Complementary Food Situation in Sierra Leone: Nutritional Problems and Possible Strategies—A Review

Low nutrient density and bulkiness of complementary foods, early introduction of solid foods, and unhygienic practices during weaning stage of a child predispose infants to malnutrition, growth retardation, infection and high mortality. In most West African countries, especially in Sierra Leone, the use of a variety of home-made complementary foods prepared from locally grown foodstuffs during the weaning process is popular, with products traditionally known as pap (mesh rice water) fofo from cassava, ogi, gari, akamu and couscous. Sierra Leone is one of the countries in West Africa that has been reported to have a challenging situation with regards to complementary foods, and little effort has so far been done to improve the situation. Despite these challenges, very little work has been directed towards the development of complementary foods using local foodstuffs as practiced in some other African countries. This situation has serious impact on the lives of infants in Sierra Leone, thus increasing the rate of mortality in the country. Complementary food situation in Sierra Leone was reviewed in terms of the past and present practices as well as the types of complementary foods used in Sierra Leone. Thus, the objective of this review was to discuss the complementary food situation in Sierra Leone: Nutritional problems and possible strategies. Formulation of high nutritive value home-made complementary foods in the country was recommended using traditional food processing techniques such as fermentation and germination, since these methods are simple, and could easily be employed at household and community levels without the use of sophisticated machinery. Nonetheless, it was recently reported that a product from the orange-flesh sweet potato could address the issue of complementary food in the country as it is easy to prepare, and the products are easily available in the rural area and even urban settings. Other recommendations made include: community nutrition education, the development of weaning recipe book, reduction in the workload of the suckling mother, promotion of breastfeeding and increased maternity leave period, which were suggested to be the most immediate possible strategies for the problems highlighted.

Effects of Nutrient Fortified Complementary Food Supplements on Anemia of Infants and Young Children in Poor Rural of Gansu

Objective To assess the effectiveness of complementary food supplements with protein and multi-micronutrients on hemoglobin and anemia in infants and young children. Methods In 5 poor counties of Gansu, 984 children aged 6-12 months were enrolled and divided into two groups. In addition to the usual home-made complementary food, all the children were fed one sachet of either Formula Ⅰ or Formula Ⅱ supplements each day. Protein and micronutrients were provided in Formula Ⅰ, while the same energy intake was secured in Formula Ⅱ as in Formula Ⅰ. A massive dose of vitamin A was supplemented to all the children every 6 months. Hemoglobin test was done at the same time. Results Prevalence of anemia was about 35% in both Formula Ⅰ and Formula Ⅱ group at baseline, and there were no differences in hemoglobin concentration between the two groups, During the 6-month and 12-month supplementation, hemoglobin of children in Formula Ⅰ group was higher than that in Formula Ⅱ group （P〈0.05）, and hemoglobin increase in Formula Ⅰ group was significantly higher than that in Formula Ⅱ group （P〈0.001）. After 6- and 12-mouth supplementation, the prevalence of anemia in Formula Ⅰ group dropped to 19.1% and 8.2% respectively, and it was 28.0% and 12.4% in Formula 2 group. The prevalence of anemia in Formula Ⅰ group was significantly lower than that in Formula Ⅱ group （P〈0.05）. After adjusting age and hemoglobin level at baseline, the hemoglobin increase at age of 24 months in formula 1 group was higher （10.7 g/L vs 7.9 g/L, P〈0.0001）. Conclusion Micronutrient fortified complementary food supplements, with large-dose vitamin A, is effective for children aged 6-12 months in terms of iron deficiency prevention.

Sensory Evaluation and Proximate Composition of Homemade Complementary Food (HCF), Made Using Milk Combinations of Plant and Animal Origin

Sensory analysis tools are the classic means for guaranteeing sensory quality, assessing acceptability, and recognizing faults in food products. Powerful sensory analysis techniques, were applied to evaluate Homemade Complementary Food (HCF) using milk combination of plant and animal origin. An experimental but descriptive method of research was used with Mubi as the study area. Milk from animal, (cow and goat) as well as milk from plant origin (soya beans milk,) was used. Milk from animal source was pasteurized using Vat pasteurization process (FDA, 2015) while quality soya beans milk was used to prepare milk of plant origin. Blended banana was also used as part of the home made complementary food alongside milk on a 50:50 ratio. A 15 member trained panel made up of mothers with children under the age of 5 years and currently breast feeding were the respondents, a sensory evaluation sheet based on the 9-point hedonic scale was used for scoring. Proximate analysis of sample was done using standard methods, AOAC (2000). Data was analyzed statistically using means and standard deviation. Results showed that sample B4 (a combination of cow, goat, and soya beans milk + blended banana slurry) had the best sensory attributes of appearance (8.00 ±1.32), taste (7.44 ± 1.01) and overall acceptability (8.00 ± 1.22), while sample B5 (goat milk + blended banana slurry) had the best sensory attributes of colour (8.00 ± 0.71) and aroma (7.78 ± 0.83). The proximate composition showed that the home made complementary food contained protein above (10.97 ± 0.00) from complementary food, this is far above the recommended 6.2 g/day, required for children 23 months and below assuming the child has an average breast milk intake daily, and fat (2.76 ± 0.00) from complementary foods, was within the recommendation range, required for children age between 9 - 11 months, also assuming the child is on average breast milk intake daily. These results can be of significant benefits in research, and in food processing industries, globally. Further research in other regions is needed to compare the obtained results in terms of its variance.

Nutrient Composition of Cereal （Maize）, Legume （Soybean） and Fruit （Banana） as a Complementary Food for Older Infants and Their Sensory Assessment

Four complementary foods were prepared from local foodstuffs which are maize （Zea mays）, soyabean （Glycine max） and banana （Musa acuminate colla）. Four complementary samples were produced from the proportion of maize/soyabean/banana composite flours as 60%： 30%： 10% （B）, 60%： 25%： 15% （C）, 60%： 20%： 20% （D）, 50%： 30%： 20% （E） and Nestle Cerelac was the control sample （A）. The formulated diets were subjected to nutritional analysis-along with a commonly used proprietary infant cereal （Nestle Cerelac） as control. Standard chemical methods were used to determine the proximate nutrient composition, some micronutrients and anti-nutritional factors. The samples produced have increased nutrients of fibre that enhances digestibility （2.07%-3.11%）, protein and ash contents. The supplementation of up to 20% soybean flour and banana flour recorded the best results in terms of proximate and mineral compositions and compared favourably with the control sample, in terms of sensory evaluation using hedonic method, sample A was most accepted but did not differ significantly from sample D. Therefore, nutritious and acceptable complementary food can be produced from fermented maize, soybean and banana flours. Results of molar ratios of some minerals and anti-nutritional factors in the compounded diets suggest that the anti-nutrients will not pose any serious problem in the usage of the complementary diets. The cost of producing the formulated diets is about N50-N100 （50 cents） per gram cheaper than cerelac. The study has therefore, revealed that with proper selection of local foodstuff, it is possible to prepare nutritious complementary diets that would be acceptable, readily available, affordable and nutritionally adequate.

Nutritional quality, functional property and acceptability of maize (Zea mays) based complementary foods enriched with defatted groundnut (Arachis hypogea L.) and ginger (Zinger officinale Roscoe) powder in Wistar rats

Traditional complementary foods in Africa are cereal-based, low in nutrient-density;hence, causing severe-acute-malnutrition. This study was aimed to formulate and evaluate nutritional quality of complementary foods (CF) using locally available food materials. Yellow maize (raw, germinated & fermented), defatted groundnut (DGF) and ginger flour (GGF) were blended to obtain RDG (76.7% raw yellow maize, 20.8% DGF and 2.5% GGF), GDG (74.4% germinated yellow maize, 23.1% DGF, 2.5% GGF), and FDG (72.6% fermented yellow maize, 24.9% DGF, 2.5% GGF). Food samples were evaluated for nutritional qualities and sensory attributes using standard methods. Protein (g/100 g), energy value (kCal/100 g), total amino acids and essential amino acids (g/100 g protein) of formulated CF ranged from 19.38 to 28.58, 373.49 to 394.53, 87.33 to 91.89 and 36.17 to 37.63, respectively, and were comparable to control (17.07, 401.22, 94.47 & 35.35). Minerals were present in appreciable amount in the foods, while phytate/mineral (Ca, Fe, Zn) and oxalate/calcium molar ratios were lower than critical levels. Bulk density (1.4 - 1.6 g/mL), least gelation (4 - 6%), water absorption capacity (10.5 - 15.8%) and swelling capacity (0.5 - 1.2%) were significantly (p < 0.05) lower in formulated CF than in control, except for bulk density. Biological value (78.44%) of FDG was significantly (P < 0.05) higher than GDG (78.4%) and RDG (75.87%), respectively, but lower than control (93.48%). Pack cell volume (22.50%), haemoglobin concentration (7.5 g/dL), red blood cell (3 × 103 mm− 3), albumin (3.72 g/dL), total blood protein (5.62 g/dL) and globulin (1.9 g/dL) of rats fed on FDG were significantly (p < 0.05) higher than other diets, but comparable to that of control. Kidney (urea, 10.16 mg/dL;creatinine, 4.8 mg/dL) and liver function index (AST/ALT ratio, 0.38) of rats fed on FDG were lower than in those rats fed on RDG, GDG and control. For sensorial attributes, RDG was ranked best next by FDG in appearance, aroma, texture, taste and overall acceptability, but were significantly (p < 0.05) rated lower than control. Finally, the study established that FDG (72.6% fermented yellow maize, 24.9% defatted groundnut and 2.5% ginger) was the best in nutritional quality and growth performance in rats;hence, this CF may be suitable to mitigate expensive commercial infant formula in alleviating severe-acute-malnutrition in children.