Abstract
Objectives
High quality fortified premixed cereals can help caregivers meet infants’ nutrient needs after 6 months of exclusive breastfeeding, as complementary foods alongside breastmilk especially where family foods have low nutrient density. Such cereals are widely used in nutrition assistance programs, but commercially-sold brands are rarely subject to quality assurance using international standards for composition and labeling. Previous work found low and variable nutrients and high mycotoxin levels in a few samples. This study aimed to provide the first combined test for nutrient and mycotoxins in multiple samples of all premixed cereal brands for sale in a country, using Malawi as an example of a country with high burdens of child malnutrition and an active market for commercial premixed cereals.
Methods
We purchased a convenience sample of 94 packages from all 8 brands available in markets representing the Central and Southern regions of Malawi, and conducted tests for macronutrients, iron and zinc as well as aflatoxins and fumonisin, using standards set by the Association of Official Analytical Chemists. Test results were compared to labeled values and the few available standards, and interpreted in the light of qualitative findings from semi-structured interviews using snowball sampling with Malawian stakeholders.
Results
Premixed cereals generally met moisture, ash, and iron standards set by the Malawi Bureau of Standards (MBS), but just 35%, 56% and 39% of samples were compliant with the MBS standards for zinc, protein, and fat respectively, and only 63% of samples met Codex standards for energy. Most of the locally-made products exceeded national and international standards for aflatoxin and fumonisin. Labeled values deviated significantly from test results (P < 0.05) for all nutrients except protein and zinc. Key informants identified several challenges in achieving high and uniform quality premixed products in Malawi including reliability and independence of test results, cost of testing, and quality control.
Conclusions
Test results showed low and variable nutrient content, discordance with labeled values and mycotoxin contamination above Malawian standards, revealing the need for introduction of trustworthy quality assurance standards to improve quality and labeling practices for complementary foods in Malawi.
Funding Sources
This project was supported by a USDA award to Tufts University.
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