EFFECT OF IMPROVED COMPLEMENTARY FOODS ON GROWTH AND IRON STATUS OF KENYAN INFANTS
Keywords:
EFFECT OF IMPROVED, COMPLEMENTARY FOODS ON GROWTH, IRON STATUS, KENYAN INFANTSSynopsis
Background: Infant growth faltering is usually associated with an increased risk of
morbidity and mortality. It is common in resource limited settings and constrains infants’ full
development resulting in reduced physical capacity and overall productivity later in life.
Major causes are inappropriate feeding practices and poor quality complementary foods with
low energy density and micronutrients deficiency. Interventions to improve the quality of
complementary foods exist like use of fortified blends among others but with mixed
results/outcomes. Among the interventions is also the use of animal source foods (ASFs) to
improve the quality of the blends. With increasing attention to ASFs and especially those that
are locally available, easily accessible, cheaper and acceptable in the localities, the effects of
the same on infant nutrition, growth and development need special attention. The impact of
incorporating indigenous nutrient rich and relatively cheap, locally available and readily
acceptable but underutilized/neglected ASFs such as edible termites and dagaa small fish and
micronutrient fortification of complementary foods on growth of infants from resource
limited settings has been inadequately studied.
Objectives: To test the acceptability and efficacy of improved complementary food blends
named WINFOOD Classic ((WFC)- with 10% edible termites, 3% dagaa small fish and
germinated grain amaranth), WINFOOD Lite ((WFL)-with germinated grain amaranth
fortified with micronutrients at the rate of Corn Soy Blend Plus (CSB+)) and CSB+ (Corn
and Soya fortified with micronutrients) on growth (measured as length and weight gain),
haemoglobin concentration, anaemia prevalence and iron status of infants 6 to 15 months
from a resource limited rural setting in Kakamega County, Western Kenya.
Study implementation: Three-stage study comprising assessment of: 1) acceptability of
improved-animal source foods enhanced-fortified complementary blends 2) prevalence of
malnutrition in the study population among infants 6-23 months and, 3) the effect of the
complementary foods on linear growth and weight gain, haemoglobin concentration, anaemia
prevalence and iron status among infants 6 -15 months of age in a randomized controlled trial
(RCT).
Design: The acceptability study was a cross over design study with wash out periods while
the nutitional status styd prior to the intervetin study was determined using a cross section
design. The intervention study was a community-based double blind randomized trial in
which infants were individually randomized at 6 months of age to receive one of the three
study complementary foods: WFC, WFL and CSB+ for 9 months.
Methods: Acceptability to mothers and infants of the improved-ASFs enhanced and fortified
complementary blends WFC, WFL or CSB+ porridge recipes was assessed prior to the
industrial production of the blends among fifty seven (57) infant-caregivers dyads.
A cross sectional anthropometric, dietary and morbidity data among six hundred and eighteen
(618) infants and young children aged 6-23 months old was also collected prior to the
randomized controlled trial (RCT).
In the intervention study, Four hundred and ninety nine (499) infants were randomized to
receive WFC (n= 165), WFL (n= 167) or CSB+ (n=167) from 6–15 months of age. The
primary outcome was linear growth while secondary outcomes included weight gain,
haemoglobin concentration, iron status (determined as ferritin and soluble transferrin receptor
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