Does the consumption of amylase-containing gruels impact on the energy intake and growth of Congolese infants?

Abstract

Objective: To assess the effect of the incorporation of amylase in maize-based flours prepared as gruels on the energy intake and growth of Congolese infants. Design: A randomised controlled trial. At 18 weeks of age, infants were randomised into either an intervention group, where they were provided with a maize/soya-based flour that contained amylase, or a control group, where they were provided with a similar flour that did not contain amylase. Setting: Urban borough of Poto-Poto in Brazzaville, The Congo. Subjects: Eighty infants (40 in each group) were randomised into intervention and control groups. Three infants in the intervention group and two controls subsequently dropped out. Results: At 24 weeks, the addition of amylase resulted in a significant increase in energy intake (in kJ kg 21 day 21 ) from gruels ðP ¼ 0:02Þ without affecting breast milk consumption. In contrast, total energy intake (in kJ kg 21 day 21 ) did not differ significantly between groups ðP ¼ 0:08Þ: After adjustment for morbidity and previous growth, infants in the intervention group showed better growth in length during the trial (+0.22 cm month 21 ; P ¼ 0:04), especially between 24 and 31 weeks of age (+0.51 cm month 21 ; P , 0:01). There were no differences in weight velocity between groups. Conclusions: The findings of this study suggest that the consumption of amylasetreated gruels allows an increase in energy intake from these gruels without affecting breast milk consumption but has no impact on total daily energy intake. However, if started after 6 months, it could be effective in preventing faltering of infant linear growth. Keywords Amylases Energy density Complementary feedingBreast-feeding Energy intake Infant growthIn developing countries, the growth rates of infants who are exclusively breast-fed during the first 6 months are similar to those of their counterparts in affluent populations 1 -3 . After this period, most infants in developing countries deviate from the satisfactory growth pattern due to recurrent infections and a lack of nutrientdense complementary foods 4 . Mothers in most developing countries traditionally use gruels as the first special transitional food. These are generally prepared from a fermented dough or a flour or mixture of flours that are produced locally. These flours typically have high starch content and, when cooked in water, they swell considerably and thicken the gruels. In order to avoid this thickening, mothers reduce the proportion of flour to water and as a result the energy and nutrient densities of the gruels become insufficient. Low-nutrient-density complementary foods play an important role in children's dietary intake and growth performance 3 . Complementary foods with low nutritional value could displace breast milk and consequently have a detrimental effect on the nutritional status of infants 3 .Modification of the dietary characteristics of bulky gruels has been used as a way to improve children's dietary intake and several studies have been carried out to assess the ef...

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