Improved Energy Intakes Using Amylase-Digested Weaning Foods in Tanzanian Children with Acute Diarrhea

Darling, Jonathan C.; Kitundu, Jesse; Kingamkono, Rose; Msengi, A; Mduma, Benedicta; Sullivan, Keith; Tomkins, Andrew

doi:10.1097/00005176-199507000-00013

Cited by 30 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It acts by activating amylase and phytase enzymes which break the starch down into sugars and reduce the phytate content, leading to a more liquid porridge of lower viscosity and greater palatability. This resulted in 30–40% increases in energy intake in studies from Bangladesh,21India,7 and Tanzania 22. Although a Jamaican study did not find much increase in mean energy intake on α-amylase ‘thinned’ maize porridge,23 it did halve mean feeding times, which would have led to bigger differences in intake in a setting where feeds are less well supervised than in a research unit.…”

Section: Discussionmentioning

confidence: 99%

Comparison of milk and maize based diets in kwashiorkor

Brewster

Manary

Menzies

et al. 1997

Archives of Disease in Childhood

View full text Add to dashboard Cite

The dual sugar test of intestinal permeability is a reliable non-invasive way of assessing the response of the small intestinal mucosa to nutritional rehabilitation. Aim-To compare a local mix of maizesoya-egg to the standard milk diet in the treatment of kwashiorkor. Design-The diets were alternated three monthly in the sequence milk-maizemilk. There were a total of 533 kwashiorkor admissions of at least five days during the study who received either milk or maize. Intestinal permeability was assessed at weekly intervals by the lactulose-rhamnose test in 100 kwashiorkor cases, including 55 on milk and 45 on the maize diet. Results-Permeability ratios (95% confidence interval) on the milk diet improved by a mean of 6.4 (1.7 to 11.1) compared with −6.8 (−16.8 to 5.0) in the maize group. The improved permeability on milk occurred despite more diarrhoea, which constituted 34.8% of hospital days (29.8 to 39.8) compared with 24.3% (17.8 to 30.8) in the maize group. Case fatality rates for all 533 kwashiorkor admissions were 13.6% v 20.9%, respectively, giving a relative risk of death in the maize group of 1.54 (1.04 to 2.28). The maize group also had more clinical sepsis (60% v 31%) and less weight gain (2.9 v 4.4 g/kg/day) than the milk group. Implications-Milk is superior to a local maize based diet in the treatment of kwashiorkor in terms of mortality, weight gain, clinical sepsis, and improvement in intestinal permeability. (Arch Dis Child 1997;76:242-248)

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of milk and maize based diets in kwashiorkor

Brewster

Manary

Menzies

et al. 1997

Archives of Disease in Childhood

View full text Add to dashboard Cite

show abstract

“…The dietary comparisons made in many existing studies on dietary management of childhood diarrhea were not compatible with the comparisons we ultimately identified for this review and were therefore not included (Additional File 3). Other approaches that have been evaluated by randomized controlled trial in low- and middle-income settings include the use of amylase-rich flours in cereal-based porridges to decrease viscosity and thus increase nutrient density and children’s nutrient intake [53-55], and incorporating into mixed diets specific ingredients thought or known to have antidiarrheal properties, such as green banana [56,57]. A synthesis of the evidence for the full range of management options would best inform guidelines for optimal diet selection for childhood diarrhea treatment.…”

Section: Discussionmentioning

confidence: 99%

Dietary management of childhood diarrhea in low- and middle-income countries: a systematic review

et al. 2013

View full text Add to dashboard Cite

BackgroundCurrent WHO guidelines on the management and treatment of diarrhea in children strongly recommend continued feeding alongside the administration of oral rehydration solution and zinc therapy, but there remains some debate regarding the optimal diet or dietary ingredients for feeding children with diarrhea.MethodsWe conducted a systematic search for all published randomized controlled trials evaluating food-based interventions among children under five years old with diarrhea in low- and middle-income countries. We classified 29 eligible studies into one or more comparisons: reduced versus regular lactose liquid feeds, lactose-free versus lactose-containing liquid feeds, lactose-free liquid feeds versus lactose-containing mixed diets, and commercial/specialized ingredients versus home-available ingredients. We used all available outcome data to conduct random-effects meta-analyses to estimate the average effect of each intervention on diarrhea duration, stool output, weight gain and treatment failure risk for studies on acute and persistent diarrhea separately.ResultsEvidence of low-to-moderate quality suggests that among children with acute diarrhea, diluting or fermenting lactose-containing liquid feeds does not affect any outcome when compared with an ordinary lactose-containing liquid feeds. In contrast, moderate quality evidence suggests that lactose-free liquid feeds reduce duration and the risk of treatment failure compared to lactose-containing liquid feeds in acute diarrhea. Only limited evidence of low quality was available to assess either of these two approaches in persistent diarrhea, or to assess lactose-free liquid feeds compared to lactose-containing mixed diets in either acute or persistent diarrhea. For commercially prepared or specialized ingredients compared to home-available ingredients, we found low-to-moderate quality evidence of no effect on any outcome in either acute or persistent diarrhea, though when we restricted these analyses to studies where both intervention and control diets were lactose-free, weight gain in children with acute diarrhea was shown to be greater among those fed with a home-available diet.ConclusionsAmong children in low- and middle-income countries, where the dual burden of diarrhea and malnutrition is greatest and where access to proprietary formulas and specialized ingredients is limited, the use of locally available age-appropriate foods should be promoted for the majority of acute diarrhea cases. Lactose intolerance is an important complication in some cases, but even among those children for whom lactose avoidance may be necessary, nutritionally complete diets comprised of locally available ingredients can be used at least as effectively as commercial preparations or specialized ingredients. These same conclusions may also apply to the dietary management of children with persistent diarrhea, but the evidence remains limited.

show abstract

“…A great deal of effort has been invested in trying to increase the nutrient density of such foods without increasing their consistency to a point that is unacceptable to mothers or children [5,9,[14][15][16]. The potential importance of such organoleptic characteristics of foods has been noted [23], but few studies have been done on maternal or child preferences for such characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…It is commonly suggested that foods of higher viscosity are less acceptable to the mother or to the child [9][10][11][12], although no published studies could be identified that specifically attempted to quantify this perception. The inadequacy of the information in this area is particularly striking, because a great deal of effort has already been invested in strategies to reduce the viscosity of complementary foods of high nutrient density, most commonly with the use of amylase-rich flours [5,9,[13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Maternal Preferences for Consistency of Complementary Foods in Guatemala

Parker¹,

Schroeder²,

Hurtado³

1998

Food Nutr Bull

View full text Add to dashboard Cite

Increasing the nutrient density of complementary food mixtures is a common strategy for improving child nutrition in developing countries. Such modification, however, typically increases the viscosity of the mixtures, which may not appeal to caretakers or children. To assess maternal preference for complementary food consistency, 46 rural Guatemalan mothers, each of whom had a child between 6 and 14 months of age, were interviewed by trained data collectors and participated in focus group discussions. Strong opinions regarding consistencies of complementary foods were identified, which varied according to the child's age and health status. Mothers preferred thinner complementary foods for children less than one year old and thicker foods for children more than one year old. When the child had a cough or fever, most mothers preferred thin, liquid complementary foods. When the child had diarrhoea, about half of the mothers believed thinner complementary foods would replace the water the child lost with diarrhoea, whereas other mothers believed that thicker complementary foods would harden the stool or stop diarrhoea. This information will help guide efforts to develop improved complementary foods, particularly those for use during illness in underprivileged populations of developing countries.

show abstract

Improved Energy Intakes Using Amylase-Digested Weaning Foods in Tanzanian Children with Acute Diarrhea

Cited by 30 publications

References 0 publications

Comparison of milk and maize based diets in kwashiorkor

Comparison of milk and maize based diets in kwashiorkor

Dietary management of childhood diarrhea in low- and middle-income countries: a systematic review

Maternal Preferences for Consistency of Complementary Foods in Guatemala

Contact Info

Product

Resources

About