TABLE OF CONTENTS
Title page i
Approval page ii
Certification iii
Dedication iv
Acknowledgement v
List of Tables xii
List of Figures/pictures xiii
ABSTRACT xv
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study 1
1.2 Statement of the Problem 2
1.3 Objectives of the Study 4
1.4 Significance of the Study 4
CHAPTER TWO: LITERATURE REVIEW
2.1 Complementary feeding 6
2.2 Nutrient density and bioavailability of nutrients in complementary foods 7
2.3 Amount of nutrients needed in complementary foods 9
2.4 Age of introduction of complementary foods 11
2.5 Meal frequency and energy density of complementary foods 13
2.6 Feeding non-breastfed children 13
2.7 Anthropometric measurements 15
2.7.1 Arm circumference 16
2.7.2 Length or statue 16
2.7.3 Weight 17
2.7.4 Head Circumference 17
2.8 Clinical observation 17
2.9 Biochemical analysis 18
2.9.1 Iron 18
2.9.2 Normal range of serum iron 19
2.9.3 Iron binding capacity 19
2.9.4 Screening for iron deficiency 20
2.10 Haemoglobin 20
2.11 Zinc 21
2.11.1 Zinc Deficiency 22
2.11.2 Dietary sources and bioavailability of zinc 23
2.12 Calcium 24
2.12.1 Calcium requirement 25
2.12.2 Dietary sources of calcium 26
2.13 Maize 26
2.13.1 Origin and classification 26
2.13.2 Chemical composition 28
2.13.3 Nutritive value 28
2.13.4 Utility 29
2.13.5 Other uses 30
2.13.6 Pellagra 31
2.14 Moringa oleifera 32
2.14.1 Origin, cultivation and utilization 32
2.14.2 Nutritional composition 33
2.14.3 Phytochemistry of Moringa oleifera 36
2.15 Soybean 36
2.15.1 Description and Classification 36
2.15.2 Origin and cultivation of soybean 37
2.15.3 Preparation and uses of soybean 38
2.15.4 Soy in infant formula 39
2.15.5 Chemical composition and nutrition value of soybean 40
2.16 Fermentation 43
2.16.1 Fermentation method employed on infant foods in developing countries 43
2.16.2 Benefits of fermentation 44
2.16.3 Availability of iron and other divalent and trivalent cations from fermentation 45
2.17 Food composite analysis for laboratory estimate 46
CHAPTER THREE: MATERIALS AND METHODS
3.1 Materials 47
3.2 Preparation of materials 47
3.2.1 Maize 47
3.2.2 Soybean 47
3.2.3 Moringa oleifera leaves 48
3.3 Chemical analysis 52
3.3.1 Proximate analysis 52
3.3.1.1 Determination of moisture content 52
3.3.1.2 Determination of ash content 52
3.3.1.3 Determination of Crude fibre 53
3.3.1.4 Determination of fat 53
3.3.1.5 Determination of protein 54
3.3.1.6 Carbohydrate determination 55
3.3.1.7 Energy determination 55
3.3.2 Vitamin analysis 55
3.3.3 Mineral analysis 56
3.4 Study area 56
3.5 Screening exercise 57
3.5.1 Inclusion criteria for both groups (control and test groups) 57
3.6 Characteristics of subjects 57
3.6.1 Sex and age distribution of the subjects fed the diets 57
3.7 Formulation of the diets (blends) used in feeding trial 58
3.8 Preparation of gruel 59
3.9 Sensory evaluation 60
3.10 Anthropometric measurements 60
3.11 Blood sample collection 61
3.12 Feeding 62
3.13 Biochemical analysis of blood samples 62
3.13.1 Haemoglobin determination 62
3.13.2 Estimation of serum iron 63
3.13.3 Serum calcium determination 63
3.13.4 Estimation of serum zinc 63
3.13.5 Determination of unsaturated iron binding capacity (UIBC) 64
3.13.6 Total iron binding capacity (TIBC) 65
3.14 Statistical analysis 65
CHAPTER FOUR: RESULTS 66-78
CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION
5.1 Discussion 79
5.1.1 Proximate and energy composition of maize, soybean and Moringa oleifera leaf 79
5.1.2 Mineral and β-carotene of maize, soybean and Moringa oleifera leaves 81
5.1.3 Nutrient and energy contents of the control and test diets 81
5.1.4 Sensory evaluation 82
5.1.5 Anthropometric indices 82
5.1.6 Biochemical parameters (a) (Serum ca, zn, fe) 83
5.1.7 Biochemical parameters (b) (Haemoglobin, unsaturated iron binding and total iron binding capacity) 84
5.2 Conclusion 85
5.3 Recommendation 85
REFERENCES 86-94
APPENDICES
- Sensory evaluation data sheet 95-96
- Ethical clearance 97
LIST OF TABLES
1. Desirable energy (kcal/g) and some nutrients (Unit/kcal) densities of complementary foods (100kcal) fed three times a day to children who are consuming average amount of breast milk 8
2. Estimated daily amounts of nutrients needed from complementary foods by age of infants and usual breast milk intake in developing countries 10
3. Minimal time intervals to detect changes in growth 15
4. Average chemical composition of typical Nigeria dent corn variety 28
5. Nutritive value /100g edible portion of Moringa 34
6. Chemical composition of soybean (per 100g) 41
3.1 Sex and age distribution of subjects fed the different diets 58
3.2 Composition of the formulated diets (blends) used in feeding trial 59
3.3 Recipes for the gruel 59
4.1 Proximate and energy composition of maize, soybean and Moringa Oleifera leaves (%) 66
4.2 Mean proximate composition of maize, soybean and Moringa oleifera leaves on dry matter basis (%) 67
4.3 Mineral and β-carotene contents of maize, soybean and Moringa Oleifera leaves (mg/100g) 68
4.4 Minerals and beta carotene of maize soybean and Moringa Oleifera leaves (mg/100g) 69
4.5 Proximate and energy composition of formulated diets (%) 70
4.6. Proximate and energy composition of the formulated diets (dry matter basis;(%) 71
4.7 Minerals and β – carotene contents of the formulated diets (mg/100g) 72
4.8 Minerals and β – carotene contents of the formulated diets (dry matter basis; (mg/100) 73
4.9 Sensory evaluation of formulated diet 74
4.10 Anthropometric indices 75
4.11.1 Serum calcium, zinc and iron of the subject before and after feeding 76
4.11.2 Haemoglobin (Hb), unsaturated iron binding capacity (UBIC) and total iron binding capacity (TIBC) of the subjects before and after feeding the two diets. 78
LIST OF FIGURES
1. Processing of maize 49
2. Processing of soybean 50
3. Processing of Moringa oleifera leaves 51
ABSTRACT
This study developed and evaluated infant – feed composite complementary food made from locally available foods which was fed to infants 6-12 months of age. Dried Moringa oleifera leaf was the fortificant. Yellow maize grains were fermented for 48 hand oven –dried. Soybean seeds were boiled for 1h, dehulled and oven-dried. Moringa oleifera leaves were shade-dried. All the food materials were milled into fine flours. The proximate, energy, mineral and β-carotene contents of the flours were determined using standard methods. The flours were used to develop 2 blends in ratios of 60:40 (control) and 60:30:10 (test) maize + soybean and maize + soybean + Moringa oleifera leaves respectively. The analysis of the blends were done using standard techniques at 5% confidence level. The blends provided 10% protein. The blends were used to prepare gruels whose sensory evaluation was conducted using 30 mothers. The gruels were fed to 2 groups of infants in the Holy Child Motherless Babies Home in Enugu for 12 weeks. Protein (15. 15% vs 11.36.2%) and carbohydrate (47.15% vs 55.73%) of the blends differed. Ash (3.43% vs 3.08%), fat (30.64% vs 27.2%), crude fiber (3.63% vs 2.74%) and energy (1877 KJ vs 1827KJ) of both blends were comparable. The Iron (8.32mg vs 6.82mg) and zinc contents (4.09mg vs 4.84mg) of the blends were similar. β-carotene (358.15 RE vs 521.28 RE) and calcium (14.6mg vs 829.28mg) of the test blend were higher than that of control blend. The blends had comparable flavor (8.03 vs 7.57) and texture (7.74 vs 7.37). Both blends were accepted well equally (7.97 vs 7.89), however, they differed in colour (8.10 vs 7.10). The body weight of the subjects increased significantly (9.34%) after feeding the test blend. There were slight increases in length (3.69% & 3.66%), head circumference (0.04% & 2.86%) and chest circumference (3661% & 2.81%) after feeding control and test blends, respectively. Serum zinc increased significantly (72.75ųg / 100ml to 148.80ųg / 100ml) in the control group. Haemoglobin (Hb) was higher (12.34% vs 8.96%) in the group fed test blend. Unsaturated iron binding capacity (UIBC) and total iron binding capacity (TIBC) increased much more (25.91% & 32.55%) in the subjects fed control blend. Moringa oliefera fortification of the infant complementary food improved the nutrient quality. Shade-dried Moringa oleifera leaves had good nutrient profile and acceptance in food. Incorporation of pulverized Moringe oleifera leaves in infants’ food could diversity food intake and reduce some micro nutrient deficiency diseases.
CHAPTER ONE
INTRODUCTION
1.1 Background of the study
The causes of malnutrition are many and complex. Inappropriate breastfeeding and complementary feeding practices coupled with high rates of infectious diseases are the major immediate cause of malnutrition during the first two years of life. Reports show that the rate of exclusive breastfeeding for 6 months is still very low in Nigeria- between 15% and 17%. Children who are not breastfed have repeated infections, experience poor growth and are almost six times more likely to die by the age of one month than children who receive at least some breast milk. From six months onwards, when breast milk alone is no longer sufficient to meet all nutritional requirements, infants enter a particularly vulnerable period of complementary feeding. They make a gradual transition to eating family foods. The incidence of malnutrition rises sharply between this age and 18 months in most countries (UNICEF, 1998; Dewey, 2003; WHO, 2003). The deficits acquired at this age are difficult to compensate for later in childhood. Infants therefore, need nutritionally adequate energy-dense complementary foods in addition to breast milk (NFCNS, 2003; WHO, 2003).
Unfortunately, complementary feeding begins too early or too late, and foods are often nutritionally inadequate and unsafe (WHO, 2002). This results to protein-energy malnutrition (PEM) and micronutrient deficiency (hidden hunger). NFCNS reported very high levels of iron deficiency anemia among infants. Poor absorption of iron, parasitic infestation and disease are equally contributory factors. Often, the traditionally complementary foods consist mainly of porridges made from un-supplemented cereals and starchy food such as sorghum, maize and millet (WHO, 1998). The foods are mostly inadequate in energy, protein and micronutrients (ACC/SCN, 2000; Jarkata, 2005).
To this effect, the formulation and development of nutritious complementary foods from local and readily available foods had received considerable attention in Nigeria (Nnam, 1994; Ifudu & Obizoba, 1989; Obizoba, 1989; Nnam, 1998; Nnam, 2001; Nnam, 2000; Ibeanu & Obizoba, 2004; Nnam, 2002).
Staple foods such as maize, soybean and iron-rich green leafy vegetables e.g. Moringa oleifera (“drum stick” or “Okwe Oyibo”) could be good for the development of good complementary food. The thrust of this study is to develop and determine the nutrient value, and acceptability of maize-based complementary food fortified with Moringa oleifera and access its quality in infants.
1.2 Statement of the problem
Micronutrient deficiencies have been recognized as an important contributor to the global burden of disease. Iodine deficiency in pregnancy has long been linked to intra-uterine brain damage and possible fetal wastage. This has led to effective programs for making iodized salt available in iodine-deficient areas (Black, 2003). Iodine deficiency disease has been improved.
Iron deficiency also affects about two billion people. However, interventions to control iron deficiency have been less successful. Recent estimates finds that iron deficiency anemia is responsible for a fifth of early neonatal mortality and a tenth of maternal mortality. Iron deficiency also reduces cognitive development and work performance. Iron deficiency is the attributable cause of about 800,000 deaths and 2.4% , of the global burden of disease (Black, 2003).
Vitamin A deficiency (VAD) harms the eyes and increase childhood and material mortality. Globally, 21% of children have vitamin A deficiency and suffer increased rates of deaths from diarrhea, measles, and malaria. About 800,000 deaths in children and women of reproductive age ate attributable to VAD which accounts for 1.8% of the global burden of disease. This appears to be lower than previous estimates possibly due to vitamin A supplementation or food fortification programs during the last decade.
The importance of zinc deficiency is being increasingly recognized. Trials have shown that zinc supplementation results in improved growth in children, lower rates of diarrhea, malaria, and pneumonia, and reduced child mortality. In total, about 800,000 child deaths per year are attributable to zinc deficiency. Zinc deficiency is responsible for 1.9% of global burden of disease.
According to WHO, 19% of the 10.8 million child deaths globally a year are attributable to iodine, iron, vitamin A, and zinc deficiencies. In Nigeria, UNICEF (2001) recorded malnutrition as the major causes of health problem of infants and young children. The problem is more common amongst children 6months to 24 months of age which coincides with the period of complementary feeding. This problem is attributed to the introduction of poor complementary foods which are inadequate in protein, energy and micronutrients. In effect, vitamin A deficiency among these children is higher than 16% in some regions in Nigeria (Profile, 2001), and anemia as high as 50%, 43.1% suffered PEM. And 22.3% suffered from moderate and severe malnutrition. Though PEM is addressed, there is still gap in micronutrient deficient problems.
To address these nutritional problems, nutritious complementary foods could be formulated from locally available foods and fortified with micronutrient dense food material. This research therefore explored the nutritional quality of infant composite complementary food prepare from maize, soybean and Moringa oleifera
1.3 Objectives of the study
The general objective of the study was to prepare infant-fed composite complementary food from locally available foods –maize (Zea mays), soybean (Gylycine max) and Moringa oleifera leaves- and evaluate the nutritional quality of the products. The specific objectives of the study were to:
a. develop infant complementary food from yellow maize (Zea mays), soybean (Glycine max) and green leafy vegetables (Moringa oleifera).
b. determine the nutrient composition of the complementary food.
c. determine the acceptability of the food.
d. determine the nutritional quality of the infant complementary food in children.
1.4 Significance of the study
The result of this study would:
1. provide a quality local infant complementary food for infants aged 6 months and above.
2. further provide baseline information for Dietitians and Nutritionists, public and community health workers on how to fight malnutrition among infants and young children in Nigeria.
3. increase food diversity.
4. create room for more researches.
5. create job opportunities for people who will embark on planting and processing of Moringa oleifera.
6. improve the country’s economy through individuals and groups.
7. create room for and encourage nutrition education.
8. project Moringa oleifera as a possible home – gardening solution to malnutrition in the third world.
