1. Complementary Foods: Filling the Nutrition Gap Feasibility of Introducing a Soy Based Micronutrient Supplement in Rural Honduras Vijaya Jain, MS,RD,CDN University of Illinois National Soybean Research Laboratory Urbana, Illinois International Food Aid Conference Kansas City, April 2009

2. Honduras: Background Population: 7 million 3rd poorest country in Latin America and the Caribbean Recurring natural disasters: Hurricanes, droughts, floods and landslides Most vulnerable people greatly affected by disasters High rates of food insecurity in affected areas

3. Malnutrition in Honduras Underweight children20% Stunted children 29% Chronic malnutrition20% In high poverty areas40 to 50% Iron deficiency anemia30 to 40% CARE report (2005) 58% to 87% malnutrition in eleven municipalities Common Health Problems Diarrhea Respiratory infections Typhoid Malaria Dengue fever Chagas HIV/AIDS

4. Optimal Feeding Guidelines Starting breastfeeding within one hour of birth Exclusive breastfeeding for the first six months Introducing appropriate and adequate complementary feeding after six months Soy cereal combination provides necessary protein Complementary foods should be fortified with micronutrients

5. Complementary Food Study: Partnerships CIDE Laboratory San Rafael Foundacion Dispensario Gaudalupano, Tegucigalpa Aragua Clinica, Zambrano Ministry of Health Honduras

6. Complementary Food Study Objectives: -Reduce chronic malnutrition among infants and children (6 to 30 months of age) by adding a complementary food that contains small amounts of macro and micronutrients added to the current daily diet Goals: -To reduce rates of chronic malnutrition -To reduce number & frequency of illnesses such as respiratory infections, diarrhea and skin problems -To reduce rates of anemia Duration: 6 months - mid September 2008 to mid March 2009 Size: 272 infants/children

7. Training & Data Health care providers, nurses, physicians, community leaders & volunteers –Obtained and recorded accurate heights/weights –Hemoglobin/hematocrit levels obtained by a certified technician –Taught nutrition and health education modules Data Collection –Monthly heights & weights –Monthly health & nutrition assessments –Blood work at the first, third and sixth month of study

8. Clinic Activities Initial enrollment Nutrition & Health Education Clinical & Health Assessments

9. Measurements: Infants and Children

10. Composition of Complementary Food and Placebo Products are coded and issued in identical looking canisters Issuance of Supplement Complementary or Placebo

11. Challenges Transportation Clean water Untreated illnesses Volunteers Poverty

12. Successes Partnering with medical centers/clinics High acceptance of products No allergies Improved health status Increased awareness about benefits of health & nutrition Demand for continuation of product usage Enabled product manufacturer to increase production

13. Preliminary Results Both soy & control groups gained weight Both soy & control groups increased in height Improved hemoglobin levels in both groups No difference in number of sick days reported between soy & control groups Improved appetites & increased activity levels Cost savings with the soy based product

14. Future Plans Verification of study results in new location –Increased numbers of children –Additional formulations Partnering with a Honduran medical institute –Better understanding of product use and effectiveness Creating system for sustainability

15. Considerations for Program Development Identify potential partners & collaborators prior to start up Recruit & train local volunteers Be cognizant of political environment Seek local industry support Stay within chosen scope of work

16. Complementary Foods: Filling the Nutrition Gap Feasibility of Introducing a Soy Based Micronutrient Supplement in Rural Honduras Vijaya Jain, MS,RD,CDN University of Illinois National Soybean Research Laboratory Urbana, Illinois Phone: 217-265-6865 Email: vjain@illinois.eduvjain@illinois.edu www.nsrl.uiuc.edu Thank you!