Effect of Moringa-Finger Millet Porridge Consumption on Protein and Vitamin A Status of Cerebral Palsy Children in Nairobi City County, Kenya
Malla, Janet Kajuju
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Malnutrition, secondary to feeding dysfunctions is common in children suffering from Cerebral Palsy (CP) and is associated with inadequate protein intake which is consequently linked with vitamin A deficiency. A diet that is both nutrient-dense and easy to chew and swallow is necessary to improve the protein and vitamin A status of these children. Previous studies have reported the potential of Moringa oleifera leaf powder in alleviating nutritional deficiencies. The purpose of this study was to find out the effect of M. oleifera consumption on the protein and vitamin A status of children with CP. Phase one involved the development, nutrient analysis and sensory evaluation of a fermented finger millet porridge fortified with M. oleifera leaf powder for the intervention. The second phase was a randomized clinical controlled trial with a sample of 113 children with CP randomly allocated to 2 study groups (intervention and control) on a 1:1 ratio. Participants in the control group were fed on fermented finger millet porridge while those in the intervention group received the fortified porridge daily for 3 months. Data collection was done by interviewing caregivers on socio-economic and demographic characteristics and dietary intake of children with CP. Nutrisurvey was used to determine the nutrient intakes of the study children which were compared against RDA values. Anthropometric measurements of children (weight and height) were also taken. The nutritional status of the children was expressed in terms serum albumin and retinol levels as well as BMI-for-age Z-scores and interpreted using WHO Child Growth Standards (2006). The Statistical Package for Social Sciences (SPSS) was used for data analysis. Relationships between categorical variables were determined using Chi-square tests while independent t-test was used to compare continuous variables. The significance level was set at p≤0.05. Results indicated that M. oleifera leaf powder had significantly high content of Protein and b-carotene which were target nutrient components for fortification of the fermented millet flour. M. oleifera fortified porridge was significantly more organoleptically acceptable than the non- fortified porridge [t (52) = 2.994; p = 0.004]. At baseline, the serum albumin levels for both groups were lower than the normal range of 3.5-5.0g/dl i.e. (3.067g/dl for intervention and 3.186g/dl for control), representing general protein deficiency. Serum retinol levels for both groups were also below the cut off values of 0.7 μmol/L i.e 0.471 μmol/L for intervention and 0.468 μmol/L for control). At end line, significant differences were observed between the control and intervention study groups respectively in the levels of serum retinol (0.471+0.03 and 0.714+0.03 μmol/L, p<0.001), serum albumin (3.198±0.06 and 3.523±0.07 g/dL, p=0.001). The BMI-for-age Z-scores between the two study groups were significantly different at end line (p=0.037) with fewer children in the intervention group found to be underweight at end line. The consumption of M. oleifera fortified porridge highly significantly improved the serum retinol and albumin levels and also the BMI-for –age Z-scores in the children in the intervention group. The study thus confirms that M. oleifera has potential of being used as suitable natural fortificant for foods consumed by children with CP in order to improve their nutritional status.