Abstract
Background: Chronic micronutrient deficiencies in Indonesian women and young children contribute to poor foetal and infant growth. To address this, we formulated micronutrient-enriched crackers (MEC) incorporating nutrient-rich chicken liver, rich in iron, zinc, vitamin A, and B vitamins, along with powdered eggshells as a calcium source. Known locally as ' sistik,' MEC may provide a sustainable solution to improve micronutrient intakes. This study evaluated MEC acceptability among non-pregnant women of reproductive age to ensure safety and feasibility before extending future research to pregnant and lactating populations.
Methods: A single-blinded, two-phase acceptability trial involved 81 non-pregnant women aged 19-35 years in Ujung Berung Sub-district, Bandung City, Indonesia. In Phase 1, participants sampled both MEC and standard wheat crackers (SWC) in a test feeding session and rated each product using a 7-point cued facial response scale, evaluating colour, smell, flavour, and texture. In Phase 2, participants were randomly assigned to receive a 14-day home supply (75 g/day) of either MEC (n=41) or SWC (n=40). Adherence was determined by weighing unconsumed products. Data were analysed using mixed linear model for liking scores and a t-test for adherence.
Results: MEC received favourable ratings, with no significant differences compared to SWC in liking scores for colour (MEC 4.5±1.2 vs. SWC 5.4±0.9), smell (MEC 4.9±1.5 vs. SWC 5.6±0.9), flavour (MEC 4.9±1.4 vs. SWC 5.6±0.9), and texture (MEC 5.4±1.0 vs. SWC 5.7±0.8); p-value > 0.05. Average daily consumption over 14 days was comparable between groups (MEC: 50.8±23.0 g vs. SWC: 51.0±20.0 g; mean difference: -0.2 g; 95% CI: -6.5 to 6.1; p-value = 0.802).
Conclusions: MEC demonstrates reasonable acceptability and feasibility as a daily snack, supporting its potential as a dietary intervention to improve women's micronutrient intake and reduce infant stunting, especially among those women who found it appealing.
Registration: ClinicalTrials.gov ( NCT04564222, 25th September 2020).