ABSTRACT
Complementary foods (CF) are needed to fill the gap between
total nutritional needs of the child and the amounts provided by the breast
milk from six months of age. This study assessed the nutrient composition of
commonly used complementary foods (CCCF) in Kaduna North local government area
of Kaduna state and then formulates a composite blends of complementary foods
(CBCF) using Elizabeth Stuart Hands and Associate (ESHA) nutrient analyser
software. Nutrients composition of the CCCF, ESHA formulated complementary food
(EFCF) and Commercial Complementary Foods (CMCF) were analysed using standard methods.
The results revealed that about 67% of respondents introduced water from birth
and complementary foods were introduced by majority of the caregivers (52%)
between 3- 6 months. Commonly used complementary foods are sorghum pap (67%),
sorghum-soybean-groundnut blend (14%), commercial formulas (12%), millet pap
(5%) and maize pap (2%). The proximate composition (g/100g dry weight basis)
shows that moisture content (10.63±0.11) of sorghum pap (SP) was significantly
higher (P<0 .05="" 0.38="" 432.29kcal="" a="" acids="" alanine="" all="" amino="" analyser="" and="" ap="" as="" ash="" b1="" by="" calories="" carbohydrates="" cccf.="" cf="" cmcf="" compared="" complementary="" composition="" crude="" cysteine="" developed="" efcf="" energy="" esha="" essential="" except="" fat="" fibre="" food.="" foods.="" had="" higher="" histidine="" in="" ip="" iron="" is="" leucine="" maize="" methionine="" millet="" moisture="" name="page7" non-essential="" nutrient="" of="" other="" pap="" phenylalanine="" protein="" revealed="" sgsp="" significant="" significantly="" sorghum-groundnut-soyabeans="" than="" that="" the="" vitamins="" were="" when="" with="">
EFCF. Oleic acid
and bicycle (5,3,0) decapentaene were of higher proportion found as the
essential and non-essential fatty acids. The results suggest that with proper
selection of local ingredients, it is possible to formulate complementary foods
of high nutrients composition than the commonly consumed complementary foods.
CHAPTER ONE
1.0 Introduction
In Nigeria, under-nutrition remains a public health problem.
According to the 2013 National Demographic and Health Survey, in Nigeria, 37
percent of children under age 5 are stunted, 18 percent are wasted, and 29
percent are underweight (NDHS, 2013). The development of children‘s full human
potential depends on adequate nutrition during infancy and early childhood.
Exclusive breastfeeding is adequate for the first six months of life but timely
introduction of nutritionally-adequate, safe, age-appropriate complementary
feeding at sixth month of age is recommended for better health and development
of infants (WHO, 2003). The World Health Organization recommends that
breastfeeding should continue with appropriate complementary feeding from 6
months to 2 years and beyond (Zere and McIntyre. 2003). According to the
Nigeria Demographic and Health Survey (2008) only 30 percent of infants aged
6-23 months and living are fed in accordance with the recommendation for infant
and young children feeding practices (NDHS, 2008). Problems associated with complementary
feeding in particular include poorly timed introduction of complementary foods
(too early or too late), bottle-feeding, infrequent feeding, unsupervised
feeding, poor feeding methods, poor hygiene, and child care practices (Shordt
and Cairncross, 2004)
Malnutrition is responsible for more than 41% of the deaths
that occur annually in children from 6 to 24 months of age in developing
countries which total approximately 2.3 million. Moreover, one third of deaths
among children less than five years of age are attributable to nutrition and
well above two thirds of these deaths, often associated with inappropriate
feeding practices, occur during the first year of life (Sandoval- Priego et al.,
2003). Inadequate feeding of girls affects nutrient stores, leading to poor
obstetrics outcome when they are having children
later in life. Other consequences include growth failure and stunting, delayed
sexual development, reduced muscle mass and strength, impaired intellectual
development, weakened immune system, poor cognitive performance and learning
achievement and increased lifetime risk of osteoporosis (WHO, 2003).
Every year, more than 200 million children under five years
old fail to reach their full cognitive and social potential. Most of these
children live in South Asia and sub-Saharan Africa (Sandoval- Priego et al.,
2003). Among preventive measures that would reduce the excess mortality for
children under the age of five years, exclusive breast feeding and good quality
complementary feeding have been listed as first and third, respectively, with a
calculated 600,000 deaths per year preventable by good complementary feeding
(i.e. 6% of deaths) (Jones et al., 2003). Growth faltering occurs mainly in the
first two years of life because of high nutritional needs for growth and
development between 6-24 months (IOM, 2006). In fact, the percentage of
children who are underweight almost doubles from 14% among children less than 6
months of age to 26% among children age 12-17 because complementary foods are
introduced to children in the latter group, thus increasing exposure to
infections and susceptibility to illness (NDHS, 2008).
In Nigeria, and indeed most developing countries, the
underlying problems have been identified to include poverty, inadequate
nutrient intake particularly during pregnancy, period of rapid growth and
complementary feeding in infants, ignorance about nutrient values of foodstuff
and parasitic infections (NPAN, 2002). Result of the 2001- 2003 Food
Consumption and Nutrition Survey showed a steep increase in the incidence of
child wasting between 6 and 12 months, which is the period of complementary
feeding for most children (IITA, 2004).
A common feature of plant foods is
their high content of water, fibre, low energy and micronutrient densities
(Solomon, 2000). This characteristic becomes particularly worrisome during the
complementary feeding period in infants and children. Hence, traditional
complementary foods from plant staples often fail to meet the nutritional needs
of the infants, due to stiff consistency and high volume which combine to offer
a low-cost filling meal that often lacks adequate nutrients (Fernandez et al,
2002). They are therefore known to poorly support growth and development.
Complementary feeding practices must be improved. Too often,
complementary foods are introduced too soon or too late. The frequency and
amounts of food that is offered may be less than required for normal child
growth, or their consistency or energy density may by inappropriate in relation
to the child's needs. Conversely, too much of a poor complementary food could
displace the more nutritive breast milk in the child's diet. Other factors,
such as the pattern of feeding (e.g., whether to breastfeed and follow it with
complementary foods, or vice versa) may effect breast milk intake. In addition,
the nutrient content of these foods may be inadequate or the absorption could
be impaired by other components in these foods. Storage safety is important as
well(NNN, 2000; NACMD, 2003).
Also very importantly, responsive feeding, maternal
encouragement to eat and other psychosocial aspects of care during feeding
likely to be important for ensuring adequate food and nutrient intake of the
child. The complete understanding of what must be done to improve complementary
feeding is somewhat limited due to the complexity of the behaviour. The
necessary behaviours and foods change rapidly with the child's age and breast
milk intake. Based on these recommendations, a joint FAO/WHO (1998)
consultative forum in 1998, established the scientific basis for the
development and evaluation of Food- Based Dietary Guidelines (FBDG) for various
regions of the world.
Sequel to this, the Federal Ministry
of Health (FMOH) in Nigeria published the Food-Based Dietary Guidelines (FMOH,
1999). The guidelines recommended some sustainable food-based approaches that
encourage dietary diversification through the production and consumption by all
population groups, of both macro- and micro-nutrient-rich foods, including
traditional foods found in different parts of the country. The report
recommended the use of staple starchy roots, tubers and cereals in combination
with legumes, vegetables, fruits and if possible animal sourced foods in
preparing complementary foods for infants and children. Based on these
recommendations, different variables affecting micronutrient intake and ways to
combat deficiency have been considered in several nutrition fora (NNN, 2000;
NACMD, 2003). Besides, the reports by many researchers on the nutritive
potentials of cereals, legumes, vegetables and fruits in the formulation of
complementary foods have been promising (Badamosi et al, 1995; Owolabi et al.,
1996; FAO, 1997; Okoh, 1998; Ladeji et al, 2000;). It is imperative that blends
of such foodstuffs found in various communities be formulated and biochemical
studies be carried out on their composites for possible use as complementary
foods. This study, which is part of an exploratory effort on the improvement of
the nutritional quality of traditional complementary foods, was designed to use
staple foodstuffs indigenous to Kaduna State to formulate composite blends that
can be nutritious, readily available and affordable to both rural and poor urban
mothers. Findings from the study would offer answers to the questions (a)
whether such local blends can meet the various dietary recommendations for
infants and children and (b) whether they can substitute the more expensive
proprietary formulas sold in the markets.
In Nigeria, thirty-seven (37%) percent of children under the
age five years are stunted, eighteen (18%) percent are wasted, and twenty nine
(29%) percent are underweight. Infants and under-5 mortality rates in the past
five years are 69 and 128 deaths per 1,000 live births, respectively. At these
mortality levels, one in every 15 Nigerian children die before reaching age one
year and one in every eight do not survive to their fifth birthday (NDHS,
2013).
Most families depend on locally formulated diets to feed
infant and young children. The locally formulated foods (pap and porridges) are
low in protein and high in anti-nutritional factors that reduce the
bioavailability of some micronutrients. Poor processing and cooking methods
also contribute substantially to loss of micronutrients, leading to
micronutrient deficiency disorders in infants fed these foods (Saskia and
Martin, 2009).
Complementary feeding practices must be improved. Too, often
are introduced too soon or too late. The frequency and amounts of food that is
offered may be less than required for normal child growth.
1.2 Justification
Complementary foods are needed to fill the gap between the
total nutritional needs of the child and the amounts provided by breast milk.
There is an alarming high rate of malnutrition in North Western region of
Nigeria with Kaduna State second to Kebbi State (NDHS, 2013). Complementary
foods are not introduced in a timely fashion for all children. Overall, only 10
percent of children ages 6-23 months are fed appropriately based on recommended
infant and young child feeding (IYCF) practices (NDHS, 2013).
The period from conception to age 2
is especially important for optimal physical, mental, and cognitive growth,
health, and development. However, this period is often marked by protein-energy
and micronutrient deficiencies that interfere with optimal growth hence the
need for safe, nutritious and affordable complementary foods (NDHS, 2013).
Proprietary formulas are usually considered nutritious,
acceptable and safe to the infant but their high cost has put them beyond the
reach of most families, especially those in the low income ―bracket.
1.4 Aim and
Objectives of the Study
1.4.1 Aim
The aim of the study is to survey commonly used complementary
foods and use the available ingredients to formulate composite blends of ready
to use complementary foods and assess the nutrient density.
1.4.2 Specific
Objectives
1. To identify the commonly used complementary foods in Kaduna
North LGA, Kaduna State.
2. To assess the nutrient composition (macro and micronutrients)
of the commonly used complementary foods.
3. To develop complementary food (CF) blend from locally
available foodstuffs using Elizabeth Stuart Hands and Associates (ESHA) Food
Processor and Nutrient Analyser software.
4. To determine the nutrient composition
(macronutrients, vitamins and minerals) of the developed CF and compare with
that of the commonly consumed CF and a popular commercial formula.
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