title: A randomized, community-based trial of the effects of improved, centrally processed complementary foods on growth and micronutrient status of Ghanaian infants from 6 to 12 mo of age.
abstract: BACKGROUND
  Koko, a fermented maize porridge used as the primary complementary food in Ghana, has been implicated in the high prevalence of child malnutrition. Weanimix, a cereal-legume blend developed by the United Nations Children's Fund and the Ghanaian government, has been promoted as an alternative.
  
  
  OBJECTIVE
  We evaluated the effect of feeding Weanimix and 3 other locally formulated, centrally processed complementary foods on the nutritional status of 208 breast-fed infants.
  
  
  METHODS
  Infants were randomly assigned to receive 1 of 4 foods from 6 to 12 mo of age: Weanimix (W), Weanimix plus vitamins and minerals (WM), Weanimix plus fish powder (WF), and koko plus fish powder (KF). Dietary and anthropometric data were collected regularly. Blood was collected at 6 and 12 mo of age to assess iron, zinc, vitamin A, and riboflavin status. Before and after the intervention, cross-sectional data on the anthropometric status of infants not included in the intervention (NI; n = 464) were collected.
  
  
  RESULTS
  There were no significant differences between intervention groups in weight or length gain or in hemoglobin, hematocrit, transferrin saturation, plasma zinc, or erythrocyte riboflavin values between 6 and 12 mo of age. From 9 to 12 mo of age, z scores were lower in NI infants than in the combined intervention groups [at 12 mo: -1.71 +/- 0.90 compared with -1.19 +/- 0.93 for weight and -1.27 +/- 1.02 compared with -0.63 +/- 0.84 for length (P < 0.001 for both), respectively]. The percentage of infants with low ferritin values increased significantly between 6 and 12 mo of age in groups W, WF, and KF but not in group WM. Change in plasma retinol between 6 and 12 mo of age was significantly greater in group WM than in the other 3 groups combined (0.14 +/- 0.3 compared with -0.04 +/- 0.3 micromol/L, P = 0. 003).
  
  
  CONCLUSIONS
  All 4 foods improved growth relative to the NI group. Infants fed WM had better iron stores and vitamin A status than those fed nonfortified foods.
authors.affiliation: Department of Nutrition and Program in International Nutrition, University of California, Davis 95616-8669, USA.
authors.forename: A
authors.initials: A
authors.lastname: Lartey
authors.forename: A
authors.initials: A
authors.lastname: Manu
authors.forename: K H
authors.initials: KH
authors.lastname: Brown
authors.forename: J M
authors.initials: JM
authors.lastname: Peerson
authors.forename: K G
authors.initials: KG
authors.lastname: Dewey
mesh_terms: D000328:Adult; D003154:Community Medicine; D003430:Cross-Sectional Studies; D002149:Energy Intake; D005260:Female; D005511:Food Handling; D005869:Ghana; D006801:Humans; D007223:Infant; D009752:Nutritional Status