Community-Based Management of Acute Malnutrition for Infants Under 6 Months of Age Is Safe and Effective: Analysis of Operational Data

Objective: To assess the effectiveness of outpatient management with ready-to-use and supplementary foods for infants under 6 months (u6m) of age who were unable to be treated as inpatients due to social and economic barriers. Design: Review of operational acute malnutrition treatment records. Setting: 21 outpatient therapeutic feeding clinics in rural Malawi. Participants: Infants u6m with acute malnutrition treated as outpatients because of barriers to inpatient treatment. The comparison group consisted of acutely malnourished children 6-9 months of age who were being treated at the same time in the same location in the context of two different randomized clinical trials. Results: A total of 323 infants u6m were treated for acute malnutrition (130 severe and 193 moderate). A total of 357 infants 6-9 months old with acute malnutrition (74 severe and 283 moderate) were included as contemporaneous controls. Among infants u6m with severe acute malnutrition, 98 (75.4%) achieved nutritional recovery; in comparison, 56 (75.7%) of those with SAM 6-9 months old recovered. Among infants u6m with moderate acute malnutrition, 157 (81.3%) recovered; in comparison 241 (85.2%) of those aged 6-9 months recovered. Conclusions: In a rural Malawian population of infants u6m who had generally already stopped exclusive breastfeeding and were now acutely malnourished, treatment with therapeutic or supplementary foods under the community management of acute malnutrition model was safe and effective. In settings where social and financial factors make hospital admission challenging, consideration should be given to lowering the recommended age of ready-to-use therapeutic and supplementary foods to infants u6m.

Composite Flour from Indonesian Local Food Resources to Develop Cereal/Tuber Nut/Bean-Based Ready-to-Use Supplementary Foods for Prevention and Rehabilitation of Moderate Acute Malnutrition in Children

Undernourishment is a threat to human health. The prevalence of undernourishment remains alarming, especially among children under five years old in many countries, including Indonesia. Nowadays, the handling of undernourishment has shifted to treatment outside the hospital, utilizing local nutrient-rich foods. At the national level, the utilization of local food resources is a part of the promotion of dietary diversification and the bioeconomy. Ready-to-use supplementary food (RUSF) refers to supplementary foods aimed at improving the nutrition of moderate acute malnutrition (MAM) children under five years old. RUSF biscuit recipes were made using local food resources available in Banten province, Indonesia. To optimize the nutritional profile of the developed RUSF, taro/talas banten were mixed with ground-nut/peanut (Arachis hypogaea L.) and mungbean (Vigna radiata) as protein and lipid sources and red rice (Oryza longistaminata) and maize (Zea mays) as carbohydrate sources, and enriched by the local banana Nangka (Musa textilia). Two formulations were selected for the pilot testing, namely the taro-peanut and taro-peanut/mungbean RUSF biscuits, made from taro Banten, cereal, peanut and/or mungbean, and local banana. The RUSF biscuit showed promising results, presenting a high level of acceptance and a macronutrient composition that meets the standards for MAM children. However, the RUSF biscuits should be fortified with micronutrient premix to fulfill the dietary requirement for the MAM children. The results of this study provide further development opportunities.

Development of home-based ready-to-use supplementary food (RUSF-HB) to overcome nutrition-related problems among children under five during the covid-19 pandemic

The most direct causes of malnutrition are food consumption and infection. Yet the prolonged Covid-19 pandemic has limited low-income families’ ability to fulfil the need for nutrition consumption, particularly for children under five. Responding to this situation, we sought to develop home-based ready-to-use supplementary foods (RUSF-HB) from local ingredients that are energy-protein-dense, affordable, simple and easy to produce at home. We created three milk-free formulas (MFFs) and six standard formulas (STFs). Three cheap and abundant local foods: soybeans, cowpeas, and mung beans were combined with rice flour, refined sugar, and coconut oil. A cross-over study design was used to assess food organoleptic, which showed that the products were comparable in several sensory aspects except for the odour and the taste. Soybeans-based formulas contain slightly more energy and protein compared to mung beans or cowpeas-based ones. However, the mung beans-based formulas were more favourable to caregivers and children, particularly their taste and smell. The products contain slightly less energy than the recommended ones but high enough to supply macronutrient for those in need on a regular basis. The caregivers considered the total price for the products was affordable, and the formula was easy to follow.

STUDY ON SUBSTITUTION OF Moringa Oleifera FLOUR AND BREADFRUIT FLOUR (Artocarpus altilis) IN MAKING SUPPLEMENTARY FOODS FOR PREGNANT WOMEN

This research aims to determine the organoleptic properties and nutritional value of the biskuit formulation by substituting Moringa leaf flour and breadfruit flour as a modified form of PMT biskuits for pregnant women. The breadfruit flour which has a high carbohydrate and fiber content and moringa flour have rich in iron can be used in substituting biskuits as supplementary food for pregnant women. This study used a completely randomized design with four variations of biskuit formulation with breadfruit and moringa flour substitutions, namely F0 (kontrol), F1 (20 g moringa flour: 40 g breadfruit flour), F2 (15 g moringa flour: 30 g flour. breadfruit), F3 (10 g moringa flour: 20 g breadfruit flour). Data were analyzed using ANOVA and followed by Mann Whitney at the 95% confidence level (α: 0.05). The results showed that difference based on the supplementary food biskuit formulation of pregnant women with Moringa leaf flour and breadfruit flour on color, aroma, texture, and taste. The results of the organoleptic test on biskuits showed that F0 was the most preferred in terms of color, taste, aroma, and texture. The higher of moringa flour and breadfruit flour substitution , the lower the overall preference for the resulting biskuits. Based on the results of the proximate biskuit test, it is known that the F1 formulation has the highest energy content, protein content, fat content, ash content, and iron content compared to other formulations. The water content and carbohydrate content of F1 formulation biskuits had the lowest levels.

Development of Gluten-Free Sorghum Cookies with Different Vegetable Oil Sources

Aims: Lipids have important role in cookies production depending on their nature and function. In this study, the effect of refined cottonseeds oil (RCO), refined palm oil (RPO), and red (or crude) palm oil (CPO) on physicochemical characteristics of gluten-free sorghum cookies was evaluated and compared to control gluten-free cookies produced with a margarine (M20). Methodology: RCO and RPO were incorporated at the level of 20 % and CPO at the level of 16%. The physicochemical characteristics were determined according to standard methods of analysis. Results: Moisture, ash, proteins, lipids, sugar, fiber, pH, fat acidity, and energy value were ranged respectively between 0.12 ± 0.05 and 1.72 ± 0.02 % ; 2.00 ± 0.00 and 2.34 ± 0.01% (g/100g DM) ; 6.91 ± 0,08 and 7.49 ± 0.07% (g/100g DM) ; 20.61 ± 0.01 and 25.62 ± 0.53% (g/100g DM) ; 61.71 ± 0.52 and 65.79 ± 0.23% (g/100g DM) ; 3.41 ± 0.52 and 8.02 ± 2.04% (g/100g DM) ; 7.01 ± 0.00 and 7.36 ± 0.00; 0.03± 0.00 and 0.11 % of H2SO4 ; 462.70 ± 8.17 and 505.79 ±5.32 Kcal. The use of RCO and RPO induced significantly increase of the fat content. But, the moisture, ash, fat, sugar and the energy of the experimental and control cookies are in accordance with the recommended value of the guidelines of codex Alimentarius on supplementary foods for older infants and young children. Conclusion: RCO, RPO and CPO exhibit the potential to be used as substitutes to margarine in the production of gluten-free cookies with interesting nutritional values.

Tıbbi ve Aromatik Bitkilerin Ekstraksiyon Yöntemleri, Gıdalarda Kullanımı ve Takviye Edici Gıda Alanında Değerlendirilmesi

Medicinal and aromatic plants (MAPs) have come to the fore in the last two decades with the increasing interest of consumers in natural nutrition and life. Turkey has an important place in terms of MAPs thanks to its geographical location, climate, and plant diversity. MAPs, which show a wide variety, are available in various forms (whole, ground, powder, extract (liquid extract), extract (dry extract), hydrosol or essential oils) due to their flavor, odor, taste, antimicrobial, antioxidant and therapeutic effects. Due to the secondary metabolites in their composition, their use as a functional food ingredient and food supplement besides medicine and pharmacy is also important. In recent years, globalization, urbanization, changing living conditions and divergence of nutritional habits have led consumers to supplementary foods. Necessary regulations have been made in this field with the use of more MAPs in the food supplements market. In this review, some information about MAPs and their use in the production of food supplements are included.

A Sociocultural Perspective on Malnutrition in Children: Evidence from POSHAN Programme, Rajasthan

Integrated Management of Acute Malnutrition or POSHAN Phase 2.0 was implemented in 20 districts of Rajasthan in 2018. After 12 weeks of outpatient therapeutic care of children with Severe Acute Malnutrition (SAM), 70.4% children were cured, 12.2% defaulted and 17.4% were non-recovered and referred to Malnutrition Treatment Centres for facility treatment. The research study attempts to (a) study the sociocultural factors at the family level responsible for varying numbers of cured, defaulted and non-recovered SAM children at different localities; (b) explore the probability of the SAM children staying healthy post successful treatment at community settings without any external intervention; and (c) explore the possible approaches beyond the emergency medical response to develop a long-term strategy to address malnutrition in children. The insights and cues gained from the phenomenology of individual experiences help us understand the structural elements that undergird a healthy living. It was observed that irrespective of socio-demographic characteristics and food basket of a family, all the SAM children had a troubled medical history and/or low birth weight. The research findings also point out that a rise in income alone does not automatically lead to increased nutritional food intake. It is also important to see the issue of malnutrition in the larger context of the agrarian crisis that has cast its shadow over the rural landscape. For sustainable and lasting solutions, it is essential to shift to and promote farming practices that facilitate indigenous, locally produced and culturally acceptable nutrition from supplementary foods.

Nutritional education during rehabilitation of children 6–24 months with acute malnutrition, under unavailability of therapeutic/supplementary foods: a retrospective study in rural Angola

Background Dietary counseling can play an important role in managing child malnutrition but is often inadequate or absent. Moreover, little emphasis is given to the usefulness of local available foods in the rehabilitation of malnourished children. This study aimed to evaluate the adherence and effectiveness of nutritional education during rehabilitation of children (6–24 months) with acute malnutrition, in a setting of unavailability of therapeutic/supplementary foods. Methods Retrospective observational study on the adherence to dietary counseling and the impact on growth in children 6–24 months who were referred for acute malnutrition at the Catholic Mission Hospital of Chiulo (Angola) from August 2018 to January 2019. Main outcome measures were change in dietary habits and growth gain. Results Sixty-four out of 120 children returned at first follow-up visit (default rate 47%). A change in dietary habits was reported in 32/64 (50%) children. Changing dietary habits was associated with an improved change in weight gain (MD 9.3 g/kg/day, 95%CI 4.2 to 14.3; p = 0.0005) and in weight/height ratio (MD 1.1 SD, 95%CI 0.7 to 1.4; p < 0.0001). Conclusions A change in dietary habits after discharge was noted in only half of the patients who returned at first follow up visit, but it provided some advantages in term of weight gain and weight/height ratio. Further studies are needed to identify children at risk of low adherence to follow-up visits and low compliance to the nutritional recommendations, in order to increase the effectiveness of rehabilitation programs.

Seminole Food: Patterns of Indigenous Foodways in South Florida, 1855 to 1917

Few systematic historical studies of Seminole Indian foodways in Florida exist, fewer even for the critical period between Removal and World War I. This paper aims to fill the gap in related foodways and historical literature, while establishing a starting point for zooarchaeological and archaeobotanical studies on the topic. It addresses the issue from the ground up, developing an inventory of Seminole selective preferences in terms of food and tracking changes in those preferences over time. The study borrows the use of presence/absence matrices from archaeology to facilitate that analysis, treating an extensive set of related documents as a stratified matrix in which historical observations of Seminole food consumption are recorded by food type. It relies on Seminole oral histories to supplement the document index by providing additional information as to food preferences and taboos. Results of data analysis lead me to the conclusion that two complimentary channels of foodways existed among Seminole Indians in South Florida at the time: (1) a conservative channel that maintained symbolically and nutritionally important foods and, (2) a more flexible channel that allowed for the incorporation of supplementary foods of various origins.

“A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE AND ATTITUDE AMONG MOTHERS OF INFANTS REGARDING WEANING PRACTICES IN SELECTED RURAL COMMUNITIES”, HARIDWAR, UTTARAKHAND

The children of today are citizens of tomorrow. During the rst 4-6 months of life, infants need only breast milk or formula to meet all their nutritional needs. After that, it is essential for mothers to give supplementary foods in addition to breast feeding because several developmental milestones take place in the child. The research design adopted for this study was descriptive survey design. The sample non-probability convenient sampling technique was adopted for selection of subject. This includes 100 mothers of Infants (6-12 months) sample in selected rural communities, Haridwar. Result: The result of this study that knowledge and attitude had no signicant difference. Conclusion: In this study showed that attitude score is better than knowledge score. Because majority of mothers of infants was had positive attitudes towards weaning practices.