Nutrient intake and dietary adequacy among infants in Kongwa District, Tanzania: A sub-study of the Mycotoxin Mitigation Trial

Abstract

Abstract Background: Early exposure to aflatoxin, a common toxin in global food systems, has been associated with child growth faltering. The Mycotoxin Mitigation Trial was a community-based cluster-randomized trial designed to assess the effect of dietary aflatoxin on stunting. The study provided low aflatoxin pre- blended porridge flour and groundnuts flour to the Intervention arm, while the same porridge recipe from home ingredients was promoted through education to the Standard of Care (SOC) arm. The objective was to isolate the effect of aflatoxin consumption while keeping dietary intake otherwise the same between the two arms. Methods: To assess dietary intake, we performed a cross-sectional study on trial participants to evaluate and compare nutrient intake and adequacy of protein, energy, lipid, iron, zinc, calcium, and vitamin A between the randomized arms of the study. Twenty paired clusters (10 per trial arm) were selected, with up to 15 households per cluster randomly selected for a structured, multi-pass 24-h recall in three different rounds of data collection at 12 months of age. Results: A total of 282 children participated. Nutrient intake was estimated from mixed models to account for clusters. The mean daily intakes of energy and lipid were 505 kcal and 13 mg respectively in the intervention and SOC while intervention children consumed slightly more proteins (13.7 g v 12.3 g, p= 0.02). There were no differences between the arms regarding the consumption of iron, zinc, calcium, or vitamin A. Generally, Iron and zinc consumption was very low. Conclusion: At the midpoint of the trial intervention only protein consumption differed between arms. Both arms met RNI for energy, protein, and vitamin A but not for other nutrients assess. Trial registration ClinicalTrials.gov: NCT03940547, registered April 24, 2019