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American Journal of Clinical Nutrition, Vol. 86, No. 4, 1094-1103, October 2007
© 2007 American Society for Nutrition

ORIGINAL RESEARCH COMMUNICATION

Fortified complementary foods with or without {alpha}-amylase treatment increase hemoglobin but do not reduce breast milk intake of 9-mo-old Zambian infants1,2,3

Victor O Owino, Lackson M Kasonka, Moses M Sinkala, Jonathan K Wells, Simon Eaton, Tegan Darch, Andrew Coward, Andrew M Tomkins and Suzanne M Filteau

1 From the Institute of Child Health, London, United Kingdom (VOO, AMT, SE, TD, and JKW); the University Teaching Hospital, Lusaka, Zambia (LMK); the Lusaka District Health Management Board, Lusaka, Zambia (MMS); the Medical Research Council, Cambridge, United Kingdom (AC); and the London School of Hygiene and Tropical Medicine, London, United Kingdom (SMF)

Background: Malnutrition in late infancy in developing countries may result from poor-quality complementary foods that displace breast milk.

Objective: The objective of the study was to assess the effects of fortified complementary blends of different energy densities on growth, hemoglobin concentrations, and breast milk intake of 9-mo-old Zambian infants.

Design: Infants were randomly assigned at 6 mo of age to receive for 3 mo a fortified blend of maize, beans, bambaranuts, and groundnuts [Chilenje Baby Mix (CBM); energy density: 68 kcal/100 g; n = 37] or a similar blend with {alpha}-amylase (CBMA; energy density: 106 kcal/100 g; n = 44). Cross-sectional data were obtained at 9 mo for a control group of infants (n = 69) not given the diets. Breast milk intake was measured by using the dose-to-the-mother deuterium dilution technique.

Results: No differences in weight or length z scores, all of which were within normal ranges, were seen between groups at 9 mo. Percentage fat mass was significantly (P = 0.01) greater in the infants in both the CBM (23.2 ± 2.7%) and CBMA (23.4 ± 2.5%) groups than in the control group (21.6 ± 2.6%). Hemoglobin concentrations were significantly (P = 0.03) greater in both intervention groups (CBM group: 104 ± 12 g/L: CBMA group: 103 ± 12 g/L) than in the control group (98 ± 14 g/L). Breast milk intake was not significantly (P = 0.87) different between groups (CBM group: 614 ± 271 g/d; CBMA group: 635 ± 193 g/d; control group: 653 ± 221 g/d).

Conclusions: The study foods improved hemoglobin concentrations without reducing breast milk intake and may be used to improve the nutritional status of infants in developing countries.

Key Words: Complementary food • micronutrient-fortified foods • {alpha}-amylase • infant growth • hemoglobin • breast milk intake • deuterium dilution • Zambia






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