A community-based dietary diversification/modification intervention, employing a quasiexperimental design with a nonequivalent control group, was conducted in two intervention and two control villages in rural Southern Malawi. The aim was to enhance the content and bioavailability of micronutrients in maize-based diets of stunted children ages 30-90 mo. Efficacy was evaluated through a comparison of the changes in knowledge and practices, anthropometry, malaria screening, hemoglobin and hair zinc after 12 mo, common infections monthly postintervention and nutrient adequacy postintervention via 24-h recalls. Intervention diets were more diverse and of higher quality than the control diets, supplying significantly more animal source foods, especially soft-boned fish, but less phytic acid (p < 0.01). Median intakes of energy, protein, calcium, available zinc, heme iron and vitamin B-12 were greater (p < 0.05) in intervention compared to the control groups; some spread of knowledge and practices to the control groups occurred. Intervention enhanced Z-scores for mid-upper-arm circumference and arm muscle area (p < 0.001), but had no impact on weight or height gain. After controlling for baseline variables, mean hemoglobin was higher (107 vs. 102 g/L; p < 0.01) postintervention, whereas incidence of anemia and common infections were lower in the intervention groups compared to the control groups, with no change in malaria or hair zinc status. Dietary strategies reduced the prevalence of inadequate intakes of protein, calcium, zinc and vitamin B-12, but not iron, because fish was the major source of animal food consumed. More efforts to raise small animals and promote their consumption are needed to enhance dietary quality and ensure optimal growth, health and cognitive development in young Malawian children.
This review describes household dietary strategies to improve the content and bioavailability of zinc in predominantly plant-based diets and the implementation of these strategies in a community-based dietary intervention study in rural southern Malawi. The strategies involve increasing intakes of foods with high bioavailable-zinc contents, absorption enhancers, or both and using germination, fermentation, and soaking to reduce intake of phytic acid, a potent inhibitor of zinc absorption. The strategies were implemented at the household level in Malawi through a participatory research process that focused on building relationships with the community and involving them in the design, implementation, and monitoring and evaluation processes. In this way, community participation and awareness of zinc deficiency might be enhanced and the dietary strategies planned will be appropriate and sustainable.Am J Clin Nutr 1998; 68(suppl):484S-7S.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.