Using Nuclear Techniques to Develop and Evaluate Food-Based Strategies to Prevent Micronutrient Deficiencies in Young Children

Closed for proposals

Project Type

Coordinated Research Project

Project Code

E43027

CRP

1770

Approved Date

20 June 2011

Status

4 - Closed

Start Date

18 November 2011

Expected End Date

17 November 2017

Completed Date

19 November 2019

Participating Countries

Bangladesh
Canada
Germany
Guatemala
India
Mexico
United States of America
Zambia
Zimbabwe

Description

Maternal and child nutrition during pregnancy and up to two years of age are critical for a child’s future. Appropriate feeding practices are essential for achieving optimal child growth, development and health. The World Health Organization and UNICEF recommend exclusive breastfeeding for the first six months of life and thereafter, infants should be given nutritionally adequate and safe complementary foods while breastfeeding continues up to the age of two years or beyond. In contrast to the high nutritional requirements in the first two years of life, traditional complementary foods in low-income countries are low in nutrient density. These foods are predominantly plant-based and generally monotonous with high contents of phytic acid and phenolic compounds, but negligible quantities of animal source foods or fruits and vegetables rich in ascorbic-acid, vitamin A and provitamin A carotenoids. They provide insufficient bioavailable amounts of key nutrients such as iron, zinc and vitamin A. Besides, the concentration of certain nutrients can be low in human milk due to mothers’ poor status and low intake. The proposed CRP will contribute new knowledge on dietary diversification and modification approaches that optimize trace element bioavailability and increase trace element and vitamin density to enhance the nutrient intake from plant-based local complementary foods and human milk. Stable isotope methods will be used to evaluate trace element bioavailability, zinc and vitamin A status and infants’ human milk intake. The overall goal is to contribute to the design of effective, feasible and sustainable interventions based on locally available foods that help prevent micronutrient deficiencies of infants and young children.

Objectives

The overall objective is to contribute new knowledge on dietary modifications that enhance the nutrient intake from plant-based local complementary foods and human milk to prevent micronutrient deficiencies in infants and young children in developing countries.

Specific objectives

Evaluate the dose-response effects of animal-source and other nutrient-dense foods added to plant-based local complementary foods on exchangeable zinc and total body vitamin A pool size.

Evaluate the dose-response effects of dietary enhancers such as muscle tissue and ascorbic acid on bioavailability of iron and zinc from plant-based local complementary foods.

Evaluate the efficacy of approaches to increase lactating mothers’ provitamin A carotenoid or preformed vitamin A intake on human milk retinol and infants’ vitamin A intake and status.

Evaluate the efficacy of single or combined strategies to degrade phytic acid and to enrich with animal-source foods or ascorbic acid-rich foods on bioavailability of iron and zinc from plant-based local complementary foods.

Impact

The CRP generated evidence for new strategies for dietary modifications to enhance micronutrient intake (vitamin A, zinc and iron) from plant-based local foods and human milk in infants and young children, in low-resource settings. For example, consumption of beta-carotene rich vegetable leaves by lactating mothers resulted in higher vitamin A content in both breast milk and blood. Additionally, Zimbabwean researchers showed that adding peanut butter to commonly consumed vegetable (kale) increased the bioavailability and bio-conversion of kale provitamin A (beta carotene) to active vitamin A (retinol) in children. Similarly, Mexican researchers showed that a puree made from beta-carotene rich Moringa oleifera provided a good source of vitamin A for children (1-2 years of age). The amount of zinc absorbed was increased by 54% (1.84 times) with the addition of a dairy product, whey protein, to a supplement compared with a plant based diet alone. More iron was absorbed when tortillas were enriched with amaranth. These strategies should be scaled up and confirmed in larger efficacy and effectiveness studies to enable recommendations to programme planners and policy makers on potential strategies to improve micronutrient nutrition. The CRP also contributed to capacity building of human resources and technical skills in addition to building collaboration between participating research entities.

Relevance

Micronutrient deficiencies remain a major public health problem, especially in the first 1000 years of life. For example, in 2016, anaemia alone affected 613.2 million women of reproductive age, 35.3 million of whom were pregnant. This CRP focused on the first 1000 days of a child’s life, from conception through age two, contributing new knowledge on dietary diversification and modification approaches that optimize trace element bioavailability and increase trace element and vitamin density to enhance the nutrient intake from plant-based local complementary foods and human milk. Mothers consuming beta-carotene rich vegetable leaves were found to have higher vitamin A content in both breast milk and blood compared to those not receiving any intervention. New data on the benefits of adding an animal source food on the bioavailability of zinc from plant-based diets was generated. Hypertensive diseases of pregnancy (HDP) such as pre-eclampsia are among the most important causes of maternal and perinatal morbidity and mortality worldwide. Workers in Canada developed and tested a novel micronutrient powder containing microencapsulated pH-sensitive calcium in addition to iron and folic acid, designed to facilitate early intestinal iron release and delayed calcium release. The new supplement was developed to support implementation of the new World Health Organization (WHO) recommendations for calcium supplementation during pregnancy in order to reduce incidences of hypertensive diseases. The IAEA supported purchase of calcium isotopes. However, due to technical problems with the encapsulation process the prototype was not successful, the coating of calcium substantially reduced calcium absorption. The CRP fostered capacity building of human resources and technical skills in addition to building and enhancing collaboration between participating research entities. Overall, the CRP generated promising strategies that should be scaled-up in efficacy trials with the inclusion of functional outcomes such as body composition.

CRP Publications

Type

Abstract in The FASEB Journal

Year

2015

Publication URL

https://www.fasebj.org/doi/abs/10.1096/fasebj.29.1_supplement.604.11

Description

Development of a “Super-Kid” Model Based on Plasma [13c10]-Retinol Kinetics in Well-Nourished Mexican Infants

Country/Organization

Mexico

Type

Poster Abstract in Archivos Latinoamericanos de Nutrition

Year

2015

Publication URL

https://www.alanrevista.org/ediciones/2015/suplemento-2/art-260/

Description

ABSORCIÓN DEL ZINC EN TORTILLAS ENRIQUECIDAS CON AMARANTO COMPARADAS CON TORTILLAS TRADICIONALES DE MAÍZ BLANCO EN NIÑOS INDÍGENAS MAYA DESCENDIENTES

Country/Organization

Guatemala

Type

Paper in Asia Pacific Journal of Clinical Nutrition

Year

2017

Publication URL

https://www.ncbi.nlm.nih.gov/pubmed/28917229

Description

Peanut butter increases the bioavailability and bioconversion of kale ß-carotene to vitamin A.

Country/Organization

Zimbabwe

Type

Paper in Journal of Nutrition

Year

2017

Publication URL

https://www.ncbi.nlm.nih.gov/pubmed/28931584

Description

Use of a "Super-child" Approach to Assess the Vitamin A Equivalence of Moringa oleifera Leaves, Develop a Compartmental Model for Vitamin A Kinetics, and Estimate Vitamin A Total Body Stores in Young Mexican Children.

Country/Organization

Mexico

Type

Abstract in The FASEB Journal

Year

2014

Publication URL

https://www.fasebj.org/doi/abs/10.1096/fasebj.28.1_supplement.lb417

Description

Peanut butter increases kale ß-carotene absorption and conversion to vitamin A in pre-school children (LB417)

Country/Organization

Zimbabwe

Type

Paper in International Journal for Vitamin and Nutrition Research

Year

2017

Publication URL

https://www.ncbi.nlm.nih.gov/pubmed/30499754

Description

Identification of Enzymatic Cleavage Products of ß-Carotene-Rich Extracts of Kale and Biofortified Maize.

Country/Organization

Zimbabwe

Type

Abstract in The FASEB Journal

Year

2015

Publication URL

https://www.fasebj.org/doi/abs/10.1096/fasebj.29.1_supplement.122.2

Description

Whey-Based Supplement Added to a Plant-Based Diet Increases Total Zinc Absorption, but not Total Iron in Mexican Children.

Country/Organization

Mexico

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