to pregnant women. We analyzed the nutrition status of zinc and iron at age 18 mo in infants who consumed the fortified cow's milk. METHODS: Forty-two healthy male children with normal growth and from lower socioeconomic groups were studied. A nutrition survey was conducted; blood and hair samples for Zn in plasma and hair, hemoglobin, hematocrit, and serum ferritin were obtained. RESULTS: Mean intakes were: energy, 106 +/- 27 kcal. kg(-1). d(-1); protein, 3.8 +/- 1.1 g. kg(-1). d(-1); Zn, 5.2 +/- 1.9 g/d (0.98 mg Zn/MJ; 68% of World Health Organization recommendations); Fe, 11.2 +/- 5.5 mg/d; and dietary fiber, 9.8 +/- 3.9 g/d. Plasma Zn in 54.8% of children was no greater than 12.3 microM/L; 36% had hair Zn level no greater than 1.23 microM/g and 39% had serum ferritin levels no greater than 10 microg/dL (12% were anemic). Hair Zn was correlated to socioeconomic level (Spearman's rank correlation, r = -0.53; P < 0.001) and plasma Zn was correlated to the z weight/length (r = 0.47; P < 0.05), subscapular skinfold (r = 0.46; P < 0.05), and Zn intake (r = 0.46; P < 0.05). CONCLUSIONS: The fortified powdered cow's milk provided to infants until age 18 mo by the Complementary Food Program in Chile favorably affects the Fe status of these children, but possibly not the Zn nutrition; we suggest re-evaluation of the levels of Zn fortification.
Animals↗
[Relationship between growth of young children and complementary feeding].
Description analysis, correlation regression analysis and logistic regression analysis were applied to evaluate the impact of complementary food on the growth of children from the aged 4 to 24 months, results on the effect of the complementary feeding were presented. Among children under 2 years in poor rural areas, 42% of them got complementary food containing animal food, 30.5% got milk, 57.8% got starchy foods, and 48.6% got vegetables and fruits. The coverage of complementary food containing animal food, vegetables/fruits was only half of that in the urban areas. Analysis revealed significantly positive correlation of HAZ, WAZ of all age group of children under 2 years with the appearance of animal foods, vegetable and fruit in the complementary food, but there was no significantly correlation with starchy foods. According to the regression coefficient, it was estimated that the prevalence of stunting aged 18-24 months could be reduced 2.6 percentage points if 10% increase of coverage of animal food containing complementary food in the CFNSS site was achieved. Logistic regression analysis showed the odds ratio (OR) of non-animal food complementary food for stunting was 2.21 for children aged 4-6 months, 1.73 for 6-12 months, 2.81 for 12-18 months, 2.58 for 18-24 months, OR for underweight was 2.87 for 12-18 months, and 2.08 for 18-24 months.
Child Development↗
Zinc and breastfed infants: if and when is there a risk of deficiency?
Infancy is a time of relatively high zinc requirements. Human milk provides an excellent source of highly bioavailable zinc and generally meets the needs of the healthy young exclusively breastfed infants for the first several months of life. Investigations of exclusively breastfed infants less than 6 mo of age have generally found zinc homeostasis and status to be adequate, although there are indications that zinc intake from human milk alone may become limiting by around 6 mo of age. Exceptions may be small for gestational age and low birth weight infants, who may well benefit from increased zinc intake before 6 mo of age. The older infant clearly becomes dependent on non-human milk sources of zinc, i.e., from complementary foods. Traditional early complementary foods, such as cereals, fruits, and vegetables provide very modest amounts of zinc, and for those high in phytic acid, bioavailability may be low. Introduction of animal products or zinc supplementation may be important to meet the older infant's zinc requirements This is likely to be particularly important in less protected environments with a high infectious burden and limited dietary options.
Age Factors↗
Impact of a food-based approach to improve iron nutrition of at-risk infants in northern Canada.
BACKGROUND: We evaluated the impact of a food-based approach in promoting iron-rich complementary feeding for mothers with infants at-risk for iron deficiency anemia (IDA). METHODS: A repeat cross-sectional design was used to assess the impact of communication strategies to disseminate key messages promoting iron-rich complementary food. Two groups of mothers with infants, aged 7-10 months, at Time 1 (n = 32; response rate = 64%) and Time 2 (n = 22; response rate = 48%) were interviewed. Main outcome variables were infants' total iron and complementary food iron intakes measured by two 24-h recalls. RESULTS: Complementary food iron intake increased between Time 1 (3.2 +/- 0.8 mg) and Time 2 (4.4 +/- 1.1 mg) (P < 0.05). The estimated prevalence of inadequacy was 56% (95% CI = 38%, 74%) for infants at Time 1 and 41% (95% CI = 20%, 62%) for infants at Time 2; however, this difference was not statistically significant. CONCLUSIONS: A food-based approach, promoted in a community with infants at-risk for IDA, can positively contribute to improved intake of complementary food iron as well as provide a sustainable and relevant prevention strategy.
Anemia, Iron-Deficiency↗
Iron and ascorbic Acid: proposed fortification levels and recommended iron compounds.
An adequate supply of dietary iron during the 1st 24 mo of life is essential for preventing iron deficiency with its attendant negative effects on mental, motor and emotional development as well as later cognitive performance. Iron reserves and the small amount of highly bioavailable iron in human milk are adequate to satisfy the iron requirements of breast-fed infants of adequate birth weight for the 1st 6 mo of life. Thereafter, complementary foods, iron supplements or both are needed to meet this requirement. Complementary foods should not displace the consumption of human milk. The quantities eaten, particularly by younger infants, may therefore be quite small. As a consequence it is essential that the iron be supplied in a highly bioavailable form. This can be achieved by fortifying complementary foods with ferrous sulfate and ascorbic acid provided that the ascorbic acid is not lost during storage or meal preparation. Suggested fortification levels for ferrous sulfate and ascorbic acid for some types of complementary foods are given. The use of ferrous fumarate or an elemental iron powder instead of ferrous sulfate has not been evaluated adequately. There is a need to develop alternative strategies for improving iron bioavailability in complementary foods because it may not be possible to preserve ascorbic acid activity in many of them.
Ascorbic Acid↗
Participatory nutrition education and adoption of new feeding practices are associated with improved adequacy of complementary diets among rural Malawian children: a pilot study.
OBJECTIVE: To introduce practices for improving complementary feeding and evaluate their adoption and association with improved dietary intakes. DESIGN: A quasiexperimental pilot study comparing dietary intakes from complementary foods among three intervention communities and one control community before and after the intervention, and adoption of new complementary feeding practices among intervention communities following the intervention. SETTING: Rural subsistence communities in southern Malawi, Central Africa. SUBJECTS: Mothers and their children aged 6 to 23 months receiving complementary foods. INTERVENTIONS: A participatory, nutrition education intervention based on four locally adapted lessons for complementary feeding practices designed to increase: (i) total complementary food intake; (ii) energy and nutrient density of the complementary diet, and; (iii) iron and zinc bioavailability of the complementary diet. RESULTS: Adoption rates for the four practices ranged from 25% for preparation of enriched porridges, to 10% for preparing soaked, pounded maize. The amount of complementary foods (g/day) and intakes of energy, animal protein, niacin, riboflavin, calcium, iron, and zinc, but not vitamin A, were significantly greater (P<0.05) in the intervention compared to control group, as were the energy, iron, and riboflavin density, and the estimated amount of bioavailable iron and zinc. CONCLUSIONS: Several intervention practices were well accepted and adopted and were associated with improved adequacy of energy and nutrient intakes from the complementary diet. Such improvements were attributed mainly to greater total intakes and, to a lesser extent, enhanced dietary quality of the complementary foods.
Biological Availability↗
Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods.
BACKGROUND: Standard therapy for anemia in infants is ferrous sulfate drops administered 3 times/d. Adherence to treatment, however, is often poor. One likely reason for poor adherence is the unpleasant side effects associated with drops. OBJECTIVE: The objective was to evaluate the use of a new form of iron and a delivery system to treat anemia in infants that is likely to produce better adherence to treatment. DESIGN: Using a prospective, randomized, controlled design, we studied 557 anemic children aged 6-18 mo (hemoglobin: 70-99 g/L) in rural Ghana. One group received a daily sachet of microencapsulated ferrous fumarate (80 mg elemental Fe) in powder form plus ascorbic acid to be sprinkled onto any complementary food eaten (sprinkles group); a control group received ferrous sulfate drops 3 times/d for 2 mo (total dose: 40 mg elemental Fe). Hemoglobin and serum ferritin concentrations were measured at baseline and at the end of treatment. RESULTS: Successful treatment of anemia (hemoglobin > 100 g/L) occurred in 58% of the sprinkles group and in 56% of the drops group, with minimal side effects in both groups. Geometric mean ferritin concentrations increased significantly in each group from baseline to the end of treatment (P < 0.001). CONCLUSION: Use of ferrous sulfate drops or a single daily dose of microencapsulated ferrous fumarate sprinkles plus ascorbic acid resulted in a similar rate of successful treatment of anemia without side effects. To our knowledge, this is the first demonstration of the use of microencapsulated iron sprinkles to treat anemia. Improved ease of use may favor the use of sprinkles to deliver iron.
Anemia, Iron-Deficiency↗
Chemical, sensory and rheological properties of porridges from processed sorghum (Sorghum bicolor), bambara groundnut (Vigna subterranea L. Verdc) and sweet potato (Ipomoea batatas) flours.
The chemical, sensory and rheological properties of porridges made from blends of sprouted sorghum, bambara groundnuts and fermented sweet potatoes were examined. Sorghum and bambara groundnuts were sprouted for 48 h while sweet potatoes were fermented for the same period. Blends were formulated from the processed ingredients in the ratio of 60:40:0, 57:42:1, 55:44:1 and 52:46:2 (protein basis) of sorghum, bambara groundnuts and sweet potatoes. Porridges were prepared from the composite flours and the traditional sorghum complementary food. Standard assay methods were used to evaluate the flours for nutrient composition. The porridges were also tested for sensory properties and viscosity. Processing increased the levels of most of the nutrients evaluated. Relative to the sorghum traditional complementary food, the composite flours had higher levels of lipids, protein, ash, crude fiber and minerals (p < 0.05). The porridges from the composite flours were generally liked slightly by the panelists and were about seven times less viscous than the porridge from the traditional sorghum complementary food. Use of the composite flours, particularly the 52:46:2 blend, as a traditional complementary food should be encouraged in Nigeria especially with the increasing cost of commercial complementary foods.
Arachis↗
Recombinant human milk proteins.
Human milk provides proteins that benefit newborn infants. They not only provide amino acids, but also facilitate the absorption of nutrients, stimulate growth and development of the intestine, modulate immune function, and aid in the digestion of other nutrients. Breastfed infants have a lower prevalence of infections than formula-fed infants. Since many women in industrialized countries choose not to breastfeed, and an increasing proportion of women in developing countries are advised not to breastfeed because of the risk of HIV transmission, incorporation of recombinant human milk proteins into infant foods is likely to be beneficial. We are expressing human milk proteins known to have anti-infective activity in rice. Since rice is a normal constituent of the diet of infants and children, limited purification of the proteins is required. Lactoferrin has antimicrobial and iron-binding activities. Lysozyme is an enzyme that is bactericidal and also acts synergistically with lactoferrin. These recombinant proteins have biological activities identical to their native counterparts. They are equally resistant to heat processing, which is necessary for food applications, and to acid and proteolytic enzymes which are needed to maintain their biological activity in the gastrointestinal tract of infants. These recombinant human milk proteins may be incorporated into infant formulas, baby foods and complementary foods, and used with the goal to reduce infectious diseases.
Humans↗
Phytic acid degradation as a means of improving iron absorption.
Phytic acid is a potent inhibitor of native and fortification iron absorption and low absorption of iron from cereal- and/or legume-based complementary foods is a major factor in the etiology of iron deficiency in infants. Dephytinization of complementary foods or soy-based infant formulas is technically possible but, as phytic acid is strongly inhibitory at low concentrations, complete enzymatic degradation is recommended. If this is not possible, the phytic acid to iron molar ratio should be decreased to below 1:1 and preferably below 0.4:1. Complete dephytinization of cereal- and legume-based complementary foods has been shown to increase the percentage of iron absorption by as much as 12-fold (0.99% to 11.54%) in a single-meal study when the foods were reconstituted with water. The addition of milk, however, inhibits iron absorption and overcomes the enhancing effect of phytic acid degradation. Dephytinization can therefore be strongly recommended only for cereal/legume mixtures reconstituted with water, especially low-cost complementary foods destined for infants in developing countries. In countries where infant cereals are consumed with milk, ascorbic acid addition can more easily be used to overcome the negative effect of phytic acid on iron absorption. Similarly with soy-based infant formulas, especially if manufactured from low-phytate isolates, ascorbic acid can be used to ensure adequate iron absorption.
6-Phytase↗
Proposed vitamin a fortification levels.
Fortified complementary foods could be effective in preventing and controlling vitamin A and other common nutritional deficiencies in young children. Milk from well-nourished women is an excellent source of vitamin A. However, in Latin America many children are weaned prematurely and must receive the entire requirement of vitamin A from food. This paper proposes vitamin A fortification levels for foods targeted for children aged 6-23 mo to meet the existing intake gap among both breast-fed and weaned infants and young children. Estimates assume a nonsignificant contribution of common complementary foods and average levels of human milk intake by breast-fed infants and children. The estimated vitamin A gap for breast-fed infants aged 6-11 mo amounts to 63-92 microg RE [16-23% of recommended daily intake (RDI)] and for breast-fed children reaches 125 microg RE (31% of RDI). Weaned infants and children would have to fully meet the RDI (400 microg RE) from complementary foods. A fortified complementary food with 500 mg RE/100 g of dry product provided daily in a single ration of 40 g would meet 50% of the gap for weaned infants aged 6-11 mo and would raise the total intake above RDI for breast-fed infants aged 6-8 mo (125%) and 9-11 mo (127%). The same fortified food given in a daily ration of 60 mg would meet most of the gap (75%) for weaned children aged 12-23 mo and would increase total intake of breast-fed children aged 12-23 mo well above the RDI (144%), with no risk of exceeding established upper tolerable intake levels.
Breast Feeding↗
Exclusive breast-feeding for 6 months, with iron supplementation, maintains adequate micronutrient status among term, low-birthweight, breast-fed infants in Honduras.
There is little information on the risk of micronutrient deficiencies during the period of exclusive breast-feeding. We evaluated this among term, low-birthweight (LBW; 1500-2500 g) infants in Honduras. Mother-infant pairs were recruited in the hospital and assisted with exclusive breast-feeding during the first 4 mo. At 4 mo, infants were randomly assigned to either continue exclusive breast-feeding to 6 mo (EBF; n = 59) or be given iron-fortified complementary foods (rice, chicken, fruits, and vegetables) from 4 to 6 mo while continuing to breast-feed (SF, n = 60). Blood samples were collected at 2, 4, and 6 mo and analyzed for hemoglobin (Hb), hematocrit, plasma ferritin, % transferrin saturation, vitamin A, vitamin B-12, folate, zinc, and erythrocyte folate. Infants with Hb < 100 g/L at 2 or 4 mo were given medicinal iron supplements for 2 mo; the proportion administered iron drops did not differ significantly between groups. There was no significant effect of complementary foods on indices of vitamin A, B-12, folate, or zinc status. Among infants not given medicinal iron at 4-6 mo, iron status was higher in the SF group than the EBF group. In those given medicinal iron at 4-6 mo, iron status was higher in the EBF group, suggesting that complementary foods interfered with iron utilization. About half of the infants were anemic by 2 mo, before the age when complementary foods would be recommended. This supports the recommendation that LBW infants should receive iron supplementation in early infancy. Given that infants given iron supplements did not benefit from complementary foods at 4-6 mo, we conclude that exclusive breast-feeding for 6 mo (with iron supplementation) can be recommended for term, LBW infants.
Anemia↗
Infant and young child feeding in western Uganda: knowledge, practices and socio-economic correlates.
In a cross-sectional household survey conducted in the rural district of Hoima, western Uganda, 720 child/mother pairs were recruited using a two-stage cluster design. Infant and young child feeding knowledge and practices were assessed in relation to recommendations and household socio-economic factors. Age specific feeding patterns were described using frequencies, proportions and life-tables. Logistic regressions were done with feeding practice as dependent and socio-economic factors as independent variables. Breastfeeding was universal (99%) with a median duration of 21 months. Pre-lacteal use was high (43%), with educated mothers more prone to the practice. Using a 24-hour recall: the median duration of exclusive breastfeeding was 3.5 months; 10% of infants were bottle-fed; 92% of the 0-5 month-old infants breastfed 6 or more times; 21% of 2-3 month-olds received complementary food instead of breast milk only and 19% of 6-8 month-olds were only breastfed instead of receiving complementary food. Of children 12 months and above, 42% were complemented twice or less and 49% complemented 3 or 4 times. Only 36% of breastfeeding children between 6-23 months received dairy milk. Over 50% of mothers did not know that adding oil to complementary food could improve it. The least poor were more likely, than the poorest, to use dairy milk (OR 3.9, CI 1.6-9.6); and educated mothers were more likely to prepare special complementary foods than the un-educated (OR 2.7, CI 1.1-6.2). Emphasis should be on promotion of exclusive breastfeeding, timeliness of complementary feeding and socio-economic empowerment.
Adolescent↗