Formulation of local food multimix sprinkle to enhance nutritional adequacy of preschool children in southernmost provinces of Thailand

@#Introduction: This study aimed to formulate an effective Food Multimix-Sprinkle (FMM-S) by using locally available materials. Methods: Fish (Threadfin bream), cow liver, and orange fleshed sweet potato (OSP) were cooked and dried by using applicable household (HH) method and drum drying (DD). Then, the dried materials were milled and sieved through a 20 mesh screen. Fish, cow liver, and OSP sprinkles were mixed in various proportions to meet nutrient level targets [at least 30% of Thai Recommended Dietary Allowance (RDA) for 1-3 years old children per 15 g serving size]. Results: Six alternative mixes were formulated. The mixture of 3 g of liver, 7 g of fish, and 5 g of OSP (3:7:5) when processed by HH method, and the mixture of 4 g of liver, 8 g of fish, and 3 g of OSP (4:8:3) when processed by DD method, had significant advantage in preference scores in all attributes over the others. Nutritional values of these formulas were 37-55% RDA of protein, 146-194% RDA of vitamin A, and 30-40% RDA of iron for a serving size. Conclusion: This study demonstrated that household preparation, as well as preparation using drum drying could be used to process raw fish, cow liver, and OSP into a sprinkle mix. The FMM-S provided appropriate amounts of protein, vitamin A, and iron to supplement nutrient intake in pre-schoolers. However, a consumer test is needed to ensure acceptance by the target population.

High prevalence of undernutrition among preschool children in Pattani Province, southern Thailand

@#Introduction: Malnutrition is one of the leading causes of childhood death. In the southern provinces of Thailand that are encountering a civil conflict, the extent of malnutrition among young children has not been adequately reported. Methods: A cross-sectional study was undertaken to assess the nutritional status of children aged 2-5 years enrolled in early childhood development centres (ECDC) in Pattani Province. A total of 112 ECDCs were randomly selected and 871 children who met the inclusion criteria were recruited. Anthropometric measurements were taken and nutritional status determined according to World Health Organization (2006) growth standards. Statistical analyses of nutritional indicators, namely wasting, stunting, underweight and Composite Index of Anthropometric Failure (CIAF) across sociodemographic variables were carried out. Binary logistic regression models, based on the different nutritional indicators, were used to determine the relationships between undernutrition status and associated factors. Results: Prevalence of wasting (7.7%), stunting (19.6%) and underweight (16.8%) were determined. Based on CIAF, 27.4% of the children were undernourished. Logistic regression odds showed that prevalence of all forms of undernutrition was statistically independent of sex and place of residence. Religion was associated with all four indicators of undernutrition. Stunting was associated with child’s age and religion, while underweight and CIAF were associated with the child’s age, religion and mother’s occupation. Conclusion: Prevalence of undernutrition was estimated to be high in comparison with the national average figure. The study findings highlighted the need for more effective nutrition promotion activities to alleviate undernutrition problems among young children in Pattani Province.

Development and validation of a dietary iron score for screening populations at risk for inadequate iron intake

@#Introduction: Inadequate iron intake is a determinant of iron deficiency. A simplified tool for dietary assessment is needed. This study aimed to develop a dietary iron scoring system (DISS) and to determine the validity of the dietary iron score (DIS) for screening populations at risk for inadequate iron intake. Methods: A three-step process was undertaken to develop the DISS, namely (1) iron score (IS) for each food was constructed based on its iron content per 100 g, adjusted for heme content equivalence; (2) the predicted modifying effect (PME) was formulated based on either enhancing or inhibiting effects of dietary constituents; (3) the DIS of a meal was obtained by multiplying the total IS and the PME of that meal. The validity of the DIS for screening populations at risk for inadequate iron intake was determined against absorbable iron calculated by the Hallberg & Hulthen algorithm. A probability of adequacy of absorbable iron intake of 0.75 was used as a cutoff in defining the population at risk. Results: There was a significant correlation between the absorbable iron and DIS (r=0.34, p<0.001). Using the Receiver Operating Characteristic (ROC) curve , three cutoffs of DIS, namely 5, 6 and 7, had comparable results. However, sensitivity (82.9%) and specificity (50.0%) was the best for DIS cutoff of 7. Conclusion: The proposed DISS is potentially a field-friendly tool for screening populations at risk for inadequate iron intake. Further verifications are needed, using more complete dietary data.