ABSTRACT
Ready to-use-therapeutic food (RUTF) is a specially designed
product for the nutritional rehabilitation of severe acute malnutrition in
children over 6 months of age. The potential of Sesame-Wheat-Soya beans blend
(SWS-RUTF) as a candidate for local formulation of RUTF was determined. Three
products were formed with varying ratios; SWS-RUTF1 (sesame 25%, Wheat 10%,
soya beans 30%), SWS-RUTF2 (sesame 25%, wheat 15%, soya beans 25%), and
SWS-RUTF3 (sesame 20%, wheat 10%, soya beans 35%), while soya oil, sugar, and
mineral/vitamin mix constitutes the remaining 35%. Statistically significant
difference (P < 0.05) was observed in the proximate composition of the
products; carbohydrate ranged between 49% - 54%, crude protein (24% to 28%),
lipid (9% to 11%), and energy value 404kcal to 411kcal. The three formulations
had Amino Acid scores of 72, 65 and 75, PDCAAS; 62, 55, and 67, and Protein
efficiency ratio; 1.08, 1.07, and 1.10, respectively. The percentage change in
body weight of weanling albino rats used in the research show that all the
animal groups fed with SWS-RUTF had values that were not significantly
different from each other, but significantly (P < 0.05) lower than animal
group fed with Pea nut-based RUTF, and greater than animal group fed with
normal feed. Impact of the product on serum total protein was found to be
higher in groups fed with SWS-RUTF, but the difference was not statistically
significant (P < 0.05). Thus, the formulation made in this study may serve as
candidate for RUTF formulation if improved.
CHAPTER ONE
1.0 Introduction
Malnutrition is one of the major problems faced by most
countries in the world. Malnutrition has been defined by WFP (2000), as “a
state in which the physical function of an individual is impaired to the point
where he or she can no longer maintain adequate performance process such as
growth, pregnancy, lactation, physical work and resisting and recovering from
disease.” The term malnutrition is a broad term which literally means bad
nutrition, and technically refers to both over nutrition and under
nutrition.The problem of over nutrition which is associated with excessive
nutrients intakes is mostly found in advanced or developed countries. Whereas
under nutrition is more prevalent in developing countries particularly in
sub-Saharan Africa and Southeast Asia. It occurs when people do not consume
food consistently, or the food consumed is not adequately absorbed by the body,
or the food is lacking in essential nutrients required by the body for its
normal functions.
In Nigeria, malnutrition (referring to under nutrition in
this case)among children is a very serious problem, accounting for about fifty
percent (50%) of one million (1 Million)deaths of children under five annually
(NDHS, 2013).About 2 out of every 5 Nigerian children are stunted, with rates
of stunting varying from one region to another across the country. Almost 30%
of Nigerian children are underweight, meaning that their weight is less than
the expected weight for their age. Wasting (i.e. being too thin for their
height) constitute about 18%(NDHS,2013). Severe acute malnutrition (SAM)
remains a major killer of children under five years of age. It is defined by a
very low weight for height (below -3z-scores of the median WHO growth
standards), by visible severe wasting, or by the presence of nutritional
(bilateral pitting) oedema (WHOet al., 2006). Children with SAM need to
be treated with specialized therapeutic diets in combination with diagnosis and
management of infections and other complications.(WHOet al.,2007).
Ready-to-Use Therapeutic Food (RUTF) is a key component for
the treatment of Severe Acute Malnutrition, which is linked to dramatically
increased childhood mortality. The term therapeutic food is used
generally to refer to foods or food products that are improved nutritionally so
as to have high energy and nutrients content, which are used in the treatment
of malnutrition. Ready-to-use therapeutic foods, from the name are therapeutic
foods that are consumed as given (without any form of cooking, or preparation)
for the management of malnutrition. RUTF contains all the energy and nutrients
required for rapid catch-up growth and are used particularly in the treatment
of children over 6 months of age with severe acute malnutrition without medical
complications (Manary, 2006).Some alternative RUTF formulations have been
proposed by SteveandJeya (2004), and are based on four main ingredients: a
cereal as the main ingredient, a protein source that can be of vegetal origin
(beans, legumes, etc.) or animal origin (milk, red or white meat, fish meat,
egg, etc.), a mineral and vitamin supplement (derived from vegetables, fruits,
or a mixture of both), and an energetic supplement (e.g. lipids, oil, sugar,
etc.).
Sesame (Sesamumindicum) is a flowering
plant in the genus Sesamum. It occurs mostly in
Africa and a smaller number in India. It is widely naturalized in tropical
regions around the world and is cultivated for its edible seeds, which grow in
pods. Sesame is one of the highest oil containing seed plants. It has a rich
nutty flavor and it is a common ingredient in cuisines across the world
(Ray,2011).
The soybean in the United State (U.S.), also called
the soya bean in Europe (Glycine max), is a specie of legume
native to East Asia, widely grown
for its edible bean
which has numerous uses. It is a leguminous plant with hairy
pod
that grows in clusters of three to five; each pod is 3–8 cm
long and usually contains two to four or more seeds. Soy flour has 50%
protein and 5% fiber. It has higher levels of protein, thiamine, riboflavin,
phosphorus, calcium, and iron than wheat flour (Lim, 2012).
Wheat (Triticumspp.) is a cereal
grain, originally from the Levant
region of the Near East but now
cultivated worldwide. Wheat is a major ingredient in many foods such foods as bread,
crackers,
biscuits, pancakes,
pies, pastries,
cakes, cookies,
and doughnuts.
In 100 grams, wheat provides 327 calories
and is an excellent sourceof multiple essential nutrients, such
as protein,
dietary
fiber, manganese, phosphorus
and niacin.
Several B vitamins and other dietary
minerals are in significant content (Zuzanaet
al., 2009).
1.1 Statement
of Research Problem
According to United Nations International Children Emergency
Fund(UNICEF) Country Representative, “There are approximately 1.7 million
acutely malnourished children under five in Nigeria – accounting for a tenth
(10th) of the global figure. Nearly about one thousand Nigerian
children die of malnutrition-related causes every day, reaching a total of
361,000 each year(Obi, 2015).However, the effectiveness of RUTF is limited
since they are not produced in Nigeria. Because the malnutrition management
programs are anchored on the availability of RUTF, without RUTF there is no
effective malnutrition management at the community level.
The cost for Community Management of Acute
Malnutrition(CMAM) is about US$160 for each child treated, including $76 for
the RUTF; the remaining $84 covers all other costs, including staff time and
training, transport and storage of supplies, and basic medicines (Obi, 2015).
The commercially produced RUTF, which are mainly bought and distributed by UN
agencies and non-governmental aid organizations, is a totally unaffordable
option for most parents of children with SAM.
Demand for RUTF has extensively increased. The endorsement
of a community based management approach to acute malnutrition in 2007 by World
Health Organization(WHO), World Food Programme(WFP), UNICEF and the United
Nations System Standing Committee on Nutrition (UNSSCN), resulted in the demand
for RUTF increasing to nearly 29,000 MT. The increased quantity represents the
treatment of more than 2 million children in 47 countries including Nigeria,
and has been driven by recent emergencies and greater programmatic acceptance
(WHO et al.,2007).
Only 20% of the global production of RUTF occurs in program
countries where therapeutic foods are used to treat malnutrition. Management of
SAM would be more effective if programmatic nations cannot continue to depend
on therapeutic foods manufactured in other countries (usually developed
nations) for their supply. As Nigeria is a country with a high burden of
malnutrition, the local production of RUTF is a logical next step; it will
increase availability, acceptability, access, and efficiency in supply, and
lower costs (Ojo, 2013).
A breakthrough in the RUTF production to reduce the cost
down could be the replacement of the milk powder in the RUTF recipe as
suggested by UNICEF.RUTF can be safely and easily produced in small or large
quantities in most settings worldwide. The local availability of the necessary
ingredients limits its use in some settings, and further investigation into
alternative ingredients is needed to overcome this limitation (Manary, 2006).
1.3 Aim
The aim of this study was to formulate and nutritionally
evaluate a potential ready to use therapeutic food formulated from sesame,
wheat and soya beans blend.
1. To
formulate a potential RUTF using sesame, wheat and soya beans (SWS-RUTF).
2. To
determine the proximate composition, minerals, andantinutrient contents of the
potential SWS-RUTF.
3. To
assess protein quality of the potential SWS-RUTF
4. To determine the effect of consumption of the potentialSWS-RUTF on growth and levels of serum proteins of weanlings albino rats.
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