title: Fortified complementary foods with or without alpha-amylase treatment increase hemoglobin but do not reduce breast milk intake of 9-mo-old Zambian infants.
abstract: BACKGROUND
  Malnutrition in late infancy in developing countries may result from poor-quality complementary foods that displace breast milk.
  
  
  OBJECTIVE
  The objective of the study was to assess the effects of fortified complementary blends of different energy densities on growth, hemoglobin concentrations, and breast milk intake of 9-mo-old Zambian infants.
  
  
  METHODS
  Infants were randomly assigned at 6 mo of age to receive for 3 mo a fortified blend of maize, beans, bambaranuts, and groundnuts [Chilenje Baby Mix (CBM); energy density: 68 kcal/100 g; n = 37] or a similar blend with alpha-amylase (CBMA; energy density: 106 kcal/100 g; n = 44). Cross-sectional data were obtained at 9 mo for a control group of infants (n = 69) not given the diets. Breast milk intake was measured by using the dose-to-the-mother deuterium dilution technique.
  
  
  RESULTS
  No differences in weight or length z scores, all of which were within normal ranges, were seen between groups at 9 mo. Percentage fat mass was significantly (P = 0.01) greater in the infants in both the CBM (23.2 +/- 2.7%) and CBMA (23.4 +/- 2.5%) groups than in the control group (21.6 +/- 2.6%). Hemoglobin concentrations were significantly (P = 0.03) greater in both intervention groups (CBM group: 104 +/- 12 g/L: CBMA group: 103 +/- 12 g/L) than in the control group (98 +/- 14 g/L). Breast milk intake was not significantly (P = 0.87) different between groups (CBM group: 614 +/- 271 g/d; CBMA group: 635 +/- 193 g/d; control group: 653 +/- 221 g/d).
  
  
  CONCLUSIONS
  The study foods improved hemoglobin concentrations without reducing breast milk intake and may be used to improve the nutritional status of infants in developing countries.
authors.affiliation: Center for International Child Health, Institute of Child Health, London, United Kingdom. vowino@hotmail.com
authors.forename: Victor O
authors.initials: VO
authors.lastname: Owino
authors.forename: Lackson M
authors.initials: LM
authors.lastname: Kasonka
authors.forename: Moses M
authors.initials: MM
authors.lastname: Sinkala
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Wells
authors.forename: Simon
authors.initials: S
authors.lastname: Eaton
authors.forename: Tegan
authors.initials: T
authors.lastname: Darch
authors.forename: Andrew
authors.initials: A
authors.lastname: Coward
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Tomkins
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Filteau
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D001823:Body Composition; D001827:Body Height / Q000187:drug effects / Q000502:physiology; D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D003430:Cross-Sectional Studies; D003903:Deuterium; D004435:Eating / Q000187:drug effects / Q000502:physiology; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005527:Food, Fortified; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000592:standards*; D007227:Infant Nutritional Physiological Phenomena / Q000187:drug effects / Q000502:physiology*; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000378:metabolism; D008895:Milk, Human / Q000737:chemistry; D009752:Nutritional Status; D009753:Nutritive Value; D014886:Weaning; D015024:Zambia; D000516:alpha-Amylases / Q000008:administration & dosage* / Q000378:metabolism
chemical_list: D006454:Hemoglobins; D018977:Micronutrients; D003903:Deuterium; D000516:alpha-Amylases