Effects of weaning biscuits on the nutritional profile and the cognitive development in preschool children

In India, Protein Energy Malnutrition(PEM) among children under five years still constitutes a major public health problem, poor infant feeding and weaning practices are major contributory factors in malnutrition especially among the under fives. Weaning diets of the low income families are often cereal gruels or regular family diet with or without small quantities of pulses thus inadequate in both calories and proteins. As a result, prevalence of PEM along with other micronutrient deficiencies is the order of the day [1].

Potato (solanum tuberosum L) belongs to family solanaceae in one of the major tuber corps of the world and most important commercial vegetable vis-à-vis food crop grown in India. It is rich in carbohydrates and good quality proteins namely tyrosine, proline, leucine and isoleucine responsible for the good nutritional status. It is are available in India round the year and is a good supplement to the cereal diets. Potato based products can be more well balanced in proteins, vitamins and calories/unit area/unit time than any other food [2].

Wheat grains are used to make flour, which is transformed into dough and then breads, which is a staple food in every country and culture. It is rich in protein and provides daily requirement of energy. It has wide culinary uses, from the making of breads, pasta and cakes to fermentation of alcoholic beverages. Finger millet is especially valuable as it contains the amino acid methionine which is lacking in the diets of hundreds of millions of the poor who live on starchy staples such as polished rice or maize meal. In southern parts of India, pediatricians recommend finger millet based food for infants of six months and above because of its high nutritional content especially calcium[3].

Soy being an excellent source of both calories and good quality protein along with other micronutrients can in a large measure help formulation of nutrient dense weaning and supplementary foods that can be recommended for consumption if mitigation of PEM is the concern [4].

The aim of the study is to develop and standardize the weaning biscuits, to study background information, clinical history, nutritional status and dietary pattern, to evaluate the supplementary effect on anthropometric and cognitive development of the selected children.

Initially good quality potatoes were taken, washed, peeled, pre treated with (3% Nacl with 0.05% ascorbic acids) sliced, blanched, cooled and once again treated with 0.02% potassium meta bisulphate, drain the treated slices, dry in sun and made into flour. The other ingredients like soya flour, ragi flour, and wheat flour were procured from the local market. Three varieties of weaning biscuits were developed using the proportion of Potato flour (Variety I) Wheat flour (Variety II) Ragi flour (Variety III) with soya flour in the ratio of 80:30 with the addition of sugar and fat. All the developed three varieties of biscuits were evaluated for their acceptability by a panel of 10 judges from Department of Food Science, Periyar University, Salem. All the judges were asked to score the products for appearance, colour, flavor, taste, texture and over all acceptability using a score of a nine point hedonic scale [5]. The developed biscuits were analyzed for its nutritive value with reference to calories, protein, fat, carbohydrates, crude fiber and total ash using the standard procedures [6].

Three primary schools situated in Omalur, Salem district, Tamilnadu, India were selected by purposive sampling method for the sample selection. A total of 150 preschool children 61 from primary school I, 46 from primary school II, 43 from primary school III, belonged to the age group of 2 - 3 were selected for the initial survey. After preliminary survey, 80 preschool children were identified as malnourished (Grade II) based on the height and weight measurement. Assessment of mean nutrient intake using food weighment survey of selected malnourished children was found to be low as energy-710 ± 23.45 K.cal, protein-10 ± 0.92 g and fat-8 ± 1.20 compared to the Recommended Dietary Allowances (RDA) and this calorie gap in their dietaries was estimated as 320 k.cal. These 80 preschool children are admitted for the experimental study.

Identified Eighty Grade II malnourished primary school children were divided into four groups with twenty subjects in each group and given the following weaning biscuits.

Group I: 20 children kept as control group they are on home diet only.

Group II: 20 children supplemented with Potato flour biscuits.

Group III: 20 children supplemented with Wheat biscuits.

Group IV: 20 children supplemented with Ragi biscuits.

Each supplemented groups received six biscuits comprising the weight of 60 grams daily. Three biscuits were given in the mid morning and three biscuits in the evening. This whole research procedure was compatible with Helsinki Declaration and written consent was received from all the participants.

Before starting the feeding trail one local school teacher from each school were selected to distribute and monitor the feeding for the selected children of their area. They were initially briefed about the importance of the study. The feeding trail was conducted for a period of 3 months and during the entire study period, all the experimental and control groups were supervised by the research staff. The study was approved by the Institutional Ethical Committee (IEC) members.

Background details such as age, sex, type of family, family size, birth order, level of income per month were elicited by interviewing the parents of the selected children using an interview schedule.

Anthropometric measurements like height and weight, clinical picture were studied before and after supplementation with the help of a physician. Apart from above data certain perceptual development that measures cognition was assessed before and after the supplementation period for the selected children using specially designed criteria [7].

The data was complied and analyzed by using statistical methods. Descriptive statistics ANOVA and paired comparison test are computed using a statistical software SPSS version 15.0 Duncan's multiple range tests is applied to determine the significant differences between the supplemented biscuits.

Studies have documented the positive correlation between the nutritional status of the children with the nutritional knowledge of the parents. As the knowledge is increased better nutritional picture was observed among their children [10–13].

Mean weight of the supplemented children increased by the end of study period compared to the baseline value. Supporting the findings of the present study supplementation of the energy dense foods had good impact on growth status of the children [14]. Similar findings have been reported in children supplemented with the Amylase Rich Flour (ARF) food [15].

In the present study, it was observed that after 3 months of supplementation hemoglobin contents was increased significantly. Owino et al [16] have reported that supplementation of energy dense foods have improved the hemoglobin concentration. In another study supplementation of fortified beverage for 6 months has significantly improved the hematologic and anthropometric measurements and significantly lowered the overall prevalence of anemia deficiency among the children [17]. Similar findings have been reported in various research studies [18].

It is thus evident that in comparison to the control group children the cognitive performance was good in the supplemented group children. This may be due to the fortification of micronutrient dense foods in the weaning biscuits supporting these findings, supplementation of fortified fruit powder beverage for 16 weeks showed significant improvements in cognitive performance [19]. In another study supplementation of beta-carotene fortified biscuits significantly improved the cognitive functions of the children [20].

In conclusion, all these observations evident that the improvement in anthropometric measurements and better cognitive performance among the malnourished children, clearly indicate that potato flour weaning biscuits undoubtedly helps to improve the nutritional picture and health of the children as that of wheat and ragi biscuits. If such potato flour can form a daily ingredient of the diets of the children right from weaning it can go a long way to help in changing the current malnutrition scenario among the children's and bring out better all round development of the children. Future researches must include development of 100% potato flour, wheat flour and Ragi flour biscuits and its impact should be studied. Alkaloids and cyanogenic compounds should be estimated in the developed biscuits.