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Item A food multi-mix supplement for pregnant women in the Vaal Region(2008-09) Twenefor, Charlotte; Kesa, Hema; Oldewage-Theron, WilnaGood maternal nutrition is vital for the health and survival of the developing foetus. Nutritive inadequacy has been associated with pregnant women in developing countries particularly Sub Saharan Africa. Adequate intake of both macro and micronutrients by this vulnerable group must be ensured to avoid maternal and infant morbidity and mortality. In this study, a novel approach was employed to develop a cost effective, culturally acceptable and nutrient-dense food multi-mix (FMM) supplement that would help meet 20-25 percent of the recommended daily allowance (RDA) of pregnant women aged between 20and 30 years in the Vaal region. Twenty FMM supplements were formulated using South African food composition tables to ensure adequate nutritional content. Two out of the twenty, were selected and named FMM C1 and C3 respectively. FMM C I and C3 was selected owing to their better nutrient contents and affordability when compared with the others. Food items used to formulate FMM C 1 included maize meal, pea powder, peanut dry, milk powder and kidney beans. FMM C3 was formulated with sorghum, maize meal, peanut dry and onion powder. Chosen food items were dried, roasted, ground and mixed together proportionately. FMM supplements (C 1 & C3) were analyzed using standard laboratory techniques to determine their nutrient content. Results obtained were from the Agricultural Research Council (ARC). The shelf life of the FMM supplements was microbiologically tested. Shelf life testing proved safety for the time of consumption, as very little microbiological growth was found in 28 days. The FMM supplements were then incorporated in the development of two acceptable recipes (soup and gravy).Simple recipe leaflets were developed for use by the subjects. The process proved that it is possible to formulate a FMM or any other food product according to certain formulation criteria since formulated FMM supplements (C1 and C3) met the criteria of at least 20% RDA of Protein (g). However, the criteria for micronutrients and energy were difficult to meet as folate iron and energy showed lower percentages of 10%, 14% and 18% respectively in the experimental situation. Sensory evaluation was conducted to ascertain the acceptability of the developed recipes (soup and gravy). The sample consisted of pregnant women randomly selected from John Haynes and Sharpeville clinics respectively, it can be concluded it is possible to formulate and develop products that were culturally acceptable to the consumers (pregnant women) as sensory analysis indicated the majority (85%) of the respondents liked the gravy and 65% liked the soup. Further research is needed to address the impact on nutritional status, long-term compliance and development of range of FMM with various ingredients to determine the most nutritional, cost effective and acceptable product for pregnant women.Item The impact of dietary diversification on the nutritional status of pregnant women in the Vaal Region(2010-06) Kesa, Hema; Oldewage-Theron, Wilna; Venter, ChristineThe main objective of this study was to develop a cost-effective, culturally acceptable, nutrient-dense food multimix (FMM) based on local food staples for pregnant women in the Vaal region. The impact of the consumption of the multimix on the nutritional status of the women, dietary diversity and outcomes of pregnancy was assessed in an intervention study by measuring the same variables as for a pilot study where the nutritional status of pregnant women was determined. Compliance was measured through monitoring of the FMM consumption and sensory evaluation tests. Quantitative food frequency questionnaires (QFFQs) and 24-hour recall questionnaires were completed in interviews. Anthropometric and biochemical measurements were recorded. The pilot study indicated that the mean total iron intake was 9,74 mg/day, below the estimated average requirement (EAR) of 22 mg/day for pregnant women. Therefore, 41,7 per cent of the women were found to be iron deficient and 50 per cent suffered from iron deficiency anaemia. Food consumed supplied little iron. Eighty per cent of the women were overweight before falling pregnant. Based on the pilot study, the FMM was developed and subjected to the following processes: chemical analysis, shelf life tests, recipe development and sensory evaluation. The product was then implemented in an intervention programme. A control group of pregnant women received soup powder. The respondents were relatively healthy and did not suffer from any chronic diseases. According to the nutrient intakes measured by the QFFQ, indicating usual dietary intakes, the iron intake of 87,5 per cent of the experimental group and 94 per cent of the control group fell below the EAR before intervention. After the intervention it improved in that the iron intake of 35,2 per cent of the experimental group and 33,3 per cent of the control group fell below the EAR. The top 10 items consumed by the experimental group during pre- and post-intervention were mainly rich in carbohydrates. Food containing iron absorption inhibitors such as tannin in tea and phytates in maize meal and bread were among the top 10 foods listed. The highest number of individual food items consumed by an individual in seven days was 39 before the intervention and 52 after the intervention, among the experimental group. The individual food variety improved after the intervention. The reason for this could be the inclusion of the FMM in their diets. The majority of the respondents consumed eight to nine of the nutritious food groups before and after the intervention. The mean food variety score (FVS) for the control group was 38,9 (±10,5) before the intervention, which decreased to 35,8 (±8,39) after the intervention. No improvement in FVS was observed after the intervention in the control group and the FVS indicated medium dietary diversity (30-60 food items). The post-intervention results show that there was an improvement in most of the iron variables. The experimental group showed statistically significant differences between pre- and post-intervention measurements in transferrin and haematocrit levels and the control group in haematocrit levels. All the babies born to the mothers of both the experimental and control groups were healthy with measurements in the normal range. The reason for this could be that the inclusion of the FMM and soup powder in the diets of the experimental and control group, respectively, made the women more aware of the importance of pregnancy monitoring. Furthermore, the attention given to the women by the clinic sisters and the researchers could have contributed to all the improvements mentioned.