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Background/objectives The objective of this study was to investigate the efficacy of small-quantity lipid-based nutrient supplements (SQ-LNS) containing essential fatty acids (EFAs) with or without long-chain polyunsaturated fatty acids (LCPUFAs) in improving LCPUFA status in South African infants fed complementary food. Subjects/methods Six-month-old infants (n = 750) were randomised to receive SQ-LNS, SQ-LNS-plus, or no supplement. Both SQ-LNSs contained micronutrients and EFAs. SQ-LNS-plus additionally contained the LCPUFAs arachidonic acid (AA) and docosahexaenoic acid (DHA), lysine, phytase and other nutrients. Plasma total phospholipid FA composition (% of total FAs) was measured at baseline (n = 353) and at 12 months (n = 293). Results At baseline, geometric mean (95% CI) plasma DHA and AA were 4.1 (4.0-4.3) and 11.5 (11.2-11.8)% respectively, with significantly higher plasma DHA and AA in breastfed than non-breastfed infants. Infants receiving the SQ-LNS-plus had significantly higher plasma DHA (4.52 (4.3-4.9)) at 12 months than the controls (3.8 (3.6-4.0)), with a higher effect size in infants who no longer received breast milk ([beta] = 1.148 (95% CI = 0.597, 1.699)) than in infants who were still breastfeeding ([beta] = 0.544 (95% CI = 0.179, 0.909)). There was no effect of either of the two SQ-LNSs on plasma AA. Consequently, infants receiving the SQ-LNS-plus had a significantly lower plasma n-6 to n-3 PUFA ratio at 12 months than control infants did. Conclusions Our study suggests that the provision of SQ-LNS-plus is efficacious in improving plasma DHA status. Particularly, infants who are no longer breastfed may benefit most from LCPUFA-enriched SQ-LNS., Author(s): Linda P. Siziba [sup.1], Jeannine Baumgartner [sup.1], Marinel Rothman [sup.1], Tonderayi M. Matsungo [sup.1], Mieke Faber [sup.2], Cornelius M. Smuts [sup.1] Author Affiliations: (1) Centre of Excellence for Nutrition, [...]

A study was undertaken to determine whether benefits gained by providing small-quantity lipid-based nutrient supplements (SQ-LNS) from age 6–12 months were maintained at age 18 months compared with a delayed intervention. Children who completed a randomised controlled trial were enrolled at age 12 months (n = 392) and followed-up until age 18 months (n = 252; dropout rate 35.7%). Two previously exposed (PE and PE-plus) groups (received SQ-LNS from 6–12 months, but no supplement from 12–18 months) were compared with the delayed intervention (DI) group (received no supplement from 6–12 months, but received SQ-LNS from 12–18 months). At age 12 and 18 months, weight, length, haemoglobin (Hb) and psychomotor development were measured. The study was carried out in peri-urban Jouberton area, Klerksdorp, South Africa. Children aged 12–18 months. Compared with DI, negative effects (either a trend or statistically significant) were observed for PE and PE-plus for length-for-age Z-scores (LAZ) (p = 0.091 and p = 0.075, respectively), PE-plus for weight-for-age Z-scores (WAZ) (p = 0.027), and PE and PE-plus for Hb (p = 0.080 and p = 0.033, respectively); and a positive effect for PE-plus for eye–hand coordination (p = 0.086). The odds for anaemia were higher for PE-plus compared with DI (OR = 1.68; 95% CI 0.91, 3.09). Regardless of group, prevalence of anaemia and stunting increased from age 12 to age 18 months. Benefits of providing SQ-LNS from age 6–12 months were not sustained at age 18 months, compared with providing SQ-LNS from age 12–18 months. Studies to determine the optimum supplementary period to achieve sustainable benefits of SQ-LNS on linear growth and iron status are warranted. [ABSTRACT FROM AUTHOR]

We determined the associations of dietary patterns with energy/nutrient intakes and diet quality. Previously collected single 24‐hr dietary recalls for children aged 6–11 months (n = 1,585), 12–17 months (n = 1,131), and 18–24 months (n = 620) from four independent studies in low socio‐economic populations in South Africa were pooled. A maximum‐likelihood factor model, with the principal‐factor method, was used to derive dietary (food) patterns. Associations between dietary pattern scores and nutrient intakes were determined using Kendall's Rank Correlations, with Bonferroni‐adjusted significance levels. For both 6–11 months and 12–17 months, the formula milk/reverse breast milk pattern was positively associated with energy and protein intake and mean adequacy ratio (MAR). The family foods pattern (6–11 months) and rice and legume pattern (12–17 months) were positively associated with plant protein, fibre, and PU fat; both for total intake and nutrient density of the complementary diet. These two patterns were also associated with the dietary diversity score (DDS; r = 0.2636 and r = 0.2024, respectively). The rice pattern (18–24 months) showed inverse associations for nutrient intakes and nutrient densities, probably because of its inverse association with fortified maize meal. The more westernized pattern (18–24 months) was positively associated with unfavourable nutrients, for example, saturated fat and cholesterol. These results highlight that underlying dietary patterns varied in terms of energy/nutrient composition, nutrient adequacy, nutrient densities of the complementary diet, and dietary diversity. [ABSTRACT FROM AUTHOR]

Objective: The socio-demography, anthropometry and food intake of women residing in rural and urban areas of Lesotho were determined. Design: Cross-sectional survey. Setting: Basotho women from four randomly selected villages in Maseru and Berea, which includes both urban and rural areas. Subjects: A total of 452 women were included in the study. Outcome measures: Socio-demographic information was collected using a structured questionnaire completed in an interview with each participant. Standard methods were used to determine anthropometric measurements, while usual food intake was determined using a short unquantified food frequency questionnaire. Results: A large percentage of participants were unemployed with a significantly higher percentage in urban compared with rural areas (65.5 vs. 49.2%; CI 6.8%; 25.4%). A higher percentage of urban than rural participants had a BMI ≥ 30 kg/m2 (53.5 vs. 44.4%, respectively) and waist circumference ≥ 88 cm (62.7 vs. 54.1%, respectively). For both rural and urban participants, stiff maize-meal porridge was commonly consumed with all meals, often with moroho (cooked green leafy vegetables). Although a variety of vegetables (onions, cabbage, pumpkin, tomatoes, turnips and potatoes) were frequently eaten by most participants, quantities of intake were not determined. Protein sources consumed almost every day by more than 50% of all participants were dried beans. Chicken, eggs and full cream milk were consumed significantly more frequently by urban participants. Significantly more urban participants had access to a variety of fruits and vegetables, and they were also more likely to consume foods such as polony, russians (sausage containing pork and beef), sausage, sweetened drinks, mayonnaise and margarine more frequently than rural participants. Conclusions: A nutrition transition associated with the frequent intake of processed, sugary and high-fat foods was identified in urban participants. These unhealthy dietary practices may lead to an increased risk of obesity and poor health outcomes. The development of culturally acceptable and relevant interventions is thus recommended. [ABSTRACT FROM AUTHOR]

Iodine is important for normal growth and psychomotor development. While infants below 6 months of age receive iodine from breast milk or fortified infant formula, the introduction of complementary foods poses a serious risk for deteriorating iodine status. This cross-sectional analysis assessed the iodine status of six-month-old South African infants and explored its associations with feeding practices and psychomotor milestone development. Iodine concentrations were measured in infant ( n = 386) and maternal ( n = 371) urine (urinary iodine concentration [UIC]), and in breast milk ( n = 257 [breast milk iodine concentrations]). Feeding practices and psychomotor milestone development were assessed in all infants. The median (25th-75th percentile) UIC in infants was 345 (213-596) μg/L and was significantly lower in stunted (302 [195-504] μg/L) than non-stunted (366 [225-641] μg/L) infants. Only 6.7% of infants were deficient. Maternal UIC (128 [81-216] μg/L; rs = 0.218, p < 0.001) and breast milk iodine concentrations (170 [110-270] μg/kg; rs = 0.447, p < 0.0001) were associated with infant UIC. Most infants (72%) were breastfed and tended to have higher UIC than non-breastfed infants ( p = 0.074). Almost all infants (95%) consumed semi-solid or solid foods, with commercial infant cereals (60%) and jarred infant foods (20%) being the most common solid foods first introduced. Infants who reported to consume commercial infant cereals ≥4 days weekly had significantly higher UIC (372 [225-637] μg/L) than those reported to consume commercial infant cereals seldom or never (308 [200-517] μg/L; p = 0.023). No associations between infant UIC and psychomotor developmental scores were observed. Our results suggest that iodine intake in the studied six-month-old infants was adequate. Iodine in breast milk and commercial infant cereals potentially contributed to this adequate intake. [ABSTRACT FROM AUTHOR]

Fortification of two staple foods, maize meal and wheat flour (bread), is mandatory, and commercial infant products are widely available in South Africa. Using a 24‐hr recall, we determined the contribution of these foods towards nutrient intakes at ages 6 (n = 715), 12 (n = 446), and 18 (n = 213) months in a cohort of children in a peri‐urban community, North West province. On the day of recall, commercial infant products were consumed by 83% of children at 6 months, 46% at 12 months, and 15% at 18 months; fortified staples were consumed by 23%, 81%, and 96%, respectively. For consumers thereof, commercial infant products contributed 33% energy and 94% iron intakes at 6 months and 27% energy and 56% iron intakes at 12 months; nutrient densities of the complementary diet was higher than for nonconsumers for most micronutrients. For consumers of fortified staples, energy contribution thereof was 11% at 6 months versus 29% at 18 months; at 18 months, fortified staples contributed >30% of iron, zinc, vitamin A, thiamine, niacin, vitamin B6, and folate; at 12 months, nutrient densities of the complementary diet were higher for zinc, folate, and vitamin B6 but lower for calcium, iron, vitamin A, niacin, and vitamin C than nonconsumers. At ages 12 and 18 months, ~75% of children had low calcium intakes. At 12 months, 51.4% of consumers versus 25.0% (P = 0.005) of nonconsumers of fortified staples had adequate intakes (>EAR) for all eight fortificant nutrients. However, despite fortification, nutrient gaps remain. [ABSTRACT FROM AUTHOR]