Nutritional intake of an undernourished infant population receiving an energy and micronutrient supplement in Indonesia

Abstract

Objectives: This paper reports the dietary intake (home, day care centers, supplement and breast milk) of the children in the clinical trial in Pangalengan. Design: Two cohorts of children were randomly assigned to three treatments: E 1171 kJ 12 mg iron; M 209 kJ 12 mg iron; S 104 kJ. Supplementation was given for 12 months. Setting: The sites were six tea plantations in Pangalengan, West Java. Subjects: A 12-month-old (n 53) and an 18-month-old (n 83) cohort were recruited from day-care-centers. Twenty children who received S belong to the 12-and 18-month-old cohorts. Inclusion criteria were: no chronic disease; length-for-age À1 standard deviation (s.d.) and weight-for-length between À1 and À2 s.d. of the median of the reference of the World Health Organization. Methods: E 1171 kJ 12 mg iron; M 209 kJ 12 mg iron; S 104 kJ. Supplementation was given for 12 months. Evaluations of intake were made at baseline and every 2 months thereafter. Results: For the 12-month-old cohort the mean increase in daily energy intake $ 2931 kJ for E, $ 1675 kJ for M, and $ 837 kJ increase over the 6 months for the S group. For the 18-month-old cohort the changes were $ 2512 kJ for E $ 1675 for the M group and $ 1047 for the S group.

Effects of an energy and micronutrient supplement on growth and activity, correcting for non-supplemental sources of energy input in undernourished children in Indonesia

“…As Durnin et al (2000) showed in a related paper on this study, the high energy (E) supplement (compared with the mineral (M ) and skimmed milk (S ) supplement) was successful in increasing energy intakes by an average of about 1047 kJ (200 kcaladay) for 7 days a week over a period of 52 weeks, resulting in a total of 261,356 kJ (62,400 kcal) extra energy. Over the course of the year E-group children gained only 90 ± 440 g more weight than M-children , and the deposition of this tissue accounts for less than 5% of the extra energy intake.…”

Effects of an energy and micronutrient supplement on play behavior in undernourished children in Indonesia

“…Since these 24-month-old children no longer breastfeed for a signi®cant source of nutrients, and the children were fed before the assessment, this behavior would not appear to be in response to physiological hunger. Furthermore, results from the larger study veri®ed that supplements did not replace breastfeeding in the E group (i.e., breastfeeding levels between groups remained the same throughout the study, see Durnin et al, 2000). Thus, these group differ- 4.00* ***P`0.01; **P`0.05; *P`0.10.…”

“…Detailed dietary analyses and tests of the effects of the supplementation on other growth and development areas demonstrated increased energy and micronutrient intake for the children in the play study (see Durnin et al, 2000). Improved nutrition had the expected in¯uences on common markers of improved nutritional status: growth, activity, and hematological status.…”

Effects of an energy and micronutrient supplement on anthropometry in undernourished children in Indonesia

“…The paper by Durnin et al (2000), dealing with dietary intakes, comes to the conclusion that, over the 12-month period of the study, the E-group received at least 304 800 kJ (72 800 kcal) of extra energy, and it is of interest to estimate how much of this extra energy was used by the E-group for growth, i.e. the laying down of extra tissue compared to the M-group.…”

“…The amount of energy and nutrients provided by a supplement can be measured, but as discussed in the paper by Durnin et al (2000), it cannot be taken for granted that total intakes will increase by the same amount, as some of the supplement may replace part of the habitual diet. The energy cost of fat and lean tissue deposition can be estimated and, if one assumes that most of the actual net supplement is used for growth, one can also calculate the maximum weight gain the supplement could theoretically produce.…”