A Randomized Crossover Study to Evaluate Recipe Acceptability in Breastfeeding Mothers and Young Children in India Targeted for a Multiple Biofortified Food Crop Intervention

Abstract

Background: A multiple biofortified food crop trial targeting iron, zinc, and vitamin A deficiencies among young children and their breastfeeding mothers is planned in India. Objective: To determine the acceptability of recipes prepared with control and biofortified pearl millet, wheat, lentils, and sweet potato. Methods: Children (6-24 months) and their mothers were enrolled as pairs (n ¼ 52). Weight and height/length were determined. Mothers and children were separately, individually randomized in a crossover design to control or biofortified recipes. Children's 3-day intake was measured per recipe and crop variety. For mothers, a 9-point hedonic scale evaluated color, odor, taste, and overall acceptability. Results: Children's mean (SD) length-/height-for-age Z-score was À1.2 (1.7), with 27% < À2 (stunted). Mean weight-for-length Z-score was À0.6 (1.2) with 9.6% < À2 (wasted). Mother's body mass index showed 17% <18.5 and 38% >25. There was no difference in the children's intake of biofortified versus control varieties of any recipe (P ! .22); overall median daily intake was 75 g (Q1: 61, Q3: 100). Mother's hedonic scores for color, odor, taste, or overall acceptability did not demonstrate any notable differences (P ! .23 for overall acceptability); combined median overall acceptability score was 8.5 (Q1: 8.0, Q3: 9.0). Conclusions:Recipes were consumed readily, were rated as highly acceptable, and did not show any differences between biofortified and control varieties.

Health outcomes associated with micronutrient-fortified complementary foods in infants and young children aged 6–23 months: a systematic review and meta-analysis

“…We included 16 studies with 6423 participants ( table ; appendix pp 42–56 ). Eight studies were randomised controlled trials randomised at the individual level, 14 , 35 , 37 , 44 , 46 , 47 , 48 , 50 one was a controlled clinical trial, 38 and seven were cluster-randomised controlled trials. 2 , 19 , 36 , 39 , 42 , 43 , 45 Most of the studies were done in upper or lower-middle-income countries.…”

“… 2 Three studies had an intervention duration of three subsequent feeding sessions 50 to 3 consecutive days. 37 , 38 Among studies investigating longer-term effects of fortified complementary food consumption, the intervention duration lasted between 10 weeks 48 and 4 years. 2 , 51 Fortified products were cereals in most of the cases ( appendix pp 59–62 ).…”

“…Acceptability of fortified compared with non-fortified complementary foods was measured in two randomised controlled trials 37 , 50 and one controlled clinical trial 38 with a total of 215 children. All studies evaluated acceptance on a 9-point hedonic scale (answers of toddlers interpreted by mothers), with a higher score representing better acceptance.…”

“…[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]. Eight studies were random ised controlled trials randomised at the indi vidual level, 14,35,37,44,[46][47][48]50 one was a controlled clinical trial, 38 and seven were clusterrandomised controlled trials. 2,19,36,39,42,43,45 Most of the studies were done in upper or lowermiddle income countries.…”

Sensory acceptability of biofortified foods and food products: a systematic review

“…Chutney, rasam, thick shake, barfi, payasam, and sharbat made from either Kamalasundurai or WSP were acceptable among breastfeeding mothers in rural India. 24 Several studies across Africa found boiled OSP (A45, Chipika, Kadyaubwerere, Zondeni, Karote DSM, Resisto) or the control (A40, Kenya, Polista, Sinia B) were acceptable. 19 , 25 , 27 Chips or crisps made with Kemb 10 or Dutch-Robyjin – a regular potato with similar moisture content to that of sweet potato – using either corn oil or palm oil were all acceptable.…”