Sustainable Micronutrient Interventions to Control Deficiencies and Improve Nutritional Status and General Health in Asia

Am J Clin Nutr. 2014 Jan; 99(1):130-8. doi: 10.3945/ajcn.113.073700. Epub 2013 Oct 23.

The use of linear programming to determine whether a formulated complementary food product can ensure adequate nutrients for 6- to 11-month-old Cambodian infants 1,2,3

1. Jutta KH Skau,
2. Touch Bunthang,
3. Chhoun Chamnan,
4. Frank T Wieringa,
5. Marjoleine A Dijkhuizen,
6. Nanna Roos, and
7. Elaine L Ferguson

- Author Affiliations

1. 1From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (JKHS, MAD, and NR); the Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (TB and CC); Institut de Recherche pour le Développement, Montpellier, France (FTW); and the Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (ELF).

- Author Notes

• ↵2 Supported by the Consultative Research Committee for Development Research, Ministry of Foreign Affairs, Denmark, and the Sustainable Micronutrient Interventions to Control Deficiencies and Improve Nutritional Status and General Health in Asia (SMILING) Project.
• ↵3 Address correspondence and reprints requests to , Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark.

Abstract

BACKGROUND:

A new software tool, Optifood, developed by the WHO and based on linear programming (LP) analysis, has been developed to formulate food-based recommendations.

OBJECTIVE:

This study discusses the use of Optifood for predicting whether formulated complementary food (CF) products can ensure dietary adequacy for target populations in Cambodia.

DESIGN:

Dietary data were collected by 24-h recall in a cross-sectional survey of 6- to 11-mo-old infants (n = 78). LP model parameters were derived from these data, including a list of foods, median serving sizes, and dietary patterns. Five series of LP analyses were carried out to model the target population's baseline diet and 4 formulated CF products [WinFood (WF), WinFood-Lite (WF-L), Corn-Soy-Blend Plus (CSB+), and Corn-Soy-Blend Plus Plus (CSB++)], which were added to the diet in portions of 33 g/d dry weight (DW) for infants aged 6-8 mo and 40 g/d DW for infants aged 9-11 mo. In each series of analyses, the nutritionally optimal diet and theoretical range, in diet nutrient contents, were determined.

RESULTS:

The LP analysis showed that baseline diets could not achieve the Recommended Nutrient Intake (RNI) for thiamin, riboflavin, niacin, folate, vitamin B-12, calcium, iron, and zinc (range: 14-91% of RNI in the optimal diets) and that none of the formulated CF products could cover the nutrient gaps for thiamin, niacin, iron, and folate (range: 22-86% of the RNI). Iron was the key limiting nutrient, for all modeled diets, achieving a maximum of only 48% of the RNI when CSB++ was included in the diet. Only WF and WF-L filled the nutrient gap for calcium. WF-L, CSB+, and CSB++ filled the nutrient gap for zinc (9- to 11-mo-olds).

CONCLUSIONS:

The formulated CF products improved the nutrient adequacy of complementary feeding diets but could not entirely cover the nutrient gaps. These results emphasize the value of using LP to evaluate special CF products during the intervention planning phase. The WF study was registered at controlled-trials.com as ISRCTN19918531.

PMID: 24153341 [PubMed - in process]