1. IMPACT OF SUPPLEMENTATION OF MID MORNING SNACKS (FLAXSEED AND RAGI BASED) ON ANTHROPOMETRIC, BIOCHEMICAL AND LEARNING ATTRIBUTES OF SELECTED SCHOOL CHILDREN
  Devaki  C S1, Meghana D R1 , Saraswathi G1, Premavalli K S2, Madhura C V2, Swamy Y S S2, Vasudheesh  C R2
1Department of Studies in Food Science and Nutrition, University of Mysore, Mysore
2Defence Food Research Laboratory, Mysore, India
ABSTRACT
Objective: To assess the impact of feeding flaxseed and ragi based snacks for school children on their anthropometric, biochemical and learning attributes
Methodology: Two schools situated in Mysore city were selected for the study. 196 children (3rd and 4th Standard) were fed with flaxseed based sweet mix (40 g) or savory cookies (40 g) and 206 children (5th and 6th Standard) were fed with ragi based sweetened mix (50 g) or spiced mix (50 g) or cookies (60 g) per day as mid morning snacks for 152 days (6 days per week). The impact of feeding children was measured before and after the supplementation in terms of anthropometric, biochemical and learning attributes.
Results and conclusion: Supplementation of snacks provided 196–230 Kcals of energy, 5-6 g of protein, mg of calcium and 1-3 mg of iron per day. There was a shift in percentage of children from malnutrition to normal grades (2-14%) due to supplementation of snacks. Supplementation also increased haemoglobin by 1 g %. Due to flaxseed supplementation,  plasma ferritin levels increased by ng / ml and  12 – 21 ng / ml in ragi supplementation. Normal levels of haemoglobin increased by 30% after the supplementation. Serum calcium increased by 1mg/dl in both supplemented children. Serum zinc levels showed no change. Intelligence, memory, reasoning and attention significantly improved in both supplemented children. Supplementation of mid morning snacks to children improved nutrient intake followed by elevation in the nutritional status and improvement in biochemical profile and learning attributes.
RESULTS :
Majority (66%) of the children had their family income ranging from Rs.10, 000 to 50,000 per annum.
Effect of Supplementation on Profile of Anaemia in Children
Children with Normal Grade : School Vs Home lunch
Adequacy of Nutrient Intake with reference to RDA
Nutrients
Flaxseed based
Boys (105)
Girls (91)
Before
After
t -test
t - test
Energy (kcal) 92
100 * 87 97
Protein (g) 85 96 81
Calcium (mg) 73 74 82
Iron (mg) 54 58
Ragi based 84 99 88 98 80 93 71 83 52 56 55 59
Impact of Feeding Snacks
on blood Calcium and Zinc content of Children
Impact of Feeding Snacks on Hemoglobin and Plasma Ferritin levels of Children: School Vs Home Lunch
Impact of Feeding Snacks on Calcium and Zinc Content of Children
 Flaxseed based
 Plasma content  
Boys (105)
Girls (91)
Before
After
t - test
Calcium mg/dl
9 ± 0
10 ± 0 *
Zinc m mol/l
88 ± 14
75 ± 21
84 ± 16
71 ± 14
 Ragi based
Boys (108)
Girls (98)
81 ± 9
72 ± 11
78 ± 11
70 ± 12 11 12 14 33 50 16 26 22 29 10 20 30 40 60
BMMS
AMMS
FLAX
RAGI
SCHOOL LUNCH
HOME LUNCH
Value
HB g/dl
Ferritin ng/ml
Impact of Feeding Flaxseed based Snacks on Body Measurements of Children
Age in Years
(n)
Height (cm)
Weight (kg)
MUAC (cm)
Before
After
Boys
8 (20)
121 ± 6
124 ± 6
20 ± 4
22 ± 5
17 ± 2
18 ± 2
9 44)
126 ± 4
129 ± 4
22 ± 3
24 ± 3
19 ± 2
10 (41)
129 ± 5
133 ± 6
25 ± 5
27 ± 5
Girls
8 (20)
120 ± 6
21 ± 4
9 (29)
127 ± 6
23 ± 5
10 (41)
128 ± 6
132 ± 6
24 ± 4
26 ± 5
METHODOLOGY
Selection of schools and subjects - Gangothri with mid day meal and JSS without mid day meal. 402 children 8-11 years (3rd to 6th standard)
Assessment before supplementation :
Anthropometric measurements – height, weight & MUAC
Diet survey-24 hour recall method
Biochemical Attributes in blood - analyzed by biochemical diagnostic laboratory, using standard method. Serum Calcium, Blood –Hemoglobin, Plasma Ferritin and Serum Zinc
Learning Attributes were assessed by Psychologist.
RCPM (Raven’s Colored Progressive Matrices) – intelligence
PGI (Pershad Gestalt Inventory) – memory
Koh’s block – cognition and reasoning
Knox cube – attention
Supplementation of midmorning snacks
Snack items - formulated , prepared and supplied once in fortnight by Defence Food Research Laboratory, Mysore
Composition of Snack items:
Ragi based - Ragi, Soya bean flour, fat, sugar, ground nut
Flaxseed based – Flaxseed, green gram, maida, sugar, spice, fat.
Feeding Time and duration :10.am ,Five days per week ,152
days spread over 7 months
Number of children : Flax seed snacks 196 (savory and sweet) school with mid day meal (Boys - 23 Girls – 38), school without mid day meal (Boys – 82, Girls – 53) Ragi based snacks 206 (sweet 2, spice -1) school with mid day meal (Boys - 38 Girls –29), school without mid day meal (Boys –70, Girls –69)
Impact of Feeding Snacks on Learning Attributes of Children (scores)
Impact of Feeding Snacks on Learning Attributes of Children: School Vs Home lunch
Attributes
Maximum Scores
Flaxseed based
Boys (105)
Girls (91)
Before
After
t -test
t - test
Intelligence 36
12 ± 8
19 ± 9 *
13 ± 8
18 ± 9
Memory 24
8 ± 2
9 ± 1
9 ± 2
10 ± 1
Reasoning 10
3 ± 1
4 ± 2
Attention 12
5 ± 2
9 ± 3
Ragi based
Boys (108)
Girls (98)
t – test
17 ± 8
23 ± 9
16 ± 9
3 ± 2
5 ± 3
10 ± 2 13 21 16 22 12 19 17 24 8 9 10 5 15 20 25 30
BMMS
AMMS
FLAX
RAGI
SCHOOL LUNCH
HOME LUNCH
score
Intelligence
max.score 36
Memory
Max.score 24
Impact of Feeding of Ragi based Snacks on Body Measurements of Children
Age in Years
Height (cm)
Weight (kg)
MUAC (cm)
Before
After
Boys
10 (61)
134 ± 5
135 ± 5
26 ± 4
28 ± 4
19 ± 2
20 ± 2
11 (51)
138 ± 6
139 ± 7
27 ± 6
29 ± 6
Girls
10 (50)
133 ± 8
134 ± 8
26 ± 6
11 (48)
141 ± 8
143 ± 7
32 ± 9
33 ± 9
20 ± 3
22 ± 3
Impact of feeding Mid Morning Snacks on Learning Attributes of Children: School Vs Home lunch
Impact on Nutritional Grades of Children (percentage)
Adequacy of Energy and Protein: School Vs Home lunch 3 5 9 4 6 8 10 2 12
BMMS
AMMS
FLAX
RAGI
SCHOOL LUNCH
HOME LUNCH
score
Reasoning
Max. score 16
Attention
Max.score 12
Nutritional Grade 
Flaxseed based
Ragi based
Boys (105)
Girls (91)
Boys (108)
Girls (98)
Before
After
Normal 30 42 18 32 24 26 25 29
Mild malnutrition 49 53 39 36 35
Moderate malnutrition 21 9 28 15 37 38 40 72 81 68 90 98 83 96 65 78 69 94 82 93 20 40 60 80
100
120
BMMS
AMMS
FLAX
RAGI
SCHOOL LUNCH
HOME LUNCH
PERCENT
Energy (kcal)
Protein (g)
Assessment after supplementation of mid morning snacks: Anthropometric measurements, biochemical attributes – calcium, haemoglobin, ferritin, zinc and learning attributes – intelligence, memory, reasoning, attention
Impact of Feeding of Snacks on Haemoglobin and Plasma Ferritin content of Children
RECOMMENDATION
Attempts should be made to introduce mid morning snacks enriched with iron and calcium along with school lunch in order to combat iron deficiency anemia which plays a significant role in school performance. In addition to this children and parents should be provided with health and nutrition education to visualize healthy citizens in future.
ACKNOWLEDGEMENT
The project team records their heartfelt thanks to the Authorities and Children of both the schools for their active participation in the study. Our sincere thanks are also expressed to all the Parents for their acceptance to feed their children, and carry out blood tests and psychological tests on their children. Thanks are also expressed to psychologists who assessed psychological parameters of children.
Adequacy of Calcium and Iron : School Vs Home lunch
 Parameter
Flaxseed based
Boys (105)
Girls (91)
Before
After
t - test
t – test
Haemoglobin g%
11 ± 1
12 ± 1 *
Ferritin ng /ml
15 ± 11
26 ± 15
16 ± 11
28 ± 15
Ragi based
Boys (108)
Girls (98)
22 ± 11
43 ± 23
18 ± 13
30 ± 19 70 80 75 84 81 95 78 91 54 62 51 55 61 65 59 63 10 20 30 40 50 60 90
100
BMMS
AMMS
FLAX
RAGI
SCHOOL LUNCH
HOME LUNCH
PERCENT
Calcium (mg)
Iron (mg)
Details of mid morning Snack / day/ child
Details of Snack items
Wt. per
serving (g)
Nutrient intake per serving
Energy (Kcal)
Protein (g)
Calcium (mg)
Iron (mg)
Flaxseed (15%) based sweet mix – ready to eat powder 40
196 5 41 1
Flaxseed based (15%) cookies, 3 pieces
Ragi (50%) based sweet mix ball- 1(raw wt -50) 70
233 6 72 3
Ragi(50%) based Spiced mix ball –1(raw wt-50)
225 7
105 4
Ragi (17%) based cookies, 3 pieces 60
251 56 2
* indicates the significance 5% level
Note: BMMS – Before Supplementation of Mid Morning Snacks
AMMS –After Supplementation of Mid Morning Snacks