Current and potential role of grain legumes on protein and micronutrient adequacy of the diet of rural Ghanaian infants and young children: Using linear programming

Abstract

Background: Grain legumes are appreciated for their contribution to dietary protein and micronutrient intake in addition to their benefits in providing income and replenishing soil fertility. They offer potential benefits in developing countries where future food demand is increasing and both undernutrition and overweight co-exist. We studied the current and potential role of grain legumes on protein, both quantity and quality, and micronutrient adequacy in the diet of rural Ghanaian infants and young children. Methods: Energy and nutrient (including amino acids) intakes of breastfed children of 6-8 months (n=97), 9-11 months (n=97), 12-23 months (n=114), and non-breastfed children of 12-23 months (n=29) from Karaga district in Northern Ghana were assessed using a repeated quantitative multi-pass 24-hour recall method. Food-based dietary guidelines that cover nutrient adequacy within the constraints of local current dietary patterns were designed using the linear programming software Optifood (version 4.0.9, Optifood). Optifood was also used to evaluate whether additional legumes would further improve nutrient adequacy. Results: We found that 60% of the children currently consumed legumes with an average portion size of 20 g per day (cooked) contributing more than 10% of their total protein, folate, iron and niacin intake. The final sets of food-based recommendations included legumes and provided adequate protein and essential amino acids but insufficient calcium, iron, niacin and/or zinc among breastfed children and insufficient calcium, vitamin C, vitamin B12 and vitamin A among non-breastfed children. The sets of food-based recommendations combined with extra legumes on top of the current dietary pattern improved adequacy of calcium, iron, niacin and zinc but only reached sufficient amounts for calcium among breastfed children of 6-8 months old. Conclusions: Although legumes are often said to be the 'meat of the poor' and current grain legume consumption among rural children contribute to protein intake, the main nutritional benefit of increased legume consumption is improvement of micronutrient adequacy. Besides food-based recommendations, other interventions are needed such as food-based approaches and/or fortification or supplementation strategies to improve micronutrient adequacy of infants and young children in rural Ghana. Trial registration: Noguchi Memorial Institute for Medical Research Institutional Review Board (NMIMR-IRB CPN 087/13-14).