Malnutrition continues to be a major health burden in developing countries. In Egypt, the data of height-for-age Z-score (HAZ) indicated that there was considerable chronic malnutrition among children. Iron deficiency is considered the most prevalent among preschool children, and iron deficiency anemia is considered a moderate public health problem. The main object of the current study was improving the nutritional status of preschool children from low and middle income groups in Egypt by an intervention with locally made snack. The study was designed as a single-blind, placebo-controlled intervention for 8 weeks. 45 children aged 24-47 months were divided into two groups. The first group was the intervention group which received the snack (n = 22), and the second group was the placebo group which received an isocaloric beverage (n = 23). The snack and the beverage were similar only in energy content. Information on the family sociodemographic characteristics and children s dietary habits were obtained during an interview with the mothers. Every child was asked about his/her acceptability of the snacks. 24-hour recall method was used to assess the usual intake of energy and nutrients for two consecutive days. Both at baseline and after the intervention, weight and height were assessed and blood samples were collected from all children. A complete blood cell count was performed and serum ferritin level was determined.
The snack was acceptable among the children for their sweet and nice taste. Using the snack had a positive effect on the nutritional status of the preschool children. In the intervention group, the prevalence of stunting and underweight was lower after the intervention than at baseline, and there was no change in the prevalence of wasting. In the placebo group, there was no change in the prevalence of stunting and underweight was found only after the intervention. The prevalence of wasting increased during the intervention.
The children in the two study groups showed a significant increment in the mean of height which was higher in the intervention group than in the placebo group (1.67 cm vs. 1.34 cm). There was an increase in the mean value of HAZ after the intervention in the two groups, and the difference between the two groups was significantly higher after the intervention (p = 0.014) than at baseline (p = 0.026). The mean value of weight-for-height Z-score (WHZ) and also of weight-for-age Z-score (WAZ) of the children in the two groups were lower after the intervention compared to baseline. This decrease in WHZ and in WAZ was not significant in the intervention group, however; it was significant in the placebo group.
There was a significant increase in the mean intakes of energy and nutrients during the intervention among the children in the intervention group, especially the deficient nutrients. However, there was no change in the nutrient intakes in the placebo group.
The blood measurements of the children in the intervention group, particularly the anemic children, improved after the intervention compared with the placebo group. The mean value of haemoglobin increased slightly (0.27 g/dl) in the intervention group, however; there was no change in the placebo group. The children in the two study groups showed a significant increase in the red blood cell counts after the intervention which was significantly higher in the intervention group (p = 0.0001) than in the placebo group (p = 0.001). Furthermore, the prevalence of low ferritin level in the intervention group decreased after the intervention compared to at baseline; however, it increased in the placebo group.
The prevalence of anemia among the children in the intervention group was 28.6% at baseline, and it decreased to 19% after the intervention. In the placebo group, there was no change in the prevalence of anemia after the intervention from baseline (19%). After the intervention, the haemoglobin value increased among 4 anemic children in the intervention group, and half of them had haemoglobin >11 g/dl. One anemic child in the placebo group had an increase in the haemoglobin value, but it remained lower than 11 g/dl.It can be concluded that a supplement made from locally available food as a snack showed a success in improving the nutritional status of the preschool children from low and middle income groups in Egypt. The snack was effective in managing iron deficiency among the children in study population.
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