School Snacks Containing Animal Source Foods Improve Dietary Quality for Children in Rural Kenya

Abstract

Provision of a snack at school could help alleviate the micronutrient malnutrition that is common among schoolchildren in developing countries. The Child Nutrition Project was designed to compare the efficacy of three school snacks in improving growth and cognitive function of children in rural Kenya. The snacks provided approximately 20% of the children's energy requirement, and were composed of equicaloric portions of githeri (a vegetable stew) alone (Energy group), githeri plus milk (Milk group) or githeri plus meat (Meat group). A fourth group of children served as Controls. When nutrient intakes from three, 24-h dietary recalls collected before feeding were compared to three, 24-h recalls conducted after feeding began, intakes of vitamin B-12, riboflavin, vitamin A and calcium increased more in the Milk group than in the Control group, whereas intakes of vitamin B-12, vitamin A, calcium, available iron and available zinc increased more than those of Controls for children in the Meat group. At most of the time points examined, total energy intake increased more for the Meat group than for the other two feeding groups, because the additional energy provided by the Milk and Energy snacks was partially balanced by a decrease in the energy content of foods consumed at home. This decrease did not occur to the same extent for the Meat group, so both dietary quantity and dietary quality improved. For the Milk group, only dietary quality improved. For the Energy group, there were no significant changes in the total day's diet compared to the Control group.

Investment in child and adolescent health and development: key messages from Disease Control Priorities , 3rd Edition

“…A Cochrane review on school feeding (Kristjansson and others 2009) conducted a meta-analysis of three randomized controlled trials in three LMICs: Jamaica (Powell and others 1998), Kenya (Grillenberger and others 2003), and China (Du and others 2004). The meta-analysis found a small yet significant effect on weight (0.39 kilogram, 95 percent confidence interval 0.11, 0.67) and a small nonsignificant effect on height gain (0.38 centimeters, 95 percent confidence interval -0.32, 1.08).…”

“…In the Jamaica study, 395 children in grades 2-5 were given breakfast for a year (Powell and others 1998). In Kenya, grade 1 schoolchildren were given meat, milk, or an energy supplement for 18 months (Grillenberger and others 2003). In China, the study focused on girls age 10 years who received milk supplementation (Du and others 2004).…”

“…The composition of school meals varies widely, and diversification may lead to higher costs. Some studies have found positive effects on anthropometric indicators from meat or milk in the meals (Du and others 2004;Grillenberger and others 2003). However, LICs are unlikely to be able to sustain the higher costs of meat, and possibly milk, in meal programs.…”

Determining minimum food intake amounts for diet diversity scores to maximize associations with nutrient adequacy: an analysis of schoolchildren’s diets in rural Kenya

“…Nutrient intakes and probability of nutrient adequacy Nutrient intakes were calculated for each individual schoolchild, for each day, using an international food composition table adapted for use in the CNP study (16,17) . The database contains complete nutrient values for the foods commonly consumed in rural Kenya.…”

Realist review to understand the efficacy of school feeding programmes

“…19 compensatory reduction in food intake at other times A few studies documented a compensatory adjustment in appetite (supplemented children ate less at the next meal). 8 24 Four studies in which the benefit of supplements was less than expected were done in very poor areas in Peru, 20 Jamaica, 23 Kenya, 22 and India. 12 The authors of two of these studies concluded that children who had been given a substantial supplement at school were provided with less food at home (substitution).…”