A randomized, community-based trial of the effects of improved, centrally processed complementary foods on growth and micronutrient status of Ghanaian infants from 6 to 12 mo of age

Background: Koko, a fermented maize porridge used as the primary complement ary food in Ghana, has been implicated in the high prevalence of child maln utrition. Weanimix, a cereal-legume blend developed by the United Nations C hildren's Fund and the Ghanaian government, has been promoted as an alterna tive. Objective: We evaluated the effect of feeding Weanimix and 3 other locally formulated, centrally processed complementary foods on the nutritional stat us of 208 breast-fed infants. Design: Infants were randomly assigned to receive 1 of 4 foods from 6 to 12 mo of age: Weanimix (W), Weanimix plus vitamins and minerals (WM), Weanimi x plus fish powder (WF), and koko plus fish powder (KF). Dietary and anthro pometric data were collected regularly. Blood was collected at 6 and 12 mo of age to assess iron, zinc; vitamin A, and riboflavin status. Before and a fter the intervention, cross-sectional data on the anthropometric status of infants not included in the intervention (NI; n = 464) were collected. Results: There were no significant differences between intervention groups in weight or length gain or in hemoglobin, hematocrit, transferrin saturati on, plasma zinc, or erythrocyte riboflavin values between 6 and 12 mo of ag e. From 9 to 12 mo of age, z scores were lower in NI infants than in the co mbined intervention groups [at 12 mo: -1.71 +/- 0.90 compared with -1.19 +/ - 0.93 for weight and -1.27 +/- 1.02 compared with -0.63 +/- 0.84 for lengt h (P < 0.001 for both), respectively]. The percentage of infants with low f erritin values increased significantly between 6 and 12 mo of age in groups W, WF, and KF but not in group WM. Change in plasma retinol between 6 and 12 mo of age was significantly greater in group WM than in the other 3 grou ps combined (0.14 +/- 0.3 compared with -0.04 +/- 0.3 mu mol/L, P = 0.003). Conclusions: All 4 foods improved growth relative to the NI group. Infants fed WM had better iron stores and vitamin A status than those fed nonfortif ied foods.