Improving Iron Status of Children: Potential of Amaranth
Schlüsselwörter
Abstrakt
Beschreibung
Background and Rationale The most severe problems of micronutrient deficiency are found amongst resource poor, food insecure and vulnerable households in developing countries. From the 1999 Kenya national survey on micronutrients, it was estimated that seven out of every ten children under five years are likely to be anaemic (Hb<110g/L) and nearly half (43.2%) were iron deficient.
The period of complementary feeding is a critical and vulnerable time in the growth and development of children. Poor complementary feeding practices combined with chronic food insecurity are found to substantially contribute to the widespread multiple micronutrients deficiencies in developing countries.
A recent food consumption study in Mwingi district in Kenya, showed that ugali (stiff maize porridge) was the primary complementary food. The use of ugali as the primary complementary food suggests that the children may be at risk of inadequate micronutrient intake among children 12-23 months. These findings underscore the need to establish solutions to increase dietary diversity and to promote use of foods that are rich in nutrients such as iron.
Amaranth grain offers the prospect of considerably improving dietary food diversification in semi arid areas. Agronomic investigations indicate that amaranth grain contains high iron concentrations ranging from 7.6-27 mg/100g of edible portion. Amaranth grain is a hardy crop and can withstand low rainfall. As such, grain amaranth may offer a viable solution in semi-arid areas where iron rich foods such as animal and fortified products are not readily available.
This study has therefore been designed to investigate the efficacy of porridge made from amaranth enriched maize flour in improving the diet quality and iron intake in children 12-59 months in a semi-arid area in Kenya. Home fortification of complementary foods using micronutrient powders has also been shown to reduce iron deficiency anaemia in many resource-poor settings including Kenya.
Objectives The primary objective of this study is To determine the efficacy of maize porridge enriched with amaranth grain flour on improving iron intake and status in children 12-59 months in a semi arid area in Kenya.
In addition we aim:
- To determine the efficacy of amaranth grain enriched maize porridge compared to maize porridge fortified with micronutrient multi-mix powder (MixMe™) to improve iron status and intake of children 12-59 months.
- To determine the iron, zinc and nutritional status of children 12-59 months.
Hypothesis
We hypothesize that:
- Children receiving amaranth grain enriched maize porridge will show greater improvement in iron status than those receiving plain maize porridge.
- Children receiving amaranth enriched maize porridge will show less improvement in iron status than those receiving maize porridge fortified with micronutrient multi-mix powder (MixMe™).
Study Area and Population The study will be conducted in Migwani within the larger Mwingi District in Eastern Kenya. This area falls within the arid and semi arid area (ASAL) and thus experiences food shortage for most part of the year. The study population will comprise children aged 12-59 months. Mothers or principal caretakers will be interviewed on behalf of the children.
Study Design The study will have a randomized controlled trial design conducted over a period of 4 months/16 weeks.
The administrative study area has been purposively selected as it falls within an agro-ecological zone of a semi-arid area. Random sampling out of a total of six Sub-locations in Migwani will be done to get 4 Sub-locations. Within a Sub-location, individual sampling units (Household with a child aged 12-59 months) will be selected using a random walk method until the required sample size of 68 children is achieved per Sub-location. Children who meet the inclusion criteria shall be randomly assigned to one of the following treatment groups:
1. Maize porridge enriched with amaranth grain flour
2. Maize porridge fortified with a multiple micronutrient powder (MixMe™)
3. Plain maize porridge
Termine
| Zuletzt überprüft: | 09/30/2010 |
| Zuerst eingereicht: | 10/17/2010 |
| Geschätzte Einschreibung eingereicht: | 10/18/2010 |
| Zuerst veröffentlicht: | 10/19/2010 |
| Letztes eingereichtes Update: | 09/27/2011 |
| Letztes Update veröffentlicht: | 09/28/2011 |
| Tatsächliches Startdatum der Studie: | 09/30/2010 |
| Geschätztes primäres Abschlussdatum: | 05/31/2011 |
| Voraussichtliches Abschlussdatum der Studie: | 05/31/2011 |
Zustand oder Krankheit
Intervention / Behandlung
Dietary Supplement: Maize and Amaranth
Phase
Armgruppen
| Arm | Intervention / Behandlung |
|---|---|
| Experimental: Maize porridge with Amaranth Maize porridge enriched with amaranth grain flour at 70:30 maize/amaranth ratio (80g/day) | |
| Active Comparator: Maize flour with multiple micronutrients Maize porridge fortified with a multiple micronutrient powder (MixMe™) | |
| Placebo Comparator: Maize Porridge Plain maize porridge group |
Zulassungskriterien
| Altersberechtigt für das Studium | 12 Months Zu 12 Months |
| Studienberechtigte Geschlechter | All |
| Akzeptiert gesunde Freiwillige | Ja |
| Kriterien | Inclusion Criteria: - Aged 12-59 months at the time of entry into the study - Resident in village for at least 6-months and the caretaker plans to remain in the area for the next year - Apparently healthy at the time of entry into the study Exclusion Criteria: - Severe anaemia i.e. Hb concentration <70 g/L (See section 5.5) - Taking iron containing haematinic supplements - Transfused in the last six months - Severely undernourished i.e. anthropometric indices <-3 Z score |
Ergebnis
Primäre Ergebnismaße
1. Hemoglobin [Start of study (T=0), End of study (T=4months)]
Sekundäre Ergebnismaße
1. Iron Status [Begin (t=0), End of study (t=4 months)]
