Local strategies to support child nutrition

Local strategies to support child nutrition

Nutrition Research, Vol. 18. No. 2. pp. 233-239,199s Cotwieht 0 1998 Elsevier Science Inc. Pri%Gin the USA. All rights reserved 0271-5317/‘98 $19.00+ ...

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Nutrition Research, Vol. 18. No. 2. pp. 233-239,199s Cotwieht 0 1998 Elsevier Science Inc. Pri%Gin the USA. All rights reserved 0271-5317/‘98 $19.00+ .@I

PII SO271-5317(98)00015-3

ELSEVIER

LOCAL STRATEGIES

Avinashilingam

TO SUPPORT

CHILD NUTRITION

Rajammal P. Devadas’ Institute for Home Science and Higher Education for Women , Deemed University, Coimbatore 641 043, Tamilnadu, India

ABSTRACT Breast feeding is of life. Weaning Locally available young children. technology so as Q1998 Elsevie* Science Inc. Key Words: Malting

the best source of complete nutrition for the first 4-6 months foods should be selected so as to represent all food groups. and inexpensive foods can be prepared for consumption by Traditional methods can be adopted to clean modern to ensure wholesome foods that are not contaminated.

Weaning

foods, Breast feeding, Growth and development,

Good health and happiness can be attained by good nutrition and good “child care”. Human childhood may be divided into three stages namely infancy, weaning stage, and preschool stage. Infancy is the period from birth to about 6 to 8 months of age. The weaning stage lies between the ages of about 4 months and 2 to 3 years, followed by the preschool stage which ends by about 5 years of age. Optimum growth and development of children depends upon (a) good maternal nutrition, (b) adequate breast feeding, (c) timely complementary foods, and (d) appropriate weaning. Weaning denotes the process in which an infant shifts from breast milk to a mixed diet progressively. At first, along with breast milk, small quantities of complementary foods are given mostly in liquid form. Slowly but regularly these complementary foods are added in increased quantities and also in the form of semi-solids and later solids as the child grows and continues until full replacement of milk by the normal adult diet. Weaning thus becomes an essential feature for balancing the nutrients such as energy, protein, vitamins, and minerals that the growing child needs. Up to the first 6 months of age, breast milk is adequate for meeting the calorie and nutrient requirements of the infant. Thereafter the breast milk supply is inadequate to meet the requirements and hence weaning should start between the 4th and 6th month in the child’s life.

‘Address correspondence to: Dr. Rajammal P. Devadas, Chancellor, Avinashilingam Institute for Home Science and Higher Education for Women, Deemed University, Coimbatore 641 043, Tamilnadu, India

233

234

R.P. DEVADAS

The weaning schedule for infants can be roughly given as follow: Table 1. Weaning Schedule For Infants ____________________~____________________________~~~~~~~~~~~~~~~~~~~~~~~~~~____________________ Age in Months Type of Foods Introduced -------_____________~~~_________________________~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3, 4, and 5 months Green’s juice, tomato juice, carrot juice, cooked and mashed banana and potato, papaya, egg yolk, cereal, porridge 6 months

Double boiled or mashed rice, iddli, mashed kicheri, dhal rice

7-8 months

Iddli, kicheri, whole egg, curds, curd rice, vegetables, fish, meat, milk, biscuits

From 9th month onwards

Rice or chappathi, dhal, mashed greens, salad, curds, milk, biscuits, fruits __________ __~___ _t-lat ____ Wl.-i-e.Eis _is__&e Ideal-~~~~~-~~~,-his-~~~~~~ ~~~~-.--o-~~~~~~~.r----.~~ in adequate quantities, and that there is absolutely no deficit in the quantity and quality of foods introduced at appropriate stages. In India, no supplementary food is given to the infants until the age of two years. The only items given, sometimes in addition to the mother’s milk are, over diluted cow’s milk with very little other foods such as cooked rice in the form of gruel. Protective foods of animal origin such as milk, meat, fish, and egg are expensive and beyond the reach of the common man. Centrally processed foods involve several problems such as transport, storage, distribution and eventually cost. Ready to consume foods made available within the reach of the rural families should be the basis for supplementary feeding programmes for the vulnerable groups particularly infants. Thus, in developing weaning foods, the important aspects to be considered are as follows: -

Locally available foods should be chosen as ingredients Easily digestible low fiber, low density foods should be selected Ingredients should be of low cost and within the reach of the common man The weaning food should be in the ready-to-eat form or should have good shelf life while it can be easily prepared into a gruel or paste at the time of feeding - The weaning food should be nutrient dense with an amino acid pattern that would promote growth in children

The above considerations bring out the necessity for processing the ingredients in ways of cleaning, dehusking, powdering, cooking, drying etc. that enable reconstitution with water or milk. One of the successful attempts in the formulation of a low cost nutritious infant food is the development of “Kuzhandai Amudhu” from indigenous cereal, pulse, and vegetable sources by Devadas and coworkers (1974) at the Avinashilingam Institute for Home Science,

PROMOTING CHILD NUTRITION

Coimbatore. formulations

Six weaning mixes were developed under the name “Kuzhandai Amudhu”. have as ingredients:

- A cereal (millet) : cholam/ragi/maize - A pulse : green gram dhal/Bengal - Groundnut -

235

These

gram dhal

Jakwry

in the ratio 3:2:1:2 respectively. formulations is given in Table 2.

The composition,

nutritive

value,

and cost of these

Table 2. Composition,

Nutritive Value, and Cost of the “Ready To Consume” Formulations

_______________________________________________________________________________~~~~~~~~~ Formulation

Jowar-Bengal g-

Ingredients

Amount

Calories

Protein

(g)

(Kcal)

(g)

cost Rs. P.

Roasted Jowar Flour

30

105

3.12

0.06

Roasted Bengal Gram Dhal Flour

20

74

4.50

0.12

Roasted Groundnut

10

56

3.15

0.09

Jag&w

20

76

0.08

0.06

80

311

10.85

0.33

Roasted Jowar Flour

30

105

3.12

0.06

Roasted Green Gram Dhal Flour

20

70

4.90

0.09

Roasted Groundnuts

10

56

3.15

0.09

J%sry

20

76

0.08

0.06

80

307

11.25

0.30

Total Jowar-Green gram

Total

(Table continued)

236

R.P. DEVADAS

(Table continued)

Maize-Bengal g-

Roasted Maize Flour

30

103

3.33

0.06

Roasted Bengal Gram Dhal Flour

20

74

4.50

0.12

Roasted Groundnuts

10

56

3.15

0.09

Jaggery

20

76

0.08

0.06

80

309

11.06

0.33

Roasted Maize Flour

30

103

3.33

0.06

Roasted Green Gram Dhal Flour

20

70

4.90

0.09

Roasted Groundnuts

10

56

3.15

0.09

Jaggery

20

76

0.08

0.06

Total

80

305

11.46

0.30

Roasted Ragi Flour

30

98

2.19

0.06

Roasted Bengal Gram Dhal Flour

20

74

4.50

0.12

Roasted Groundnuts

10

56

3.15

0.09

Jaggery

20

76

0.08

0.06

Total

80

304

9.92

0.33

Roasted Ragi Flour

30

98

2.19

0.06

Roasted Green Gram Dhal Flour

20

70

4.90

0.09

Roasted Groundnuts

10

56

3.15

0.09

Jaggery

20

76

0.08

0.06

10.32

0.30

Total Maize-Green gram

Ragi-Bengal gram

Ragi-Green gram

Total 80 300 Jowar - Sorghum vulgare; Bengal gram - Cicer arietinum Green gram - Phaseolus aureus; Maize - Zea mays Ragi - Eleusine coracana; Groundnut - Arachis hypogea

237

PROMOTING CHILD NUTRITION

The mix was prepared by roasting the cereal, pulse, and groundnut followed by grinding the cereal-pulse combination in a mill and pounding the roasted groundnut. All the ingredients were then mixed with powered jaggery. To 80 g of the formulation, 25 ml of water was added, mixed, and the mixture made into balls designated as “laddus”. Porridge can also be prepared by adding 100 ml of boiling water. Items like iddli, dosai, adai, chapati, pittu, modakam, and kolukkattai - the indigenous delicacies - can also be prepared. These formulations have the advantages of being highly nutritious with good supplementary value, high acceptability, have ease in preparation, low in cost, have locally available ingredients as components, and have a good shelf life. The acceptability of the six mixtures was tested on 100 pre-school children. All the mixtures were found acceptable. Feedine Trial on Pre-School Children One hundred infants in the age range of 6 months to 3 years from two rural communities in Perianaickenpalayam, Coimbatore district were selected for the study. The maize green gram formulation was selected for the feeding trial, because it has good digestibility. 80 g of the formulation was fed to the children daily for a period of 12 months continuously. The mixture supplied 305 calories, 11.46 g of protein per day. The nutritional status of the 20 randomly selected children was evaluated every month in terms of changes in heights and weights and the findings are given in Table 3.

Table 3 Mean Increases in Heights and weights of Infants Receiving Kuzhandai Amudhu

Groups

. . . . . . . . . .Mean Height - cm.. . . . . . . . . Initial

Final

Difference

. . . . . . . . . . .Mean Weight - kg.. . . . . . . . . . . .

Initial

Final

Difference

Experimental

80.15 +4.52

86.17 f3.71

6.02 +0.81

8.58 +1.04

10.72 +1.51

2.14 ~0.61

Control

79.97 f3.21

82.60 24.51

2.63 +0.71

8.37 f1.12

9.56 +1.61

1.91 f0.32

No. of Children:

Experimental: Control : Period :

100 50 1 yr

“t” value for height 21.6-; “t” value for weight 4.56*Significant at one percent level

238

R.P. DEVADAS

Towards the end of the study, children receiving Kuzhandai Amudhu were heavier and taller than their counterparts. The mean difference in the increases in heights and weights between the groups were statistically at one percent level.

Traditional Technoloeies Traditional technologies have been practised by mothers to slightly improve the texture and enhance the nutritional quality of the weaning foods commonly prepared in homes. Some such simple methods include malting of cereals, extrusion, flaking, popping of cereal grains and enzyme hydrolysis. Malting is one of the traditional methods of food processing and it is simple with nutritional advantages. Among Indian cereals and legumes, ragi and green gram are specially suited to malting. The steps involved in this process include cleaning, soaking, germination, drying, dehusking/devegetation, toasting, grinding, and sieving to obtain malt flour. The malted weaning food is not fully cooked, hence needs cooking prior to feeding. The malted flour should be stirred with cold water or milk and heated slowly to boiling. Heating enables the malt enzymes to hydrolyze starch giving a thin slurry after cooking. Malted weaning food is easy to digest and nutritionally balanced and does not produce flatulence. Cereal malt flours are mixed with malted green gram or cow pea flour in the ratio of 2: 1 respectively. The blends can be mixed with sugar, milk powder, vitamins, and mineral if desired. Based on the consideration of taste, flavour, and keeping qualities, wheat based food shows high promise. Weaning foods can also be formulated based on chapati and vermicelli processes. The dough is prepared from a mixture of cereal flour, green gram dhal, and popped Bengal gram dhal (7:2: 1). The dough can be rolled and baked into chapati, then dried and ground into weaning food. Or, the dough could be extruded into vermicelli which is then steamed, dried, and ground into weaning food. Cereals can be moistened, tempered, and popped, and the popped grains can be ground into flour which can be blended with a mixture (2: 1) of green gram dhal flour and Bengal gram dhal flour. Similarly, weaning foods based on rice flakes and expanded rice can also be prepared. Banana based weaning foods are prepared from a blend of processed cereal flour, banana flour, green gram dhal flour, and Bengal gram dhal flour (5:2:2:1). Using such simple technologies in the home level ensures a high potential for producing low cost weaning foods that can serve as substitutes to commercial formulae. CONCLUSION The improvements of the nutritional status of the rural communities cannot be brought about through the use of expensive feeding programmes and such programmes would only bring

PROMOTING CHILD NUTRITION

239

temporary amelioration of malnutrition. The solution lies in the judicious use of inexpensive local foods, which are available within a radius of 10 miles of most rural communities in the country. The need of the hour is to help poor mothers in the rural areas to prepare nutritious recipes based on inexpensive locally available foods for feeding their children. REFERENCES 1.

Devadas RP, Jamala S, Chandrasekhar U, and Murhty NK. Nutritional Evaluation of a maize-based indigenous infant food, “Kuzhandai Amudhu”. The Ind J Nutr Dietet, 1974; 11:257-263.

2.

Chandrasekhar U, Bhooma N, and Reddy S. Evaluation of a malted weaning food based on low cost locally available foods. Paper presented at the V. Asian Congress 6 Nutrition held from Oct. 26-29, 1987, at Osaka, Japan. 3.

Chandrasekhar U, Devadas RP, Bhooma N. Alleviation of childhood malnutrition with local foods. Paper presented at the II International Symposium on Clinical Nutrition held at Sydney, Australia from Sept. 29 - Oct. 2, 1985.

4.

Regional Extension Service Centre (Rice Milling). Ministry of Food Processing Industries. Government of India: Weaning Foods. Discipline of Grain Science and Technology, CFIRI, Mysore. REX Scientific Series No. 8, 1988.

Accepted for publication October 29, 1998