Scientific Research and Essays Vol. 7(9), pp. 972-988, 9 March, 2012
Available online at http://www.academicjournals.org/SRE
DOI: 10.5897/SRE11.1362
ISSN 1992-2248 ©2012 Academic Journals
Review
Complementary food blends and malnutrition among
infants in Ghana: A review and a proposed solution
Francis Kweku Amagloh
1,2
, Janet L. Weber
1
, Louise Brough
1
, Allan Hardacre
1
, Anthony N.
Mutukumira
1
and Jane Coad
1
*
1
Institute of Food, Nutrition and Human Health, Massey University, Turitea Campus, Private Bag 11 222, Palmerston
North 4442, New Zealand.
2
University for Development Studies, Tamale, Ghana.
Accepted 22 November, 2011
Widespread malnutrition among Ghanaian infants could be attributed to unfortified plant-based
complementary foods commonly used at the household level. This review summarises the publications
on the development of complementary food blends and intervention trials aimed at improving the
nutritional status of Ghanaian infants. The complementary food blends are cereal-based which are
developed from maize (in higher proportion) together with soyabean, cowpea and/or groundnut-an
effort to improve protein and energy levels. The cereal-legume blends affect growth more positively
than cereal-only formulations but not micronutrient status unless fortified with micronutrients. The low
level of micronutrients (including vitamin A) and the high phytate content of cereal-legume blends
partly account for micronutrient deficiencies. Phytate limits the bioavailability of nutrients such as iron,
calcium and zinc. We propose an alternative complementary food blend which is based on sweet
potato. This proposed formulation would be relatively high in endogenous β -carotene (vitamin A
precursor) and low in phytate compared to household-level cereal-based complementary foods.
Key words: Cereal-legume, complementary food, Ghana, malnutrition, phytate, sweet potato.
INTRODUCTION
The level of childhood malnutrition in Sub-Saharan Africa,
an area that includes Ghana, is among the worst in the
world. The proportion of children under 5 years with
chronic malnutrition (<-2 SD from the reference median
for height-for-age) in Sub-Saharan Africa was 38%,
against a worldwide prevalence of 28% (UNICEF, 2009).
Globally, an estimated 33% of children under 5 years
were vitamin A deficient; in Africa, the prevalence was
higher (42%) (WHO, 2009). Although the prevalence of
anaemia (haemoglobin threshold of ≤110 g/L) among
children under 5 years was a worldwide problem (47%),
the occurrence was markedly higher (68%) in Africa (de
Benoist et al., 2008). Infants are more likely to become
malnourished in low-income countries when
complementary foods are introduced (Dewey et al., 1992;
*Corresponding author. E-mail: J.Coad@massey.ac.nz. Tel:
+64 06 350 5962. Fax: +64 06 350 5446.
Dewey, 1998; Gibson et al., 1998; Lutter and Rivera,
2003). The inadequacy of infant nutrition and its negative
influence on attainment of full potential in life is now well
established (Pan American Health Organization (PAHO)
and WHO, 2003; Engle et al., 2007; Adu-Afarwuah et al.,
2008; Beard, 2008). Grantham-McGregor et al. (2007)
suggested that poor nutrition during infancy is likely to
lead to poor academic achievement, low incomes in
adulthood and inadequate care for the children of
subsequent generations. This cycle has contributed to
the inter-generational poverty bedevilling low-income
countries in South Asia and Sub-Saharan Africa (Walker
et al., 2007). Therefore, a review of the types of
complementary foods available/being promoted in low-
income countries, such as Ghana, demands more
attention. Ghana was chosen because of the vigorous
efforts by local and international researchers to improve
the nutritional status of infants during the last two
decades in the country.
This review is limited to publications on the formulation