Bioaccessibility of Iron and Zinc from Micronutrient Powder Added in Germinated Porridges among Children Aged 6-23 Months in Homabay County, Kenya
Moraa, Momanyi Susan
MetadataShow full item record
Iron and zinc deficiency remains a burden among Kenyan children. Point-of-use fortification of complementary foods using micronutrient powder [MNP] containing vitamins and minerals has been recommended to improve the health and nutrition of children aged 6-23 months. Evidence-based information on different food vehicles for optimum bioavailability of micronutrients from the MNP is lacking. The main objective of this study was to determine the bioaccessibility of iron and zinc from micronutrient powder added in germinated porridges in children aged 6-23 months in West Kwabwai location, Homabay County, Kenya. Phase 1 of the study was the in vitro bioaccessibility of iron and zinc from germinated and non-germinated maize, millet and sorghum porridges with MNP. Non-germinated or germinated cereals were milled to flour. Porridge was cooked following the local known procedures. One-gram sachet of MNP [10mg iron as NaFeEDTA and 4.1mg zinc] was added to a 250ml cup of cooked porridge. Iron and zinc bio-accessibilities [%] were measured using in vitro dialysability methods. Factorial ANOVA was used to determine the effect of germination and cereal type on iron and zinc bioaccessibility. Phase 2 was conducted to establish the acceptability of different germinated porridges with MNP among children. The trial was single blind cluster randomized parallel study for 8 weeks with four sub-locations being randomized. A total of 200 children were selected by simple random sampling. A questionnaire and a morbidity data sheet were used to collect data on the amount of porridge consumed and health status of children, respectively. The acceptability trial data was analyzed using ANOVA. Phase 3 determined the anthropometric, iron and zinc nutritional status, and dietary intake of children. A descriptive cross sectional survey was done in the location. Using a population weighted simple stratified sampling method, 314 children were selected in the three sub-locations. Structured questionnaires were used to collect data on sociodemographic status, and anthropometric measurements of children. Food frequency questionnaire and a 24-hour dietary recall questionnaire were used to identify the complementary foods and to assess the dietary adequacy, respectively. ENA for SMART software was used for analysis of anthropometric data while Nutri-survey was used for analysis of nutrient intake. Serum content of iron and zinc were determined by spectrophotometric method. Binary logistic regression models were computed to identify the association of food and nutrient patterns as independent variables with wasting, stunting, underweight, anemia, iron deficiency, iron deficiency anemia and zinc deficiency as the dependent variables. The association was considered statistically significant when the p-value obtained was less than 0.05. Both, germination and cereal type significantly affected iron and zinc bioaccessibility. Germination significantly increased bioaccessibility of added iron in maize [1.3 to 2.7%] and millet [1.8 to 5.5%] porridges, but not in sorghum [5.3 to 4.5%; p=0.192]. Germination significantly increased bioaccessibility of added zinc in all three cereal porridges [maize: 12.6 to 30.7%; millet: 10.6 to 33.7%; sorghum: 15.5 to 38.8%]. The mean amount of germinated porridges [millet 241.46ml, maize 238.69ml, sorghum 230.29ml] consumed during the trial was more than the non-germinated porridges. The survey revealed that, at <-2SD, 17.5% of children were stunted, 13.4%; underweight, 6.4%; wasted. The prevalence of anemia, iron and zinc deficiency is 50.6%, 39.5% and 43.6%, respectively. These results indicate that germination of cereal-based porridge can significantly improve the bioaccessibility of added iron and zinc from MNP.