Optimal dietary patterns designed from local foods to achieve maternal nutritional goals.

BACKGROUND: Achieving nutritional requirements for pregnant and lactating mothers in rural households while maintaining the intake of local and culture-specific foods can be a difficult task. Deploying a linear goal programming approach can effectively generate optimal dietary patterns that incorporate local and culturally acceptable diets. The primary objective of this study was to determine whether a realistic and affordable diet that achieves nutritional goals for rural pregnant and lactating women can be formulated from locally available foods in Tanzania. METHODS: A cross sectional study was conducted to assess dietary intakes of 150 pregnant and lactating women using a weighed dietary record (WDR), 24 h dietary recalls and a 7-days food record. A market survey was also carried out to estimate the cost per 100 g of edible portion of foods that are frequently consumed in the study population. Dietary survey and market data were then used to define linear programming (LP) model parameters for diet optimisation. All LP analyses were done using linear program solver to generate optimal dietary patterns. RESULTS: Our findings showed that optimal dietary patterns designed from locally available foods would improve dietary adequacy for 15 and 19 selected nutrients in pregnant and lactating women, respectively, but inadequacies remained for iron, zinc, folate, pantothenic acid, and vitamin E, indicating that these are problem nutrients (nutrients that did not achieve 100% of their RNIs in optimised diets) in the study population. CONCLUSIONS: These findings suggest that optimal use of local foods can improve dietary adequacy for rural pregnant and lactating women aged 19-50 years. However, additional cost-effective interventions are needed to ensure adequate intakes for the identified problem nutrients.

Context-specific food-based approach for ensuring nutrition security in developing countries: a review.

Sustainable food strategies for meeting nutrient needs in developing countries are not well established. The available evidence shows that more than one-third of the world's population is facing under-nutrition, of which the most affected individuals are children and mothers from poor countries. In most developing countries, losses resulting from malnutrition are between 3 and 16% of the gross domestic product. This burden is far larger than the donor-driven and government programmes can tackle alone. As such, an innovative approach, which is independent and not donor-based, is needed to reduce the burden of malnutrition in low-income countries. In this review, we describe a context specific food-based approach for addressing malnutrition in developing countries. The approach deploys the hybrid public-private delivery model that enables cost sharing and efficiency gains in resource-poor countries. The model influences players to consider consumers' perspectives, which often are neglected and truly engage them as key stakeholders.

Analysis of nutritional adequacy of local foods for meeting dietary requirements of children aged 6-23 months in rural central Tanzania.

BACKGROUND: Under nutrition remains a serious problem among children in Sub-Saharan Africa. Analysing how diets composed of local foods could achieve nutritional goals for infants and young children in low-income settings is essential. The objective of this study was to analyse how local foods can be used rationally and to what extent these foods can be supplemented to achieve nutrient requirements for children aged 6 - 23 months in resource-poor settings. METHODS: A cross-sectional study was carried out to estimate dietary intakes of 400 children aged 6-23 months using a 12-h weighed dietary record, 24-h dietary recalls, and 7-days food records. Anthropometric measurements on each subject were also taken. Analyses were done to establish the level of nutrient intake, and nutritional status of the study population using Microsoft Excel 2013 and ProPAN software version 2.0. RESULTS: The results showed that the prevalence of stunting, wasting and underweight for children aged 6-23 months was 30-41%, 1.5-3% and 4-9%, respectively. In addition, the results showed that diets that were consumed by the subjects comprised of local foods met vitamin A, vitamin C, protein and energy requirements for children aged 6-23 months. However, the extent of deficit in iron, zinc and calcium in baseline diets was large and difficult to meet under the existing feeding practices. CONCLUSIONS: The study shows that local foods in the study area have a potential to achieve recommended dietary intakes of some essential nutrients, and that interventions are needed to meet the required amount of iron, zinc and calcium for children aged 6-23 months. The interventions we propose here may encourage changes in traditional feeding habits and practices of the target population. Possible intervention options are (1) supplementation of local foods with nutrient-dense foods that are not normally consumed in the locality (2) providing new avenues for increasing the production and wide consumption of local nutrient-dense foods, or optimizing the way local diets are constituted so as to achieve nutrient recommendations for infants and young children.

Optimal formulations of local foods to achieve nutritional adequacy for 6-23-month-old rural Tanzanian children.

Background: Achieving nutritional goals of infants and young children while maintaining the intake of local and culture-specific foods can be a daunting task. Diet optimisation using linear goal programming (LP) can effectively generate optimal formulations incorporating local and culturally acceptable foods. Objective: The primary objective of this study was to determine whether a realistic and affordable diet that achieves dietary recommended intakes (DRIs) for 22 selected nutrients can be formulated for rural 6-23-month-old children in Tanzania. Design: Dietary intakes of 400 children aged 6-23 months were assessed using a weighed dietary record (WDR), 24-hour dietary recalls and a 7-days food record. A market survey was also carried out to estimate the cost per 100 g of edible portion of foods that are commonly consumed in the study area. Dietary and market survey data were then used to define LP model parameters for diet optimisation. All LP analyses were done using linear program solver (LiPS) version 1.9.4 to generate optimal food formulations. Results: Optimal formulations that achieved DRIs for 20 nutrients for children aged 6-11 months and all selected nutrients for children aged 12-23 months were successfully developed at a twofold cost of the observed food purchase across age groups. Optimal formulations contained a mixture of ingredients such as wholegrain cereals, Irish potatoes, pulses and seeds, fish and poultry meat as well as fruits and vegetables that can be sourced locally. Conclusions: Our findings revealed that given the available food choices, it is possible to develop optimal formulations that can improve dietary adequacy for rural 6-23-month-old children if food budget for the child's diets is doubled. These findings suggest the need for setting alternative interventions which can help households increase access to nutrient-dense foods that can fill the identified nutrient gaps.