In what situations can Moringa oleifera help to improve nutrition?

In what situations can Moringa oleifera help to improve nutrition?

A. Health and nutrition outcomes B. Behaviors related to food and health C. Beliefs about food and health D. Cultural and natural environment

Diarrhea Parasites HIV/AIDS Malaria Anemia Other (Obesity, Type 2 Diabetes) Resources WHO database Local Health Clinics

Child growth standards Weight for height (wasting) Length for age (stunting) Weight for age (underweight) Mid Upper Arm Circumference BMI (kg/m 2 ) Resources: The WHO Child Growth Standards Training Course Manual for Measuring and Interpreting Malnutrition and Mortality. WFP and CDC

Edema/Oedema protein, kcal Anemia Protein, iron Night Blindness and Xerophthalmia vitamin A Goiter Iodine Resources Local Health Clinics Manual for Measuring and Interpreting Malnutrition and Mortality. WFP and CDC

Breastfeeding Responsive Feeding Safe preparation and storage of complementary foods Increase the quantity of food as the child ages Increase food consistency as the child ages Increase the frequency of feeding complementary foods as the child ages

Feed a variety of foods In some populations young children and breastfeeding women may need supplements or fortified foods Encourage breastfeeding, fluid, and food intake during illness and give more food during recovery

Immunizations Availability and use of nutrient supplements and fortified foods Physical activity level Water and fuel supply Availability and use of child growth and health monitoring Availability and use of mosquito nets, worming, anti-malarial and anti-retroviral drugs

Appropriate foods for pregnant and breastfeeding women Appropriate breastfeeding behaviors Age for introducing complementary foods Appropriate types of complementary foods Priorities for distributing limited food resources

Reasons for illness Value of traditional healers and remedies Value of Western medicine Immunizations Nutrition supplements

The natural, spiritual, and cultural environment in which food and health beliefs developed Community organization and power structures Manners Attitudes about change Key decision makers

Climate Soil Seasonal patterns Resources: The community Individuals with expertise in agriculture

A. Does Moringa oleifera provide nutrients which are lacking in the diets your community? B. Will the people of the community be willing to prepare and consume the leaves?

Iron Zinc Vitamin B-6 Vitamin A Calcium Vitamin C In some areas the foods fed to children have a low energy density and children have difficulty consuming enough to meet their needs.

Increasing consumption of foods containing the needed nutrients Meat, poultry, egg, fish Dark green or orange fruits and vegetables Dehulling, roasting, soaking, fermentation, germination Fortification adding nutrients to foods Supplements Vitamin A capsules Packets of sprinkles containing iron, zinc, and vitamin A Moringa leaf powder? Control of infections

An internet search of Moringa and nutrition results in a large number of sites, some making extraordinary claims A lot of the information on the web is derived from just a few sources Some of the comparisons are based on 100 grams of food, which can be quite different from the amounts humans typically consume. Some of the comparisons are based on information from the early 1950 s, and the techniques for assessing the nutrient content of food have improves since then. A comparison of nutrient content based on a more typical portion sizes follows. This comparison reveals that Moringa leaf powder does provide significant amounts of some of the nutrients often lacking in human diets.

20 mg vitamin C = 1/2 small orange 380 mcg RAE vitamin A = 40 g (60 ml or 1/4 cup) cooked carrots 200 mg calcium = 240 ml (1 cup) milk 3 g protein = 60 ml (1/4 cup) yogurt or 40 ml (3 TBSP) soybeans, or 14 g (1/2 ounce) peanuts 2.5 mg iron = 50 g (2/3 cup) cooked soybeans or 100 g (3/4 cup) peanuts or 60 g (1/3 cup) cooked spinach 2

Percent of Recommended Intake Contribution of typical foods and 10 g Moringa leaf powder to the nutrient needs of 12-23 month old children in Burkina Faso 250 200 150 100 50 0 Energy (kcal) Protein (g) Vitamin C (mg) Vitamin A (mcg RE) Nutrient Ca (mg) Fe (mg) Zn (mg) Moringa (10 g) Sauce (100 g) Toh (200 g) Gruel (50 g) Breastmilk (500 ml)

Fresh Leaves Fresh leaves Stews (search drumstick leaves) ECHO technical note Dried Leaf Powder Sauces Incorporate into noodles Sprinkle on almost anything Putting powder in capsules is not practical Involve the individuals who prepare food your community as you select a method for including Moringa leaves in the diet

A. Why do funding agencies demand evidence? B. How to set up a study

Data From: Med Sci Sports Exerc. 2006 Dec; 38(12):2159-64

Work collaboratively with other groups Use a control group and a placebo if possible Use established methods for evaluating growth and nutritional status Use appropriate ethical safeguards Communicate what you discover Health effects Anemia (Hemoglobin or Hematocrit levels) Growth Rates of illness and Death Acceptability Recipes Economic results