Intakes from Complementary Foods Consumed by Young Children (Aged 12-23 Months) from North Wollo, Northern Ethiopia, are Inadequate in Calcium, Zinc, Vitamin A and C but not in Iron.

Objectives: To characterize current feeding practices and to evaluate the adequacy of selected micronutrient intakes of young children in subsistence farming rural households in North Wollo, Ethiopia. Methods: Using a cross-sectional survey on 76 breastfed young children (aged 12-23 months) in two rural villages in Gobalafto district, data on the socio-demographic status, anthropometry and complementary feeding practices were collected. Two, in-home, non-consecutive 24h recalls were conducted to estimate intakes in iron, zinc, calcium, vitamin A, and vitamin C. Intakes were compared with estimated needs based on WHO/FAO recommended intakes, assuming average breast milk intake and composition. Results: About 33% (25 / 76) of the children were stunted. Complementary foods were predominantly cereal and legume based with little consumption of animal products, fruits and vegetables. The children's diet was entirely that of the family with little or no special attention. The contribution of animal source foods (ASF) to intakes of Ca, Fe and Zn was less than <5 %. Intakes of Ca, Zn, vitamin A and vitamin C from complementary foods were below WHO recommendations. However, iron intakes (mg) and densities (mg/ 100 kcal) met WHO recommendations even when assuming low bioavailability. Conclusions: Multiple micronutrient deficiencies and inadequate complementary feeding practices are likely in these communities. Food fortification or efforts to enhance dietary diversity by including ASF, dairy, and fruits and vegetables rich in vitamin A and vitamin C are needed. Further investigations are needed on the source (intrinsic/extrinsic) and bioavailability of the iron in these cereal-based complementary foods.

Iron Contamination in Cereal-based Products in Africa Can Challenge the Accurate Estimation of Iron Intakes.

Objectives: To characterize the changes in iron content through cereal processing for a better evaluation of iron intakes and its origin. Methods: Most frequently used processing methods of maize, millet, sorghum, barley, wheat and teff were followed (n≥3) in households in Benin, Burkina Faso and Ethiopia. Iron contents in raw materials, intermediary and final products were analyzed by atomic absorption spectrometry. In vitro iron dialyzability studies were performed on final products to characterize iron behavior during digestion. Results: Threshing, decortication, soaking, milling, sieving, fermentation and cooking were the unit operations most often included in traditional processing of cereals. Although decortication or soaking led to iron losses, other processing steps often led to substantial increases in iron contents (3 to 10 times or more) in final products. This contaminant iron came either from the soil or from processing equipments used for decortication and milling or cooking utensils. After in vitro digestion of dishes prepared with iron-contaminated or uncontaminated flours, the contaminant iron was mainly found in the insoluble fraction and thus not likely available for absorption. However, in some cases, a small proportion of the contaminant iron was found in the soluble or dialyzable fractions, suggesting that a very small part could be absorbable. Conclusions: Iron content in “as eaten foods” is the result of gains and losses that occur during processing. Contaminant iron in African cereal-based foods may lead to an overestimation of the satisfaction of iron requirement, implying the necessity to determine the share between intrinsic and extrinsic iron.

Adequacy of Iron and Zinc Contents and Estimated Bioavailability in Commercially Available Complementary Foods in Ethiopia.

Objectives: Evaluate the adequacy of iron and zinc contents and estimated bioavailability of complementary foods (CFs) processed in Ethiopia. Methods: Seven locally-produced fortified and non-fortified cereal-based CFs were purchased from supermarkets in Addis Ababa, Ethiopia. Iron and zinc contents were determined by atomic absorption spectrometry and results were compared with recommendations for fortified CFs. Phytate particularly myo-inositol hexaphosphate (IP6) was determined using high-performance anion-exchange chromatography. Iron and zinc bioavailability was estimated by calculating IP6-to-mineral molar ratios. Results: Iron and zinc contents of CFs were in the range of 5.85-22.31 and 0.80-12.07 mg/100g DM, respectively. The contribution to iron and zinc requirement assuming a daily intake of CF equal to the recommendations (i.e. 40 and 60 g for the 6-11 and the 12-23 month-old children, respectively) was 21-81% and 6-97% for 6-11 months and 50-100% and 10-100% for 12-23 month-old children respectively. With IP6 content in the range of 235-893 mg / 100 g DM, the molar ratios of [IP6]:[Fe](0.89-7.07) and [IP6]:[Zn] (1.93-30.63) were above the recommendations for most CFs analyzed. Conclusions: All CFs analyzed had iron content below the recommendation for 6-11 month-old children but 5 out-of 7 CFs contained adequate iron for 12-23 month-old children. Regarding zinc, only 2 out-of 7 CFs could contribute to more than 80% of the requirement for both age groups. Mineral-to-phytate molar ratios also predicted low bioavailability. Therefore, manufacturers need to consult nutritionists to define proper fortification of processed CFs and for further modification of their processing methods to improve mineral bioavailability, so that children meet their daily nutrient requirements.