CONTRIBUTION OF COMPLEMENTARY FOODS TO ENERGY AND NUTRIENT INTAKES AMONG CHILDREN LIVING IN THE URBAN SLUMS OF MUMBAI, INDIA

Background and objectives: This cross-sectional study was conducted in preparation for a randomized controlled feeding trial assessing the efficacy of iron-biofortified pearl millet based complementary foods in improving child health outcomes. The main objective of the present study was to characterize dietary intake and their appropriateness based on the Indian recommended dietary allowances (RDAs) in urban slums of Mumbai, India. Methods: Study participants were children aged eight to 22 months (n=106). Children's dietary data was collected using 24- hour dietary recall (administered to mothers). Nutrient intakes were calculated using CS Dietary System and compared with the Indian RDAs per day for children. Results: Mean intake of complementary foods was 260 ± 231 g per day. Daily energy intake was less than the RDA for complementary foods in 53% (6 to 12 months, RDA=276 kcal/d) and 89% (12 to 24 months, RDA=714 kcal/d) of children. Protein intake from complementary foods accounted for 81% (6-12 months, RDA=14 g/d) and 88% (12-24 months, RDA=16 g/d) of the total RDA. Iron, zinc, vitamin B-12, and vitamin A intakes were inadequate in more than 90% of children. Dietary iron intake from complementary foods was 24% (6 to 12 months, RDA=5 g/d) and 17% (12 to 24 months, RDA=9g/d) of the Indian RDA. Zinc intake from complementary foods contributed to 10% of the RDA (12 to 24 months, RDA=5 g/d). Vitamin B-12 intake contributed to only 1 % of the total RDA (12 to 24 months, RDA=0.2-1 g/d). Vitamin A intake provided 4% and 5% of RDA in the children from both the age groups. Seventy-two percent (n=76) of children consumed animal source foods including whole milk, eggs, yogurt, and chicken. Conclusions: Our results demonstrate the widespread prevalence of inadequate energy and nutrient intake from complementary foods among children in Mumbai. Implementation of effective and sustainable nutritional interventions is essential to ameliorate nutritional deficiencies in such vulnerable populations (ClinicalTrials.gov ID: NCT02233764).