Azupogo Fusta, Borgonjen-van den Berg Karin J, Aryeetey Richmond, Brouwer Inge D
Institute for Global Nutrition and Department of Nutrition, University of California, Davis, USA.
Department of Family and Consumer Sciences, Faculty of Agriculture, Food and Consumer Sciences, University for Development Studies, Box TL 1882, Tamale, Ghana.
Br J Nutr. 2025 Jul 28;134(2):134-146. doi: 10.1017/S0007114525103929. Epub 2025 Jul 10.
A local food-based approach, including school lunch with multiple-micronutrient fortified biscuits (MMB) as supplementary snacks, may enhance dietary adequacy, although current evidence remains limited. This study assessed nutrient inadequacies and developed food-based dietary recommendations (FBR) incorporating school lunch from the Ghana School Feeding Programme (GSFP) and MMB. Data from 292 girls aged 10-17 years, enrolled in the Ten2Twenty-Ghana study was analysed. Dietary intake was assessed via a quantitative 24-h dietary recall. Usual intakes were estimated using the National Cancer Institute method. Linear programming with Optifood was used to develop FBRs based on commonly consumed foods (≥5% of participants) and their median serving sizes, intake frequency, nutrient content, and cost per 100 g. Constraints included estimated energy needs and harmonised average nutrient requirements. The mean usual energy intake was 2351 (sd 66) kcal/d. Ca (99·8 %), vitamin B (99·8 %), riboflavin (96·2 %), vitamin A (91·5 %), vitamin C (87·6 %), Fe (73·7 %), folate (49·3 %) and Zn (8·5 %) inadequacies were prevalent. Optimised diets achieved adequacy for protein and most micronutrients, except Ca and vitamin B, besides vitamin A for 15-17-year-old girls. School lunch from the GSFP did not enhance micronutrient levels when added to the daily diet. Adding MMB to the daily diet ensured adequacy for vitamin C, riboflavin and Fe, although marginal for Fe. Ca and vitamin A improved substantially with MMB for girls aged 15-17 but remained below the harmonised average requirements. Integrating regular school lunch with specialised fortified foods may be a cost-effective strategy to enhance dietary adequacy for adolescent girls in rural areas.
一种基于当地食物的方法，包括将含有多种微量营养素强化饼干（MMB）的学校午餐作为补充零食，可能会提高膳食充足性，尽管目前的证据仍然有限。本研究评估了营养不足情况，并制定了基于食物的膳食建议（FBR），其中纳入了加纳学校供餐计划（GSFP）的学校午餐和MMB。对参加“十岁至二十岁加纳研究”的292名10至17岁女孩的数据进行了分析。通过定量24小时膳食回顾评估膳食摄入量。使用美国国家癌症研究所的方法估计通常摄入量。使用Optifood进行线性规划，根据常见食用食物（≥5%的参与者）及其平均食用量、摄入频率、营养成分和每100克成本制定FBR。限制条件包括估计的能量需求和统一的平均营养需求。平均通常能量摄入量为2351（标准差66）千卡/天。钙（99.8%）、维生素B（99.8%）、核黄素（96.2%）、维生素A（91.5%）、维生素C（87.6%）、铁（73.7%）、叶酸（49.3%）和锌（8.5%）的不足情况普遍存在。优化后的饮食除了15至17岁女孩的维生素A外，蛋白质和大多数微量营养素都达到了充足水平，但钙和维生素B除外。GSFP的学校午餐添加到日常饮食中时，并没有提高微量营养素水平。在日常饮食中添加MMB可确保维生素C、核黄素和铁达到充足水平，尽管铁只是勉强达到。对于15至17岁的女孩，添加MMB后钙和维生素A有显著改善，但仍低于统一的平均需求。将常规学校午餐与专门的强化食品相结合，可能是提高农村地区少女膳食充足性的一种具有成本效益的策略。
