Adding a-amylase to Weaning Food to Increase Dietary Intake in Children. A Randomized Controlled Trial by Leo den Besten,* Ingrid I. Glatthaar* and Carel B. Ijsselmuiden** *Department of Human Nutrition, Faculty of Medicine, Medical University of Southern Africa, PO Box 177, Medunsa 0204, South Africa ""Department of Community Health, University of Pretoria, PO Box 667, Pretoria 0001, South Africa Summary The addition of a-amylase to a food supplement for weaning-age children was proposed as an alternative to traditionally prepared Amylase-Rich Foods (ARF) for reducing the dietary bulk of weaning diets. In a self-controlled clinical trial including 30 healthy children, aged 10-24 months, the effect of the addition of a-amylase and extra cereal to a diet including three meals, was determined in terms of dietary intake. A mean increased intake of 23.8 per cent in energy and 10.4 per cent in protein was found. The addition of commercial a-amylase to maize-based weaning foods is a useful method of Increasing the nutritional value of weaning diets. Introduction Protein-energy malnutrition (PEM) in young children ranks as one of the most prevalent forms of malnutrition in developing countries, 1 including South Africa. 2 Although the causes behind malnutrition are diverse and complex, inadequate dietary intake, particularly at weaning-age, is a major contributory factor and deserves critical attention. Adverse dietary bulk characteristics of weaning diets are seen as an important factor in the aetiology of PEM in the developing world. 3 ' 4 Dietary bulk is concerned with both the volume and the viscosity of food. In many developing areas, including large parts of South Africa, home-made, starch-based foods are used as weaning foods, and these are characterized by a high water content, and low energy and nutrient density. To achieve an intake that is sufficient to meet energy and nutrient requirements, a child must ingest a relatively large volume of such foods. The volume can be diminished by adding less water to the maize meal or other starch-based food. However, this increases the viscosity of the food, which, in turn, makes it more difficult for the young and, Acknowledgements The health authorities of the Ditsobotla district are acknowl- edged for permission to conduct the study, and Dr C. van der Merwe for assistance with the data analysis. The a-amylase preparation and the dried skimmed milk powder was provided to the researchers free of charge by the National Co-operative Dairies Ltd, Sandton, South Africa, and funding for payment of salaries of the research assistants was provided by Clover South Africa. Correspondence: Professor Ingrid I. Glatthaar. particularly, for an ill child to eat. The caretaker's challenge is to combine adequate energy and nutrient density with acceptable viscosity. One solution to the dietary bulk dilemma is the addition of flour from germinated grains, called Amylase-Rich Food (ARF), to the starch-based food. This option has received considerable attention since the early eighties. 5 ""* The addition of a small amount of ARF to cooked porridge causes a dramatic reduction in the viscosity of the porridge, due to the action of amylolytic enzymes—particularly a-amylase—present in ARF. It thus lowers the viscosity without lowering the nutrient and energy density of the food. In spite of the fact that the process of cereal germination is culturally familiar in countries such as Uganda, Tanzania, and India, the actual application in practice of ARF technology appeared disappointing in these countries. ' The extra time needed for the preparation of ARF and the link made with the process of beer-brewing, were found to be obstacles to the regular use of ARF in optimizing weaning diets. Similar obstacles were expected to occur in the South African context where germination is no longer generally practised, and where ARFs have never been introduced before. However, the addition of a commercial a- amylase preparation to skimmed milk powder that was already being used in a food supplementation pro- gramme, was considered as an alternative and pragmatic way of improving the dietary bulk characteristics of local weaning diets. The specific objective of this study was to determine the effect on dietary intake of the addition of extra cereal and a commercial a-amylase preparation to porridge-based meals consumed by weaning-age children. © Oxford University Press 1998 Journal of Tropical Pediatrics Vol. 44 February 1998 Downloaded from https://academic.oup.com/tropej/article/44/1/4/1636048 by guest on 27 October 2021