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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #416177
Research Project: Microbiota and Nutritional Health

Location: Children's Nutrition Research Center

Title: Feasibility and acceptability of a supplementary food with added fish oil and choline for undernourished pregnant women in Sierra Leone

Author
item KOROMA, AMINATA - Ministry Of Health & Sanitation
item GUSTAFSON, B - Project Peanut Butter
item KOHLEN, CORRINE - California Polytechnic State University
item MOORE, M - Project Peanut Butter
item NGEGBAI, S - Ministry Of Health & Sanitation
item KLEBAN, ELIZA - Washington University
item WEGNER, DANIEL - Washington University
item KIDD, P - Washington University
item STEPHENSON, KEVIN - Washington University
item LI, Y - University Of Texas At Austin
item BRENNA, J - University Of Texas At Austin
item MANARY, MARK - Children'S Nutrition Research Center (CNRC)

Submitted to: African Journal of Food, Agriculture, Nutrition and Development
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/20/2024
Publication Date: 4/27/2024
Citation: Koroma, A.S., Gustafson, B., Kohlen, C., Moore, M., Ngegbai, S., Kleban, E., Wegner, D.R., Kidd, P., Stephenson, K.B., Li, Y.N., Brenna, J.T., Manary, M.J. 2024. Feasibility and acceptability of a supplementary food with added fish oil and choline for undernourished pregnant women in Sierra Leone. African Journal of Food, Agriculture, Nutrition and Development. 24(4):26072-26093. https://doi.org/10.18697/ajfand.129.24480.
DOI: https://doi.org/10.18697/ajfand.129.24480

Interpretive Summary: Maternal ready-to-use supplementary foods (M-RUSF) improve birth outcomes and are acceptable (able to be consumed) in undernourished pregnant women. The goal of this study was to determine if adding essential fatty acids and choline to M-RUSF is possible, able to be produced at scale, and acceptable to pregnant women in Sierra Leone when compared to the M-RUSF that did not contain DHA or choline. The M-RUSF containing added essential oils and choline was able to be produced and acceptable to the population of pregnant women from rural southern Sierra Leone.

Technical Abstract: Maternal ready-to-use supplementary foods (M-RUSF) have been shown to improve birth outcomes among undernourished pregnant women. Docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and choline have been hypothesized to further improve gestational duration and cognitive development. The primary objective of this study was to determine the acceptability and feasibility of a new formulation of M-RUSF, referred to as M-RUSF+, that included fish oil, containing about 400 to 500 mg DHA and EPA, and 550 mg choline among pregnant women in the Pujehun District of Sierra Leone. Both the control and the experimental supplementary foods contained 18 g of high quality protein and 580 kcal, with generous amounts of all essential micronutrients. The ration size was 100 g/d. Both intervention and control recipes were locally produced using peanut paste by the Project Peanut Butter Factory in Freetown, Sierra Leone. The fish oil was added to the M-RUSF+ after all the grinding had been accomplished to limit degardation. The study used a 2x2 crossover design to assess the acceptability of the M-RUSF and M-RUSF+ formulations. Pregnant women were assigned to one of two sequences of foods: either M-RUSF+ followed by M-RUSF, or M-RUSF followed by M-RUSF+. Each food was given for one week. Fifty-one pregnant women were enrolled (day 0), with data collection occurring on days 3, 7, 10 and 14 after enrollment. At each visit, women returned the packets, either empty or partially consumed. Acceptability was assessed at all follow-up visits based on overall consumption, likeability, and adverse events reported. Consumption of M-RUSF and M-RUSF+ averaged 99%. The likability scores averaged 4.8 and 4.9 out of 5 for M-RUSF and M-RUSF+, respectively. For 85/90 visits during which M-RUSF+ was being consumed and 77/83 visits during which M-RUSF was being consumed, the foods were rated with a likability score of 5. Adverse events, defined as diarrhea, vomiting or rash were infrequent (<7%) and showed no significant differences. These results suggest that both M-RUSF and M-RUSF+ are acceptable and feasible for use among pregnant women in the Pujehun District, Sierra Leone.