The Impact of Animal Source food (ASF) on the Growth of Malnourished Children in Bachok, Kelantan: Randomized Controlled Intervention Trial

2014 ◽  
Vol 04 (06) ◽  
Author(s):  
Rohana AJ Wan Manan WM
2009 ◽  
Vol 30 (3_suppl3) ◽  
pp. S434-S463 ◽  
Author(s):  
Saskia de Pee ◽  
Martin W. Bloem

Reducing child malnutrition requires nutritious food, breastfeeding, improved hygiene, health services, and (prenatal) care. Poverty and food insecurity seriously constrain the accessibility of nutritious diets that have high protein quality, adequate micronutrient content and bioavailability, macrominerals and essential fatty acids, low antinutrient content, and high nutrient density. Diets based largely on plant sources with few animal-source and fortified foods do not meet these requirements and need to be improved by processing (dehulling, germinating, fermenting), fortification, and adding animal-source foods, e.g., milk, or other specific nutrients. Options include using specially formulated foods (fortified blended foods, commercial infant cereals, or ready-to-use foods [RUFs; pastes, compressed bars, or biscuits]) or complementary food supplements (micronutrient powders or powdered complementary food supplements containing micronutrients, protein, amino acids, and/or enzymes or lipid-based nutrient supplements (120 to 250 kcal/day), typically containing milk powder, high-quality vegetable oil, peanut paste, sugar, and micronutrients. Most supplementary feeding programs for moderately malnourished children supply fortified blended foods, such as corn–soy blend, with oil and sugar, which have shortcomings, including too many antinutrients, no milk (important for growth), suboptimal micronutrient content, high bulk, and high viscosity. Thus, for feeding young or malnourished children, fortified blended foods need to be improved or replaced. Based on success with ready-to-use therapeutic foods (RUTFs) for treating severe acute malnutrition, modifying these recipes is also considered. Commodities for reducing child malnutrition should be chosen on the basis of nutritional needs, program circumstances, availability of commodities, and likelihood of impact. Data are urgently required to compare the impact of new or modified commodities with that of current fortified blended foods and of RUTF developed for treating severe acute malnutrition.


Author(s):  
Esther Charlotte Evang ◽  
Tsige-Yohannes Habte ◽  
Willis Omondi Owino ◽  
Michael Bernhardt Krawinkel

Abstract Purpose In the rural Kenyan diet, the bioavailability of iron is low and predisposes the population to iron deficiency. Fruit pulp of the indigenous baobab tree contains significant amounts of vitamin C, which enhances non-heme iron bioavailability. We studied the impact of baobab fruit pulp (BFP) consumption on the hemoglobin (Hb) and iron status of Kenyan schoolchildren. Methods The single-blind randomized controlled intervention trial was implemented daily among apparently healthy schoolchildren aged 6–12 years with hemoglobin level < 12.2 g/dl. For 12 weeks, children in the intervention group (n = 29) received a drink with BFP, while the control group (n = 29) received an isoenergy drink without BFP. At baseline and endline, blood samples were taken. Results The development of hemoglobin, ferritin (FER) and soluble transferrin receptor (sTfR) did not differ significantly between the intervention and control groups. However, in the intervention group, Hb levels improved slightly (2.2%), while they decreased slightly (1.2%) in the control group. Levels of geometric means of sTfR remained almost unchanged (0.7%) in the intervention group and slightly worsened (2.7%) in the control group. In both the groups, geometric mean of FER levels decreased, yet to a smaller extent in the intervention (17.3%) than in the control (26.0%) group. Conclusion Even though no significant effects of BFP could be detected in this study, the identification of products such as BFP remains pertinent to help improve non-heme iron absorption in the most vulnerable populations.


2013 ◽  
Vol 83 (1) ◽  
pp. 59-66 ◽  
Author(s):  
Francisco Plácido Nogueira Arcanjo ◽  
Paulo Roberto Santos ◽  
Álvaro Jorge Madeiro Leite ◽  
Francisco Sulivan Bastos Mota ◽  
Sérgio Duarte Segall

More than two billion people suffer from anemia worldwide, and it is estimated that more than 50 % of cases are caused by iron deficiency. In this community intervention trial, we evaluated infants aged 10 to 23 months of age (n = 171) from two public child day-care centers. Intervention lasted 18 weeks. The 50-g individual portion (uncooked) of fortified rice provided 56.4 mg of elemental iron as ferric pyrophosphate. Capillary blood samples to test for anemia were taken at baseline and at endpoint. The objective of this study was to evaluate the impact of rice fortified with iron (Ultrarice®) on hemoglobin and anemia prevalence compared with standard household rice. For the fortified rice center, baseline mean hemoglobin was 113.7 ± 9.2 g/L, and at endpoint 119.5 ± 7.7 g/L, p < 0.0001; for the standard rice center, baseline mean hemoglobin value was 113.5 ± 40.7 g/L, and at endpoint 113.6 ± 21.0, p = 0.99. Anemia prevalence for the fortified rice center was 27.8 % (20/72) at baseline, and 11.1 % (8/72) at endpoint, p = 0.012; for the control center, 47.1 % (33/70) were anemic at baseline, and 37.1 % (26/70) at the end of the study, p = 0.23. The Number Needed to Treat (NNT) was 4. In this intervention, rice fortified with iron given weekly was effective in increasing hemoglobin levels and reducing anemia in infants.


2020 ◽  
Author(s):  
Martina Bientzle ◽  
Marie Eggeling ◽  
Simone Korger ◽  
Joachim Kimmerle

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.


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