title: Increased food intake after the addition of amylase-rich flour to supplementary food for malnourished children in rural communities of Bangladesh.
abstract: BACKGROUND
  In Bangladesh, as in other developing countries, protein-energy malnutrition is mostprevalent among children during weaning. After weaning, children are often fed cereal-based diluted low-calorie porridge, resulting in growth-faltering.
  
  
  OBJECTIVE
  To assess the effect on food intake of adding amylase-rich flour (ARF) from germinated wheat to supplementary food among children in nine rural Community Nutrition Centers under the Bangladesh Integrated Nutrition Project (BINP).
  
  
  METHODS
  A total of 166 malnourished children of either sex, aged 6 to 24 months, received one of three diets randomly allocated to the Community Nutrition Centers. The composition of the diets was the same; however, the consistency and calorie density were altered by adding either ARF or water. Thirty-five children received the standard supplementary food of the BINP (S-SF), 65 received supplementaryfood with added ARF (ARF-SF), and 66 received supplementary food with added water (W-SF). The children were studied for six weeks. Results. The mean +/- SD intake of supplementaryfood from a single meal by children completing six weeks on the diets was higher for children receiving ARF-SF (33.91 +/- 8.25 g) than for those receiving S-SF (25.66 +/- 6.73 g) or W-SF (30.26 +/- 8.39g) (p < .05 for both comparisons). The weight of vomited food was significantly higher for children receiving W-SF than for children in the other two groups. Weight gain and increments in length and weight-for-height were higher for children who received ARF-SF than for children in the other two groups, but the differences were not statistically significant. The acceptability ofARF-SF was higher than that of the two other diets. The additional cost of adding 2 g of ARF to the diet was about Taka 0.25 (U.S. dollar 1 = Taka 48).
  
  
  CONCLUSIONS
  Addition of ARF to existing standard supplementary food, as used under the BINP program, is a simple and effective means to increase the intake of food by changing its consistency, thus making it easier for malnourished children to ingest.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Mohakhali, Dhaka, Bangladesh. ihossain@icddrb.org
authors.forename: M Iqbal
authors.initials: MI
authors.lastname: Hossain
authors.forename: M A
authors.initials: MA
authors.lastname: Wahed
authors.forename: Shaheen
authors.initials: S
authors.lastname: Ahmed
mesh_terms: D000681:Amylases / Q000008:administration & dosage* / Q000378:metabolism; D001459:Bangladesh / Q000453:epidemiology; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D002149:Energy Intake; D005260:Female; D005527:Food, Fortified / Q000592:standards; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D009753:Nutritive Value; D011502:Protein-Energy Malnutrition / Q000178:diet therapy* / Q000453:epidemiology; D012423:Rural Health; D016896:Treatment Outcome; D014839:Vomiting / Q000453:epidemiology; D014886:Weaning
chemical_list: D000681:Amylases