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Formulation of supplementary infant foods at the home and village level in Thailand

Kraisid Tontisirin, M.D., Ph.D., Benjawan Moaleekoonpairoj, M.S., Sakorn Dhanamitta, M.D., D.Sc., and Aree Valyasevi, M.D., D.Sc.
Ramathibodi Hospital and Institute of Nutrition, Mahidol University, Bangkok, Thailand

INTRODUCTION

During the last twenty years, great efforts have been made to develop, produce, and distribute protein-rich foods to alleviate protein malnutrition in developing countries. Most of the food mixtures have been high in protein but relatively low in fat content. However, these food mixtures played a very small part in solving protein malnutrition since they were usually unavailable to low income groups in urban slums or poor rural areas.

In a recent effort to alleviate protein-energy malnutrition in infants and pre-school children in Thailand, the Institute of Nutrition, Mahidol University (INMU), has developed and tested several supplementary food mixtures. They are low-cost, high-protein, and energy supplementary foods which are readily available for use at the village level.

FORMULATION OF SUPPLEMENTARY FOODS

The formulation of seven supplementary food mixtures was based on the Thai Standard for Infant Foods (1). According to the standard, the protein should not be less than 2.5 g per 100 available kcal of standard protein. The protein quality expressed in terms of amino-acid score should not be less than 70 per cent of the FAD/WHO reference pattern (2). The product should contain linoleic acid at a level not less than 300 mg per 100 available kcal and fat at a level not less than 2 g nor more than 6 g per 100 available kcal.

Each formula was proportionally prepared from a mixture of locally available carbohydrate, fat, and protein food sources. Since rice is a staple food, it was used as a major ingredient of the mixture. Protein sources were derived from either soybeans, mung beans, or fish meal. Groundnuts and sesame were supplemented to the mixture to provide fat as well as protein. The nutrient composition of the seven supplementary food mixtures is shown in table 1. Protein and fat contents range from 13.2 to 18.5 and g.2 to 13.2 g per 100 g of the food mixture respectively, and energy content varies from 437 to 454 kcal per 100 g-all of which meet the recommended allowances.

TABLE 1. Ingredients and Composition of Supplementary Food Formulas

* Numbers in parentheses indicate the proportion of the individual ingredients.

TABLE 2. Nutrient Composition of Supplementary Food Formulas per 100 kcal

TABLE 3. Amino-Acid Score of Supplementary Food Formula I (Rice, Soybeans, Groundnuts)

S-AA = sulphur-containing amino acids
arom AA = aromatic amino acids.
* AA score of Formula I is 80.

If protein, fat, and linoleic acid contents are considered as per 100 available kcal, all the supplementary food mixtures meet the standard. Table 2 shows these nutrient compositions per 100 kcal of the food mixtures.

At the institute, the formulation of these supplementary food mixtures was obtained manually by calculating the proportion of the ingredients that had to be used in the formulas to meet the content standards for protein, fat, and linoleic acid. The amount and cost of individual ingredients were taken into consideration in order to obtain a product at the lowest cost possible.

To illustrate the calculation, consider Formula I-rice, soybeans, and groundnuts. Table 3 shows that, of its constituent amino acids, the sulphur-containing acids have the lowest score, 80, and they are therefore limiting for the mixture as a whole; consequently the amino-acid score of the formula is 80. To determine the required protein content to meet the standard of 2.5 g per 100 available kcal, use the calculation

For Formula I, then, with its AA score of 80:

That is, the protein content should be no less than 3.1 g per 100 kcal. But we have already seen in table 2 that the actual protein content of Formula I is 3.77 g per kcal, which is higher than the calculated value. The fat and linoleic acid contents of this mixture are also higher than 2 g and 300 mg per 100 kcal respectively. With the aid of linear computer programmes, many more formulations can be obtained.

PREPARATION OF SUPPLEMENTARY FOOD

Preparation of the supplementary food mixture followed a simple technique. Beans, groundnuts, and sesame had to be roasted for five to ten minutes first, in order to obtain simultaneously well-cooked ingredients. In addition, the roasting of these ingredients added an aroma to the food mixture. Rice was roasted for a shorter period of time of three to five minutes to kill contaminated organisms.

Roasting of the rice reduced moisture content, hence increasing the storage time.

After roasting, each ingredient was weighed and mixed proportionally with other ingredients of the mixture. The mixture was ground with an electrical grinder capable of grinding one kilogram of the mixture in five minutes. The ground mixture was packed and sealed in small plastic bags of 100 or 250 g per package. Each 100 g package provides approximately 450 kcal.

To cook the food, the ground mixture was immersed in six times its volume of water, stirred, and then boiled at 100 ºC for 10 to 15 minutes. The operational flow of preparation is shown in figure1.

A child who weighs 10 kg will be adequately provided with both protein (30-40 g) and energy (1,000 kcal) from 250 g of any of the food mixtures. Infants from 4 to 6 months old may be able to eat one meal of 20 to 40 g of this supplementary food.

EVALUATION AND TESTING FOR TOLERANCE AND ACCEPTABILITY

Since the supplementary food mixtures in this study were prepared from common food sources and the steps in the production of the mixtures were quite simple, these food mixtures were tested directly with infants and young children.

FIG. 1. Operational Flow for Preparation of Supplementary Food Mixtures Made from Rice, Beans, and Groundnuts or Sesame

An evaluation of chemical analyses for composition and microbial contamination was completed with satisfactory results. The food mixtures may be kept for at least six to eight weeks without any evidence of spoilage or overgrowth of micro-organisms (3).

Some preliminary tests for acceptability and tolerance of the supplementary food mixtures l-IV were conducted on young children in Ubon province, northeast Thailand. Results showed good acceptance and tolerance by these children.

A study had previously been carried out on Thai infants and children involving Kaset Infant Food, made from soybean flour, and sugar supplemented with vitamins and minerals or from a mixture of rice and mung beans. Results showed good absorption, digestion, and utilization of protein from the mixture of rice and legumes (4).

CONCLUSION

There is a need to produce family- and village-based supplementary foods for weaning infants. The food pro. ducts have to be made from locally available foods, and they must be acceptable, easy to prepare, and adequate in protein, energy, and other nutrients.

Seven supplementary foods with high protein and energy densities were formulated by the Institute of Nutrition. Each formula was proportionally prepared from a mixture of locally available carbohydrate, fat, and protein food sources. Since rice is the staple food, it took up the major portion of the food and was mixed with soybeans, mung beans, or fish meal for protein and with groundnuts and sesame to add fat. The nutrient composition of these mixtures provided adequate protein, fat, and energy contents, all of which met the recommended allowances. Preparation of these food mixtures is simple and easily performed at the village level.

Some preliminary tests for acceptability and tolerance of Formulas l-IV have been conducted on young children in Ubon province, and the findings showed good acceptability and tolerance. However, further studies are still required to develop more formulas and improve the products.

REFERENCES

1. Ministry of Public Health, Thai Standard for Infant Food (Thailand, 1979)
2. Report of the Joint FAD/WHO ad Hoc Expert Committee on Energy and Protein Requirements, WHO Tech. Rep. Ser. No. 522 WHO, Geneva, 1973).
3. B. Mouleekoonpairoj, "The Formulation of Rice-Based Supplementary Foods for Thai Infants," thesis submitted for the degree of M.S. nutrition (Mahidol University, Thailand, 1980).
4. N. Aranyakanonda, "Metabolic Evaluation of Kaset Infant Food," thesis submitted for the degree of M.S. nutrition (Mahidol University, Thailand, 19771.

Home and village prepared weaning foods project

A project to assist countries with the development of home- and village-based weaning foods has been initiated by the MIT/Harvard International Food and Nutrition Program (IFNP) through a three-year grant from USDA/USAID. Its purpose is to provide assistance to developing countries and private voluntary organizations for the development and promotion of locally produced food supplements for weaning-age children and pregnant and lactating women.

Although the project's goals are broad in scope, they focus on:

- Collection and dissemination of information about the best local approach to improving the feeding of weaning-age children and expectant or breastfeeding women. An archive of literature in the field is being assembled which will be available to countries and programmes through a computerized printout of abstracted literature, review summaries, and reports of successful programmes.

- Provision of technical expertise in response to requests for assistance in designing, implementing, and evaluating programmes that will improve the nutritional status of weaning-age children and pregnant and lactating women. Specific requests will be met by consultants selected from an international panel.

- Demonstration of practical ways of integrating such programmes into local health programmes using local personnel and resources and appropriate technology. Responses to appropriate requests at no charge. For further information, contact: Dr. Gretchen Berggren, International Food and Nutrition Program, MIT 20A-201, Cambridge, Mass. 02139, USA.

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