WINFOOD

2013

Chamnan, C., Skau, J.K.H., Roos, N., Dijkhuizen, M.A., Berger, J., Friis, H., Michaelsen, K.F., Wieringa, F.T. (2013). Body composition in relation to micronutrient status in Cambodian infants: the Winfood Project. Annals of Nutrition and Metabolism 63(Suppl. 1): 1452. (Poster PO2457)

Kinyuru, J.N., Konyole, S.O., Onyango-Omollo, S.A., Kenji, G.M., Onyango, C.A., Owino, V.O., Owuor, B.O., Estambale, B.B., Friis, H., Roos, N. (2013). Development and evaluation of amaranth grain based complementary foods supplemented with edible termites and dagaa fish. Annals of Nutrition and Metabolism 63(Suppl. 1): 1793. (Poster PO3162)

Konyole, S., Kinyuru, J., Omollo, S., Owuor, B., Roos, N., Friis, H., Estambale, B., Owino, V. (2013). Prevalence and severity of malnutrition among infants and young children in an HIV and malaria prone rural setting, Western Kenya. Annals of Nutrition and Metabolism 63(Suppl. 1): 560. (Poster PO625)

Konyole, S., Kinyuru, J., Owuor, B., Roos, N., Friis, H., Aagaard, J., Estambale, B., Owino, V. (2013). Acceptability of complementary foods with indigenous animal source foods and corn soy blend plus among young children/mothers in Kenya. Annals of Nutrition and Metabolism 63(Suppl. 1): 1729. (Poster PO3022)

Kuong, K., Chamnan, C.,Touch, B., Skau, J.K.H., Wieringa, F.T., Berger, J., Friis, H., Michaelsen, K.F., Roos, N. (2013). Development of local processed complementary food products - 'WinFoods' - in Cambodia, for food aid programmes for prevention of child malnutrition. Tropical Medicine & International Health 18(S1): 194-195. (Poster P.3.3.2.001 (A))

Makurat, J., Skau, J.K.H., Khov, K., Sok, S., Touch, B., Lach T, Chhoun C, Roos N, Friis H, Michaelsen KF, Wieringa F. (2013). Prevalence of poor iron status among 6 months old infants in a rural part of Cambodia differs by infant feeding practice. Tropical Medicine & International Health 18(S1): 195. (Poster P.3.3.2.002 (A))

Ogden, M., Roos, N., Faurholt-Jepsen, D., Skau, J., Friis, H., Ritz, C., Brage, S., Chamnan, C. (2013). Volume and patterns of physical activity in rural Cambodian children aged 15-months. Annals of Nutrition and Metabolism 63(Suppl. 1): 982-983. (Poster PO1499)

Onyango-Omollo, S.A, Konyole, S., Kinyuru, J., Owuor, B., Roos, N., Friis, H., Estambale, B., Owino, V. (2013) Cross-sectional adiposity and lean mass of six month old infants determined by deuterium oxide dose-to-infant in rural Kenya. Annals of Nutrition and Metabolism 63(Suppl. 1): 177. (Oral Communication O041)

Skau, J.K.H., Chamnan, C., Touch, B., Chea, M., Unni, U., Filteau, S., Wieringa, F.T., Dijkhuizen, M.A., Wells, J., Berger, J., Friis, H., Michaelsen, K.F., Roos, N. (2013). Effect of animal-source foods and micronutrient-fortification complementary foods on body composition, linear growth, iron status - the WinFood Project in Cambodia. Annals of Nutrition and Metabolism 63(Suppl. 1): 163-164. (Oral Communication O014)

Skau, J.K.H., Touch, B., Chamnan, C., Roos, N., Ferguson, E. (2013). The use of linear programming retrospectively to clarify if an intervention product can optimize the complementary food diet - WinFood study from Cambodia. Tropical Medicine & International Health 18(S1): 195-196. (Poster P.3.3.2.003 (A))

The WINFOOD PhD students and partners have been participating in a range of international conferences and fora to present their research work, either as conference speaker or by presenting posters.

Conference presentation

Roos, N., Friis, H., Kinyuru, J.O., Nurhasan, N., Michaelsen, K.F. (2012) Nutrition and food safety of edible insects. Invited background paper and presentation at FAO expert consultation: Assessing the Potential of Insects as Food and Feed for Assuring Food Security, FAO, Rome, Italy, January 23-25, 2012.

Münke, C., Chamnan, C., Thea, L., Ao, V., Hjorstø, N., Roos, N.(2012) Edible Tarantulas and Crickets in Cambodia: Informal market and potential contribution to rural livelyhoods (preliminary findings from a field survey) Presentation at the Regional Symposium on “Promoting underutilised food resources for better nutrition”. Khon Kaen, Thailand, 21-23 May 2012. Organised by The Food and Agriculture Organization of the United Nations (FAO), Khon Kaen University, Thailand, and National Research Council Thailand (NRCT).

Poster presentation

Münke, C., Chamnan, C., Thea, L., Ao, V., Hjorstø, N., Roos, N.(2012) The market for edible tarantulas and crickets in Cambodia; Potentials of traditional food sources. Presented at Tropentag, University of Hohenheim, Stuttgart, Germany, Sep 13-17 2012. Poster presenation by Münke, C. (poster, awarded 3^rd price of 250 posters, for presenting new prospective topic)

Chamnan, C., Roos, N., Nurhasan, N., Kuong, K., Berger, J., Skau, J., Thang, B., Wieringa, F., Münke, C., Thea, L., Friis, H., Michaelsen, K.M. (2012) WinFood Cambodia: Improving Child Nutrition through utilization of local food. Presentation at the Regional Symposium on “Promoting underutilised food resources for better nutrition”. Khon Kaen, Thailand, 21-23 May 2012. Organised by The Food and Agriculture Organization of the United Nations (FAO), Khon Kaen University, Thailand, and National Research Council Thailand (NRCT). Poster presentation by Münke, C. and Thea, L.

Roos, N., Nurhasan, M., Touch, B., Skau, J., Wieringa, F., Kuong, K., Friis, H., Michaelsen, K.F., Chamnan, C. (2010) WinFood Cambodia: Improving child nutrition through improved utilization of local food. Symposium on Biodiversity and Diets, FAO, Rome. 03-05.11.2010. Poster presentation by Roos, N.

Background

More than 10 million children die each year in developing countries, half of them due to underlying malnutrition, mainly because the typical diet lacks diversity with little vegetable and fruit, and little or no animal source foods. This diet has a low energy and nutrient density and low bioavailability of iron, zinc, and vitamin A. Present interventions for improved child nutrition are dominated by supplementation and food-fortification. The safety of iron-supplementation to children has been questioned, as it may increase morbidity and mortality. Improved diet quality is a safe and sustainable intervention. In many developing countries, the intake of traditional foods (wild plants, fish, mollusc, insects etc.) is further spread among communities. Through a systematic approach to improve the utilisation of nutrient dense traditional foods an underutilised source for improved child nutrition WINFOOD is trying to develop more locally sourced intervention food products.

The overall aim of the "WINFOOD project" is to develop nutritionally improved foods for infants and young children in low-income countries, based on improved utilization of traditional foods (semi-domesticated and wild indigenous foods from uncultivated land or aquatic environment), together with improved traditional food technologies (e.g. fermentation). These foods are dubbed WINFOODs. The WINFOOD concept was developed through parallel studies in the “model countries” Cambodia and Kenya. Based on the results, generic guidelines for a feasible, efficient, safe and environmentally sustainable nutritional intervention strategy for improved childhood nutrition based on improved utilisation of traditional foods were developed.

WINFOOD was funded by DANIDA

Specific objectives

The specific objectives were:

1. to identify traditional foods (review, survey);
2. to identify iron and zinc dense foods (nutrient analysis);
3. to develop culturally accepted nutrient-dense meals for children (linear programming);
4. optimise the meals for iron bioavailability (in vitro systems);
5. testing for efficacy for improving child nutritional status, and;
6. develop guidelines for dissemination through collaboration with national stakeholder groups (human intervention studies).

Methodology

In a randomized, controlled design, infants received WinFood or corn–soy blend (CSB) for 9 months from 6 to 15 months of age. Lean mass accrual and blood nutrition indicators (lipid profile, iron and zinc status) were measured cross-sectionally at 9 and 15 months of age, respectively. Lean mass was determined by measuring deuterium oxide enrichment in saliva samples following a standard dose of deuterium solution (0.5 g/kg body weight) to infants. Blood nutrition indicators were determined following the drawing of 3 mL of blood by venipuncture.

Output

The WinFood project have successfully brought together an interdisciplinary research group in Cambodia, Kenya and Denmark, and identified how locally available foods can be used for improved feeding of children during the critical phase of complementary feeding. Specifically the portential of using insects and other arthropodes as an alternative protein source has been highlighted. By applying highly advanced research methodology the project has contributed significant capacity building in partner countries, and have provided new understanding of prevention of undernutrition. The conclusion from Cambodia is that nutritous local foods can contribute significantly to improve dietary quality, but also that a level of fortification with micronutrients appears to be needed to meet nutrient requirements, especially iron. The conclusion in Kenya supported this conclusion. The study provided evidence that local products can exchange imported food aid products, and that a rice and fish based product are equal to support growth to a milk based imported product. Major stakeholders including World Food Programme consider that the results can support a shift to a future supply of locally produced products. In Kenya, the results have shown that especially insects holds a portential as alternative source of animal-source food, envisaging a shift from being recognised as a traditional food item collected from wild sources, to be a domisticated food source.

Ethical approvalIn Kenya, the study was approved by the Kenyatta National Hospital/University of Nairobi Ethics Review Committee. Written and oral information in the local language was given to the parents or guardians of alleligible children before obtaining written consent. Deuterium oxide is a naturally occurring and nonradioactive isotope of water, and there are no health concerns about its use in any age group. The foods were assessed for microbiological contamination at the Department of Food Science and Post Harvest Technology, Jomo Kenyatta University of Agriculture and Technology, and the Kenya Bureau of Standards food laboratories.

In Cambodia, all caregivers of participating infants voluntarily signed the consent form for participation and were informed that they could leave the study whenever they wanted to. The protocol was approved by the National Ethics Committee for Health Research, Ministry of Health, the Royal Government of Cambodia and consultative approval was obtained from the Danish National Committee on Biomedical Research Ethics.

Registration

Trial registration in both Cambodia (ISRCTN19918531) and Kenya (ISRCTN30012997) were registered with Controlled-trials.com.