Bulletin of the National Nutrition Institute Arab Republic ...€¦ · Bulletin of the National...

2010 1

Bulletin of the National Nutrition Institute of the Arab Republic of Egypt


Bulletin of the National Nutrition InstituteArab Republic of Egypt

The Official Publication of the National Nutrition Institute

EDITOR- IN- CHIEFDr. Azza Gohar

Director of National Nutrition InstituteDEPUTY EDITORS

Prof. Mohamed Amr Hussein Prof. Salah Abd El-FatahDr. Hanaa Hussein El- SayedEDITORIAL ASSISTANTS

Prof. Fardous Soliman Ass. Prof. Deena Shehab

EDITORIAL BOARD MEMBERS INTERNATIONAL ADVISORY BOARD Prof. Wafaa Moussa Prof. Osman Galal (USA)

Prof. Mohamed Ehab Hegazy Prof. Vankatesh Prakesh ( India) Prof. Farouk Shaheen Prof. Claudia Parvanta (USA)

Prof. Adel Gamal El- Din Prof. Fre Pepping (Royal Netherlands) Prof. Hoda Abdel Fattah Prof. Mirijana Pavlovic (Serbia)

Prof. Nafissa Eid Prof. Ibrahim El- Madfaa (Austria) Prof. Salah Abdel Fattah Prof. Geok Lin Khor (Malasia)

Prof. Mohamed Fahmy Seddik

NATIONAL ADVISORY BOARD REGIONAL ADVISORY BOARD Prof. Mamdouh Gabr Prof. Ibrahim Khatib (Jordon)

Prof. Mohamed El- Khafif Prof. Ridha Mokni (Tunisia) Prof. Hanaa Ismail Prof. Nahla Houalla (Lebanon)

Prof. Mohamed El- Gundi Prof. Najat Sarhan (Morocco) Prof. Ahmed Khorshid Prof. Sediga Washi (Sudan)

Prof. Saad Mahmoud Saad Prof. Yousef Shrek ( Libya) Prof. Ashraf Shaalan

Prof. Mohamed Abdel Salam

HONORARY ADVISORS

Dr. Khaled El- Madani (KSA) Dr. Khairiya Moussa (Bahrain) Dr. Deena Asfour (Sultanate of Oman)

Scope of the Bulletin:The bulletin is the official publication of the National Nutrition Institute (NNI). It publishes; (original articles, papers, book reviews, case reports, research reports, invited editorials, letters to the Editor, special communications, announcements and upcoming events) in the area of human nutrition in health and disease and related sciences. It is published three times / year. Principal areas covered are community nutrition. nutrition education, nutrition assessment, psychology of food habits and behavior , hospital dietetics, capacity building in nutrition, food safety, food security, food sciences, biotechnology, anthropology, nutrition biochemistry. Editorial correspondence:All articles, general correspondence and enquiries should be addressed to the editorial secretary c/o NNI 16 Kasr El- Aini St.; Kasr El- Aini post office, Cairo, Egypt; Fax: 23647476; Tel: 23643522 – 23646413 – 25324305- 25324307, E-mail: [email protected].

EDITORIAL SECRETARIALMr. Saleh Mohamed Saleh Mr. Abd El- Rahman Attya

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16 El-Kasr El-Aini St. - Cairo - Arab Republic of Egypt. Fax: 23647476


2 The National Nutrition Institute 2010 3



Bulletin of the National Nutrition InstitutePublished by the National Nutrition Institute

General Organization for Teaching Hospitals and InstitutesMinistry of Health.

Contents

Original Articles Page

- Effect of Feeding Pomegranate on Hepatotoxic rats ..................................................................................Hussein. E.A

1

- Chemical, microbiological, physical and sensory evaluation of some soy-based formulas prepared for infants and young children with acute diarrhea.............................................................................................Shafika A. Zaki, Ahmed T. El- Akel, Laila El- Mahdy and Nadra S. Y.Hassan

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31

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Current Vitamin A Status in Egypt

Tawfik, A. A., Gohar, A. S., Abdel Halim, Sh., Abdel Rahman, M. K.

AbstractBackground: A National Survey for Assessment of Vi-tamin A Status in Egypt was conducted in 1995 among preschool children (6-71 months) and their mothers, where it revealed that vitamin A deficiency is consid-ered as a moderate sub-clinical public health problem. for children under five and pregnant women. Based on the finding of this national survey, vitamin A capsules supplementation program was adapted in 1999 as one of the strategies for prevention and control in Egypt Objec-tive: The aim of this study is to assess the current vi-tamin A status in Egypt after implementing vitamin A capsule program, in order to suggest more sustainable intervention programs for virtual elimination of VAD in Egypt. Design: This survey was carried out among 4490 target subjects (2132 mothers and 2359 pre-school children 6-71 month) representing six geographic areas and considering urban and rural areas. The assessment for vitamin A status was based on biochemical indica-tor (serum retinol level), and ecological indicators (food frequency, breast feeding, disease patterns, and social status). Result: Result on serum retinol level indicates that 6% of the children and 3.7% of their mothers hav-ing serum retinol below the cut-off level (<20µg/dl) and generally VAD among children was higher than mothers in all areas. The prevalence of VAD was low (about 4%) among young-age children (<18 moths where supple-mentation is taken place) than older-age children. There are no significant differences in the prevalence of VAD between gender (boys & girls), between location (urban and rural) as well as between different social classes. Vi-tamin A capsules coverage reach 89.8% among children and 50.8% among mothers (50.8%). Almost 93% of the studied pre-school children were breast-fed, and breast feeding rate is higher in rural than in urban. Dietary data showed majorities of households did not consume good source of vitamin A (about 88 % and 76% of households consume rich source of vitamin A and carotene-rich foods, less than three times per week, respectively). Ill-ness and disease patterns showed about 65% of children have upper respiratory tract infection (URTI) and 34.3% have gastro-intestinal tract diseases (GIT) as diarrhea, vomiting or both. Conclusion: The study concluded that VAD in Egypt is a mild public health problem and the vi-tamin A supplementation program had a positive impact on VAD. Ecological factors, especially dietary practices of Egyptian’s households and infection both remain as immediate cause for VAD in Egypt. Recommendation: The study recommends an integrated and sustainable in-

tervention programs to control VADD.

Keywords: Vitamin A deficiency – Vitamin A capsules- preschool childern - serum retinol- Dietary intake-Infec-tion- Social status

IntroductionOver the last two decades, the world had gain much ex-periences to apply different approaches for the assess-ment and control of vitamin A deficiency (VAD) and the resulting disorders (VADD). In 2002, the XX Interna-tional Vitamin A Consultative Group (IVACG) meet-ing was seen as an opportunity to revise and simplify guidelines and indicators as well as to try and identify what remains unknown and untested. Encouraging to all was that VAD prevention and control represents a pub-lic health problem where very real progress has been made. Although the international goal of elimination by the year 2001 may not have been realized, xerophthal-mia, the most visible form of VAD, is less commonly a problem in many of the countries where it had been endemic. Nevertheless, VADD remain a problem in most countries where it has been recognized—73 based on the most recent estimates from the World Health Organiza-tion (WHO), United Nations Children’s Fund (UNICEF) and IVACG (West, 2002 ). As in several other countries that have achieved the same status, non-xerophthalmic VAD, as measured by serum retinol (Ramakrishnan and Darnton-Hill, 2002).

The addition of vitamin A capsules to the polio immu-nization programs (National Immunization Day NID) has been an important factor in the current high rates of vitamin A capsule coverage. The global program to eliminate polio has covered almost all countries with im-pressive coverage (consistently over 95% of the target young child population). However, the polio campaign is scheduled to last only 5 y and has already come to an end in much of the world. The challenge being addressed is how to maintain such high coverage in the absence of NID (Ramakrishnan and Darnton-Hill ,2002).

In 1995, the National Survey for Assessment of Vitamin A Status in Egypt was conducted among 1577 preschool children (6-71 months) and their mothers using clini-cal, biochemical and dietary indicators. The results on the prevalence of xerophthalmia, or clinical vitamin A deficiency (VAD), were lower than the cut-off point es-

tablished by the World Health Organization (WHO) to indicate a significant public health problem. However, according to the prevalence of sub-clinical VAD (non-ocular) as measured by low serum retinol level (less than 0.7µmol/liter < 20ug/dl), VAD is considered as a moderate sub- clinical public health problem. is problem for children under five and pregnant women. The prev-alence of sub-clinical (non-ocular) VAD in Egypt was 11.9% among 6-71 months children and 10.9% among their mothers. VAD was the highest among the age group 12-24 months and in Upper Egypt (Moussa et al., 1995 &1997).

Based on the finding of the national survey, vitamin A capsules supplementation program was adapted in 1999 as one of the strategies for prevention and control in Egypt. The program scheduled for children at 9 and 18 months capsules with 100,000 and 200,000 IU vitamin A respectively using immunization schedule and for moth-ers within a month of delivery with 200,000 IU vitamin A single dose.

In 2002, a national survey was conducted by High Insti-tute of Public Health in collaboration with MOHP and UNICEF among preschool children to assess vitamin A status after supplementation. The study revealed that the prevalence of vitamin A deficiency among preschool children (6- 71 months) was 7.2%, implying that the vi-tamin A status of those children had improved from that recorded in 1995 (11.9%), but still beyond the goal of the Consultation Group on VAD which recommends that less than 5%of children aged 6-71months should have serum retinol <0.7Umol/L. The success of the VAD con-trol program in Egypt is attributed mainly to the effec-tiveness of high dose vitamin A supplementation, as the fortification program has not yet been established. Con-cerning vitamin A supplementation coverage, about two thirds (65.6%) of target mothers and 90% of target chil-dren were covered by vitamin A capsules (DHS, 2005).

Vitamin A supplementation program, implemented since 1999, is a short term intervention strategy which costs a lot comparing to its coverage and compliance. Thus there is a need to reassess the magnitude of VAD problem and the ecological factors affecting it, in order to identify and integrate sustainable intervention strategies (food-based approach of fortification and dietary diversification, as well as public health intervention) for controlling VAD in Egypt.

AIM OF THE STUDYThe aim of this study is to reassess the vitamin A status in Egypt after implementing vitamin A capsule program since 1999.

METHODOLOGYPre-school children (6-71 month) and their mothers were selected using the multistage probability sampling ap-proach. The governorates were chosen randomly from the six geographic area as follows: Metropolitan: Cairo, Coastal area : Alexandria, Lower Egypt: Sharkia and Behaira , Upper Egypt : Bani-suif and Quena , Canal area: Suez , Frontier area: North Sinai and New Valley governorates, and about half the sample was urban and the other half was rural. The same pattern of selection was carried out from the same geographic areas and lo-cation (urban and rural) as that survey of 1995 for com-parison. The total sample of mothers was 2131 while the pre-school children sample was 2359. Pre-structured questionnaire were designed to collect the following data:

• Bio-demographic information (age, gender, ……..)

• Breastfeeding and weaning status of children < 2y

• Social and economic information using Park & Park, 1979.

• Morbidity history of children

• Dietary data: household food frequency

• Biochemical result record for serum retinol.

The data was collected through the survey conducted by National Nutrition Institute teams from July to Septem-ber, 2007 using personal interview from the target sam-ple (pre-school children and their mothers) and record the information using survey questionnaire. Blood sam-ples from the target members were collected at the near-est PHC unit to the household and all collected samples were coded & sent to central laboratory under the proper preserving conditions. Serum retinol levels were deter-mined using HPLC according to Bieri et al, 1979. Statis-tical analysis of data was done to find out vitamin A status among different target populations. Descriptive statistic and bivariate relationships were done using SPSS pack-age including frequency distribution, cross tabulations, Chi-square and analysis of variance

WHO/UNICEF (1996) classifies the level of importance of an identified vitamin A public health problem accord-ing to certain prevalence rates. The prevalence of low plasma retinol level (<20µg/dl) among children 6-71 months of age between ≥2-<10% is considered a mild public health problem, while prevalence ≥10 %-< 20% is considered a moderate public health problem. Preva-lence rates ≥20% is considered a severe public health problem wherever other supporting indicators should be considered.

Current Vitamin A Status in EgyptTawfik, A. A., Gohar, A. S., Abdel Halim, Sh., Abdel Rahman, M. K.

National Nutrition Institute



RESULTS & DISCUSSIONSocial status of the family was classified according to Park & Park, (1979) into low, intermediate and high lev-el. Description of the studied households sample showed that 25.5% of the total sample was in the low social class; the intermediate social class represents 59.9% of the population. The high social class represents 14.6% of the total sample. This result resembles the same sample distribution as that of survey 1995 & 2002

Serum Retinol AnalysisVAD is defined as liver stores below 20 Ug (0.07 Umol) of retinol per gram liver (WHO/UNICEF, 1996). VAD disorders are defined as any health and physiologic con-sequences attributable to VAD whether clinically evident (xerophthalmia) or not. There are combinations of indi-cators useful in identifying populations with vitamin A deficiency at levels that pose an important public health problem. There are biological indicators as functional, biochemical, and histological. The only biochemical parameter validated for VAD assessment is serum reti-nol concentration. A composite of non-specific but sup-portive ecologic and demographic indicators is useful in locating VAD populations. These indicators include: Nutritional and dietary: breast-feeding patterns, dietary patterns of vulnerable groups, semi-quantitative and qualitative indicators of food consumption, illness and disease patterns, and socioeconomic variables (WHO/ UNICEF, 1996).

This study considers the following indicators: biological (serum retinol level) as main indicator, Dietary (semi-quantitative and qualitative indicators of food consump-tion), illness and disease patterns, ecological indicators and socioeconomic variables.

Table (1) shows the mean, median, minimum and maxi-mum values of retinol levels in the total sample for pre-school children and their mothers, respectively.

Our results in table (2 and 3) showed that 6% of pre-school children and 3.7% of their mothers having serum retinol level below the cut-off level (20ug/dl). Moreover, there was no significant different between geographic areas. This means that VAD is considered as a mild pub-lic health problem in Egypt according to the most recent recommendation (WHO, 2002). A National Survey for Assessment of Vitamin A Status in Egypt (1995) was conducted among 1577 preschool children (6-71 months) and their mothers using clinical, biochemical and dietary indicators. The results on the prevalence of xerophthal-mia, or clinical vitamin A deficiency (VAD), were lower than the cut-off point established by the World Health Organization (WHO) to indicate a significant public health problem. However, according to the prevalence

of sub-clinical VAD (non-ocular) as measured by low serum retinol level (less than 0.7µmol/liter < 20ug/dl), VAD is considered as a moderate sub- clinical public health problem. is problem for children under five and pregnant women. The prevalence of sub-clinical (non-ocular) VAD in Egypt was 11.9% among 6-71 months children and 10.9% among their mothers. In 2002, a na-tional survey was conducted by High Institute of Public Health in collaboration with MOHP and UNICEF among preschool children to assess vitamin A status after sup-plementation. The study revealed that the prevalence of vitamin A deficiency among preschool children (6- 71 months) was 7.2%, implying that the vitamin A status of those children had improved from that recorded in 1995 (11.9%), but still beyond the goal of the Consultation Group on VAD which recommends that less than 5%of children aged 6-71months should have serum retinol <0.7Umol/L. The success of the VAD control program in Egypt is attributed mainly to the effectiveness of high dose vitamin A supplementation, as the fortification pro-gram has not yet been established.

Results in table (4) shows that the higher prevalence of VAD (<20µg/dl) exists among the age group 18 months and older followed by 24 months to less than 36 months. Results confirm that the higher percentage VAD was above 18 months of age may be due the low dietary con-sumption of vitamin A food sources as well as bad wean-ing practices with the alteration of other ecological fac-tors (morbidity load, caring and breastfeeding practices). Hence, the recommendation to assess the retinol levels of school children as they are the age group supplemented with vitamin A capsules since 1999. In the National Sur-vey for Assessment of Vitamin A Status in Egypt, 1995, VAD was the highest among the age group 12-24 months and in Upper Egypt (Moussa et al., 1995 &1997).

Classification of plasma retinol level by gender revealed that 6.2 % of females and 5.8% of males have retinol level < 20 µg / dl. There is no significant difference be-tween males & females in the different regions regarding retinol Levels (table 5).

Table (6) showed that the prevalence of VAD among ur-ban is higher than rural for both children and mothers, but, there was no statistical difference between urban and rural location regarding serum retinol levels either among preschool children or their mothers. In the con-trast, results of the prevalence of VAD among studied samples in the survey of Moussa et al., 1995 was higher in rural than urban locations. Recently, following 2005 after many economic and social changes, results of many studies having higher prevalence of malnutrition in ur-ban than rural areas as vulnerability study WFP, 2008 and EDHS, 2008.

Table (7) showed that the higher prevalence of VAD among preschool children and their mothers were low social class. The lowest prevalence of VAD among stud-ied sample was from the high social class. There is no

significant difference between prevalence of VAD in the different social classes. These results were similar to the finding of survey 1995 and 2002.

Coverage of vitamin A supplementation:Vitamin A supplementation program was the only con-trol program for vitamin A in Egypt till now, so to meas-ure supplement distribution programme (coverage of at risk population) is one of process indicators. Evaluation of the impact of control programmes requires the use of biological indicators.

Coverage of vitamin A capsules among preschool chil-dren is 89.8% and among mothers reached 50.8% as shown in table (8). Concerning vitamin A supplementa-tion coverage, about two thirds (65.6%) of target moth-ers and 90% of target children were covered by vitamin A capsules (DHS, 2005). however, EDHS (2008) after the supplementation of vitamin A capsules phasing- out revealed that capsules coverage reached 12%% among children and 50.8% among mothers. After phasing-out of vitamin A supplementation program, there is a fear that the prevalence of low serum retinol increases again and the problem of VADD in Egypt increases to its former levels.

Vitamin A supplementation program costs a lot com-paring to its coverage, hence it is time to identify and integrate different strategies (food-based approach of fortification and dietary diversification, as well as public health intervention) for controlling VAD in Egypt.

Ecological factors of VAD1. Morbidity statusIllness and disease patterns among preschool children are indicators denoting susceptibility to vitamin A defi-ciency. Although the survey was conducted during sum-mer time (July- September), results showed that about 65% of children have upper respiratory tract infection (URTI) and 34.3% have gastro-intestinal tract diseases (GIT) as diarrhea, vomiting or both (table 9). This find-ing was similar to the results of Moussa, 1995 which was conducted in January, affection by upper respiratory tract infection in many survey had higher prevalence all through the year with no difference between incidence in winter and summer, while gastro-intestinal diseases had to some extent higher prevalence in summer than winter.

2. Breastfeeding statusChildren less than 2 years of age are classified into breast-fed and non breast fed children (Table 10), it is noticed that 92.9% of them were breast-fed and breast feeding rate is higher in rural than urban areas. Rate of breast feeding is highest among both urban and rural areas of Coastal and Frontier governorates. Results of Moussa et al., 1995 revealed higher prevalence of breastfeeding (98%-99%) but always rural areas had higher percentage than urban.

3.DietaryTable (11) presents frequency of consumption of vitamin A sources and relevant foods less than three times per week for households (HH). The data focus on vitamin A rich sources (animal and plant) as well as fat and oil as vitamin A carrier. Plant vitamin A rich food is cultivated in Egypt all over the year with no difference between winter and summer times.

As frequency of consumption of vitamin A reach sourc-es; results revealed that about 88.6% of HH consumed meat, poultry, fish, dairy product and eggs less than 3 times per week. While, 76.5% of HH consumed vegeta-bles and fruits (precursor of vitamin A) less than 3 times per week.

On the other hand, fats and oils were almost regularly consumed by both urban and rural households; the fre-quency of consumption was 60% of the average.

According to WHO/ UNICEF (1996) this situation is considered a high risk ecological factor for VAD. The same situation is also true regarding foods of animal ori-gin where percent of those who consume meat, chicken and fish less than 3 times per week is almost 90% of the total sample of children and mothers.

ConclusionThe national study has clearly identified VAD as a prob-lem of mild public health importance in Egypt. It is a problem of mild severity affecting both preschool chil-dren and their mothers. Vitamin A dietary inadequacy beside infection is the main immediate causes. Lack of household food security adequate maternal and child care and healthy environment including food safety are the main underlying causes. Social and economic levels of the population including education particularly mater-nal education are contributing causes.





RecommendationsA combination of interventions is needed to eradicate and prevent VAD in Egypt. These include: Dietary modi-fication and diversification for consumption of vitamin A and carotene-rich foods. Protection and promotion of breast-feeding should have more attention for initiation optimal breast-feeding practices and duration as well as enhancing the nutrition status of the mother. Food fortifi-cation with vitamin A is potential solution for preventing VAD. Meanwhile, Vitamin A supplementation program should be continued especially for risk group (children at 18 months children and their mothers) with social mar-keting for good coverage rates and compliance for the program.

ReferencesBieri J. G. Tolliver T.J. and Catiganu G.L ( 1979): Si-multaneous determination of a – tocopherol and retinol in plasma or red cell by high pressure liquid chromatog-raphy. AM. J. CliN. Nutr. 32: 2143.

DHS, (2005): Demographic health survey.

DHS, (2008): Demographic health survey.

El – Sayed ,N.(2002): Profile of micronutrient status in Egypt. Compilation of studies and programes. Cairo, MOHP, Primary Health Care Department.

Moussa, W.A., El – Nehry, F. and Abdel Galil, A. (1995): National Survey for assessment of vitamin A sta-tus in Egypt Final report, Nutrition Institute / UNICEF.

Moussa, W.A., Shaheen, F.M., El – Nehry, F. and Ab-del Galil, A. (1997): Vitamin A status in Egypt. In Pro-ceedings of the XVIII IVACG meeting, Cairo

Park, J.E. and Park, K. (1979): Text book of preven-tive and social medicine, seventh edition, page 81. Hess-ers Barinar sides, Ph. Not publisher, 1268 Napier Town.

Usha Ramakrishnan and Ian Darnton-Hill ,(2002): Assessment and Control of Vitamin A Deficiency Disor-ders. Supplement: Proceedings of the XX International Vitamin A Consultative Group Meeting. The American Society for Nutritional Sciences J. Nutr. 132:2947S-2953S, September 2002

WHO/UNICEF, (1996): Indicators for assessing vita-min A deficiency and their application in monitoring and evaluating intervention programmes. Reprinted in 1998

World Health Organization (2002): CARK MCH FO-RUM. Distribution of vitamin A during national immu-nization days. A «generic» addendum to the Field guide for supplementary. activities aimed at achieving polio eradication, 1996 revision, Department of vaccines and other biologicals and department of nutrition for health development 4th annual meeting 4-6 november, 2002, ashgabat, Turkmenistan

Table (1): Mean, Median, Minimum and Maximum Values of Retinol levels (Ug/dl) for studied population sample.

Retinol Levels Mean ± SD Median Minimum Maximum

Children

10 - < 20 16.4 ± 1.99 (No. = 142) 16.8 10.2 19.0

≥ 20 39.5±13.9(No. = 2217) 37.3 20.0 87.0

F = 263.6 DF= 2359 P=0.000 Sig.

Mothers

10 - < 20 16.54± 2.23(No. = 78) 17.1 11.6 19.48

≥ 20 39.2 ± 12.6(No. = 2053) 37.7 20.0 80.5

F = 96.9 DF= 2131 P= 0.000 Sig.

Table (2): Distribution of preschool children according to plasma retinol level and geographic areas

Plasma retinol levels (ug/dl)Geographic

Area Total≥20< 20

%No.%No.%No.

19.445893.44286.630Metropolitan

17.340990.23699.840Coastal

17.040195.03815.020Canal

12.529692.92757.121Lower Egypt

18.242997.74192.310Upper Egypt

15.536694.33455.721Frontier

100.0235994.022176.0142Total

Chi-square=22.6 DF= 5 P=0.000 Sig.

Table (3): Distribution of mothers by plasma retinol and geographic areas

Plasma retinol levels (ug/dl)Geographic

Area Total≥20< 20

%No%No%No

18.138594.83655.220Metropolitan

16.434994.33295.720Coastal

18.539597.03833.012Canal

12.326397.02553.08Lower

17.537397.13622.911Upper Egypt

17.236698.13591.97Frontier

100.0213196.320533.778Total

Chi-square=12.5 DF= 5 P=0.02 Sig.





Table (4): Distribution of preschool children by plasma retinol levels and age in the total sample

Retinol level (Ug/dl)

Age (months)Total

6- 12- 18- 24- 36- 48- 60-72

<20No. 8 2 10 34 27 28 33 142

(%) 5.2 2.1 8.8 6.8 5.5 5.6 6.5 6.0%

≥ 20No. 145 92 104 463 463 474 476 2217

(%) 94.8 97.9 91.2 93.2 94.5 94.4 93.5 94.0%

TotalNo. 153 94 114 497 490 502 509 2359

(%) 100 100 100 100 100 100 100 100.0%

Chi-Square= 5.4 DF=6 P= 0.5 Non sig

Table (5): Distribution of preschool children according to retinol levels and gender in the total sample

retinol level (Ug/dl)

Male Female Total

No. (%) No. (%) No. (%)

<20 71 5,8 71 6,2 142 6

≥ 20 1148 94,2 1069 93,8 2217 94

Total 1219 100 1140 100 2359 100

Chi-Square= 0.170 DF= 1 P=.680 Non sig

Table (6): Distribution of the studied population according to plasma retinol level and location

retinol level (Ug/dl)

Urban Rural Total

No. (%) No. (%) No. (%)

Children

<20 98 6.8 44 4.7 142 6

≥20 1334 93.2 883 95.3 2217 94

Total 1432 100 927 100 2359 100

Mothers

<20 54 4.3 24 2.7 78 3.7

≥20 1194 95.7 859 97.3 2053 96.3

Total 1248 100.0 883 100.0 2131 100.0

Table (7): Distribution of the studied population according to plasma retinol level and social status

Retinol level (Ug/dl)

Low Middle High Total

No. (%) No. (%) No. (%) No. (%)

Children

<20 45 7.2 80 5.7 17 5.0 142 6.0

≥ 20 581 92.8 1314 94.3 322 95.0 2217 94.0

Total 626 100.0 1394 100.0 339 100.0 2359 100.0

Chi-square=2.311 DF=2 P=0.315

Mothers

<20 20 3.7 53 4.2 5 1.6 78 3.7

≥ 20 525 96.3 1223 95.8 305 98.4 1780 83.5

Total 545 100 1276 100 310 100 2131 100.0

Chi-square= 4.367 DF=2 P=0.113

Table (8): Coverage & compliance of vitamin A capsules among preschool children

Coveragepreschool children

No %

Yes 2118 89.8

No 241 10.2

Total 2359 100.0

Chi-square=3.026 DF=2 P=0. 220

Coverage

Mothers

No %

Yes 1083 50.8

No 1048 49.2

Total 2131 100.0

Chi-square= 0.271 DF=2 P=0.873





Table (9): Distribution of preschool children by morbidity status

%NoMorbidity

34.3809Yes

Diarrhea, vomiting or both 65.71550No

100.02359Total

65.11536Yes

Upper respiratory tract diseases 34.9823No

100.02359Total

Chi-square= 2.2 DF=2 P=0. 825

Table (10): Distribution of children <2years according to breastfeeding status

Geographic Breast fed (%)

Non breast fed(%)

Total(No)

Urban 92.0 8.0 472

Rural 94.8 5.2 235

Total 92.9 7.1 707

Chi-Square= 38.8 DF=5 P= 0.000 sig

Table (11): Frequency Distribution of households consuming less than 3 times/ week of vitamin A rich sources by urban and rural areas

Food items Urban Rural Total

Fats/ Oils 40.5 37.0 38.9

Animal sources

Meat, poultry, fish 98.3 98.5 98.7

Milk, egg, cheese 72.0 80.0 75.6

Total animal sources 87.0 90.5 88.6

Plant sources

Dark Green Leafy Vegetables (DGLV) 77.0 74.1 75.7

Other colored vegetables 70.6 83.9 74.2

Total vegetables 73.8 79.0 75.0

Citrus fruits 52.0 64.2 57.4

Other colored fruits 99.2 98.9 99.0

Total fruits 75.8 81.6 78.5

Total plant sources 74.6 80.1 76.5

�لو�صع �حلايل لفيتامني ) �أ ( يف م�صرعفاف أحمد توفيق , عزة صالح جوهر, شوقية سيد عبد احلليم, محمد كمال عبد الرحمن

املعهد القومى للتغذية

مقدمة: مت إجراء بحث قومي في مصر سنة 1995 و ذلك لتقييم وضع فيتامني )أ( لدى األطفال دون السن املدرسي و أمهاتهم. و قد تنب أن نقص فيتامني أ ميثل مش��كلة صحية معتدلة احلدوث بني األطفال دون س��ن اخلامسة و السيدات احلوامل. استنادا إلى ما خلص إليه هذا البحث القومي فقد مت تبنى برنامج لإلمداد بكبس��والت فيتامني أ باعتباره أحد اس��تراتيجيات الوقاية من و الس��يطرة على نقص الفيتامني في مصر. الهدف من الدراس��ة: تهدف هذه الدراس��ة إلى تقييم الوضع احلالي لفيتامني أ في مصر بعد تنفيذ برنامج اإلمداد بكبس��والت فيتام��ني )أ( ، من أجل اقتراح املزيد من البرامج املس��تدامة للتدخل من أجل القض��اء الفعلي على نقص هذا الفيتامني في مصر. خطة البحث: مت إجراء هذه الدراسة على 4490 من الفئة املستهدفة ) 2132 أم و 2359 طفل دون السن املدرسي من 6-71 شهرا( متثل ست مناطق جغرافية في مصر متضمنة املناطق احلضرية و الريفية. وقد مت تقييم وضع فيتامني أ بناء على القياسات الكيميائية )محت��وى مص��ل الدم من الريتينول(، واملؤش��رات البيئية )الغذاء وتك��راره ، والرضاعة الطبيعية ، وأمناط األم��راض ، واحلالة االجتماعية(. النتائ��ج: أظه��رت النتائ��ج أن 6 ٪ من األطف��ال ، و 3.7 ٪ من أمهاتهم يعانون من نقص فيتامني أ )مس��توى الريتين��ول في الدم أقل من 20ميكروج��رام/100 مليمتر دم( مع ارتفاع معدل اإلصابة بنقص فيتامني ألف بني األطفال عن األمهات في كل املناطق وانخفاض معدل انتش��ار نقص الفيتامني )حوالي 4 ٪( بني صغار الس��ن من األطفال )أقل من18 ش��هرا حيث مت تنفيذ برنامج اإلمداد( عن األطفال األكبر سنا مع عدم وجود فروق معنوية في معدالت انتشار نقص فيتامني أ بني اجلنسني )بنني وبنات( ، وبني املناطق )احلضرية والريفية( وكذلك بني مختلف الطبقات االجتماعية. كما أظهرت النتائج أن 89.8٪ من األمهات و 50.9٪ من األطفال قد حصلوا على كبسوالت الفيتامني و أن حوالي 93٪ من األطفال دون الس��ن املدرس��ي قد تلقوا رضاعة طبيعية مع ارتفاع معدل الرضاعة الطبيعية في املناطق الريفية عن املناطق احلضرية.و قد أظهرت البيانات الغذائية أن غالبية األسر لم تستهلك مصدرا جيدا للفيتامني )أ( )حوالي 88 ٪ و 76 ٪ من األسر تس��تهلك مصدرا غنيا للكاروتني وفيتامني )أ( أقل من ثالث مرات في األس��بوع ، على التوالي(. كما تبني من بيانات األمراض وأمناطها أن نحو 65 ٪ من األطفال يعانون من عدوى اجلهاز التنفس��ي العلوي و 34.3 ٪ لديهم أمراض املعدة واألمعاء )اجلهاز الهضمي( ، واإلس��هال والق��يء ، أو االثن��ني معا. اخلالصة: خلصت الدراس��ة إلى أن نقص فيتامني أ في مصر ميثل مش��كلة صحية عام��ة معتدلة احلدوث و أن برنامج مكمالت فيتامني )أ( كان له أثر إيجابي على نقص الفيتامني.هذا و تبقى العوامل بيئية ، وخاصة املمارس��ات الغذائية من األس��ر املصرية واإلصابة بالعدوى هي السبب املباشر لنقص فيتامني أ في مصر. التوصيات وتوصي الدراسة بالتدخل ببرامج متكاملة ودائمة

للسيطرة على نقص فيتامني أ.





Effect of Feeding Pomegranate on Hepatotoxic rats

Hussein. E.A

ABSTRACTBackground: Pomegranate fruits are rich in antioxi-dants of the polyphenolic class, which includes tannins and anthocyanins. Objective, This research occurred on pomegranate fruit to study some chemical analysis of juice, rind and peel and the effect of feeding pomegran-ate on hepatotoxic rats. Materials and methods, Forty -two albino male rats were classified into control (-ve), and five groups treated with CCl4 which were control (+ve), drug, pomegranate juice, rind and mixture of pomegranate juice and rind groups. The chemical results showed that the juice of pomegranate contains the higher value of moisture, caffeic and catechol acids compared to the rind. Results, The rind of pomegranate contains the higher value of protein, fat, carbohydrate, vanillic acid than the peel and juice. The peel of pomegranate contains the higher value of ash, caffeic and chlorogenic acids than the juice and rind. Control (+ve), drug ,juice and rind groups showed decrease in final weight, weight gain, weight gain percent and FER while mixture group decreased weight gain percent and FER compared to control

(- ve). Drug, juice, rind and mixture groups showed de-crease in serum amino transferase (ALT&AST), alka-line phophatase enzymes , total bilirubin,A/G ratio ,urea ,cholesterol, triglyceride ,LDLc ,VLDLc and cholesterol / HDLc and liver cholesterol ,total lipids and malondial-dehyde but showed increase in weight gain, weight gain percent ,FER ; serum total protein ,globulin ,HDLc and liver glutathione, and glutathione peroxidase in compar-ing to control (+ ve) group. Histopathological examina-tions of liver showed a decrease or amelioration of patho-logical lesions and damages caused by CCl4 intoxicated liver. Conclusion: Pomegranate as a natural antioxidant alleviated effect of CCl4 toxicity.

Key world: Pomegranate - Hepatotoxic – Experimental animals

INTRODUCTIONPhenolic compounds, or polyphenols, are reducing agents in the plant kingdom. They can range from simple molecules, such as phenolic acids, to highly polymerized compounds, such as tannins. The content of total phe-nolics was well correlated with the antioxidant capac-ity of fruits (Halliwell and Gutteridge 2000 and Ricci et

al., 2006). Polyphenols may protect the body>s tissues against oxidative stress and associated pathologies such as cancer, cardiovascular diseases and inflammation.

Pomegranate fruits are consumed fresh and in processed form as juice, wines, flavors, and extracts. Pomegranate fruits are rich in antioxidants of the polyphenolic class, which includes tannins and anthocyanins (De Nigris et al., 2007). Pomegranate juice has 0.2-1.0% soluble poly-phenolic compounds.The major ones are being punicala-gins and tannins, anthocyanins , catechins, ellagic , gallic and ellagic acids, and minor flavonoids (Aviram and Fu-harm 2003 and Seeram, et al., 2005). These compounds are known for their properties in scavenging free radicals and inhibiting lipid oxidation in vitro that displays po-tent antiatherogenic action in atherosclerotic mice and humans(Noda, et al.,2002; Rozenberg et al.,2006 and Jingjing et al., 2007).

Pomegranate juice byproducts were shown to reduce oxidative stress in serum and in macrophages by reduc-ing cellular cholesterol accumulation and foam cell for-mation (Rosenblat et al., 2006). Pomegranate peels have highest antioxidant activity among the peel, pulp and seed fractions of 28 kinds of fruits commonly consumed in China (Guo et al., 2003). The officinal part, rind of fruit, is astringent, digestive, cardiotonic, stomachic and highly effective in chronic diarrhea, dysentery, dyspep-sia, colitis, piles and uterine disorders. The oral admin-istration of pomegranate rind extract could effectively protect against CCl4 induced hepatotoxicity (Murthy et al., 2002).

The aim of this research was to study the effect of feed-ing pomegranate fruit on hepatotoxic rats.

MATERIALS AND METHODSA – Materials:1-Carbon tetrachloride (CCl4):

Carbon tetrachloride (CCl4) was used to induce experi-mental acute hepatitis in rats. It was purchased from El Gomhorya Co., Egypt in the form of 40% liquid dis-pensed in 1 L plastic bottles.

2-Ursofalk drug:

Ursofalk drug is, white capsule, obtained from Minap-harm Company. Each capsule contains 250 mg ursode-oxycholic acid. Ursofalk drug is used in improvement of liver functions in chronic hepatitis, protection of liver cells in chronic liver disease and treatment of primary

biliary cirrhosis.

3- Pomegranate fruit:

Pomegranate fruits were purchased from a local mar-ket. Fruits were washed in cold tap water and drained.The peel and rind were manually removed. The juice in the sacs was manually pressed. The juice obtained was deep red. It was stored at 4C over night for the settling of suspended particles, then filtered and concentrated. Parts of juice, rind and peel were used fresh for chemical analysis while juice and rind were dried in dry freezer and crushed into powder then added to standards diet in substitution of fiber.

4- Rats:

Forty-two male albino rats of Sprague Dawley strain were purchased from Laboratory Animal Colonies, Hel-wan, Egypt. The average weight was 115 ± 5 g.

B - Methods:1-Determination of the chemical composition and phenolic acids in juice, rind and peels of pomegran-ate:

Protein, fat, ash, and moisture of pomegranate were determined according to the methods of the A.O.A.C. (1995), while total carbohydrates were calculated by dif-ference as following:

Carbohydrates % = 100 - (moisture % + protein % + fat % +ash %). Phenolic acid was determined in Central Laboratory of Food Tech. Res. Inst., Agric. Res. Center, Giza, Egypt. An HP 1100 HPLC system equipped with an alpha Bond C18 125A column (4.6 × 250 mm, particle size 5 μm) and coupled with Agilent 1100 series Chem Station software was used for quantifying the individual phenolic compounds (Narr Ben et al., 1996).

2-Preparation of the basal diet:

The standard diet comprised of casein (200g/kg), corn starch (497g/kg), sucrose (100g/kg) , cellulose (30 g/kg) ,corn oil (50g/kg), mineral mixture (100g/kg) , vitamin mixture (20g/kg) and DL-methionine (3g/kg).The stan-dard diet was performed according to NRC (1995).

3- Grouping of rats and experimental design:

Rats were housed in wire cages at a room temperature maintained at 25°C (+/- 2°C) with a 12 hour lighting sys-tem. All rats were fed the basal diet for five day before starting the experiment for adaptation then the rats were allocated into six equal groups. Control (- ve) group fed on the basal diet only while the other five groups were subcutaneously administered a single dose of CCl4 in paraffin oil in dose 1ml/kg for two days from the start of the experimental period for inducing rats liver injuries according to the method described by Lee et al.,(2005). The CCl4 rats were classified as following:

Control (+Ve) group: fed on the basal diet only.

Drug group: fed on the basal diet and administered urso-falk drug dissolved in distilled water in dose 10 mg/kg of rat intragastric.

Juice group: fed on the basal diet containing dry juice.

Rind group: fed on the basal diet containing rind pow-der.

Mixture group: fed on the basal diet containing dry juice and rind.

4-Calculation of food intake, body weight gain per-centage and food efficiency ratio in rats:

The study was assigned for eight weeks. The food in-take was calculated daily and the body weight gain was recorded daily. Food efficiency ratio was determined ac-cording to the method of Chapman et al., (1959).

5- Collection of blood samples:

At the end of the experimental period all rats were fasted overnight then sacrificed. Blood samples were immedi-ately collected in clean and dried Wiesserman tubes from the portal vein. The blood samples were centrifuged at 3000 rpm for 15 minutes to obtain serum which frozen at -10°C for some analyses.

6- Collection of liver samples and histopathological examination:

The liver of sacrificing rats was removed by careful dis-section, blotted frees of adhering blood, washed with cold saline solution, and dried between two filter papers. Parts of livers collected and immersed in 10% neutral buffered formalin as fixative. The fixative liver samples were sent to Cancer Institute for histopathological exam-ination according to Bancroft et al., (1996).Other parts of the Livers perfuse with 50 to 100 of ice cold 0.9%NaCL solution for some analyses.

7-Analytical Methods:

Serum (ALT& AST) activity, alkaline phosphates, bili-rubin were estimated according to Reitman and Frankel (1957), Kind and King (1954) and Jendrassik (1938), respectively. Total protein, albumin (A) and urea were determined according to Weichselbaum (1946); Bartho-lomev and Delany (1966) and Patton and Crouch, (1977), respectively. Serum globulin (G) value was determined by subtracting the albumin from the total proteins ac-cording to Coles (1974). A/G ratio was calculated using albumin and globulin values for each individual sample.

Serum cholesterol, triglycerides, high density lipoprotein cholesterol, low and very low density lipoprotein cho-lesterol were determined according to Trinder and Ann (1969), Wahlefeld (1974), Richmond (1973) , Fruchart, (1982) and Friedwald, et al.,(1972),respectively. Athero-genic index (cholesterol /HDL-c) was calculated accord-ing to Castelli and levitar, (1977).

Liver cholesterol ,total lipids ,triglyceride, glutathione

Effect of Feeding Pomegranate on Hepatotoxic ratsHussein. E.A

Nutrition and Food Science Dept., Faculty of Home Economics, Minufiya University,Shebin El-Kom, Egypt.



(GSH) ,glutathione peroxidase (GPX) , and malondial-dehyde (MDA), were determined according to Abell et al., (1952)., Folch et al.,(1957) and Young and Pestaner (1975) Beuchamp and Fridovich,(1971).,Beuther et al.,(1987) and Habig et al.,(1974) ,respectively.

8-statisticl analysis:

Collected data were presented as mean +_SDM and sta-tistically analyzed using one way analysis of variance (ANOVA).Student «t» test was used for significance ac-cording to Armitage and Berry (1987).

RESULTS and DISCUSSIONChemical composition of juice, rind and peel of pome-granate:

The juice of pomegranate contains the higher value of moisture. The rind of pomegranate contains the higher value of protein and crbohydrate than the peel and juice. The peel of pomegranate contains the higher value of ash than the juice and rind as shown in table (1).

These results were agreed with Badria, (2002) and Cui et al. (2004). The fruit of the pomegranate comprises 80% juice and 20% seeds; the fresh juice contains 85% wa-ter, 10% total sugars and 1.5% pectin, ascorbic acid, and polyphenolic flavonoids (El-Nemr et al., 1990, Aviram et al., 2000, Jahfar et al., 2003 and Vidal et al., 2003).

Phenolic acids contents in juice, rind and peel of pomegranate:

The juice of pomegranate contains the higher value of caffeic and catechol acids than the rind. However, the rind of pomegranate contains the highest value of gal-lic and vanillic acids compared to the peel or juice. The peel of pomegranate contains higher value of caffeic, catechol and chlorogenic acids than the juice and rind as shown in table (2).

These results were agreed with Artik, (1998), Amakura et al., (2000) and Huang, et al., (2005). Pomegranate is a rich source of polyphenols such as gallic acid, protocat-echinuie acid, chlorogenic acid, caffeic acid, ferulic acid, coumaric acids and catechin (Poyrazoglu et al., 2002 and Seeram et al., 2005).The ellagic acid is a breakdown product of punicalagin and gallic acid which is another phenolic acid present (Kulkarni et al., 2004). The content of soluble polyphenols in pomegranate juice varied be-tween 0.2% and 1.0% and include mainly anthocyanins , catechins, ellagic tannins, gallic and ellagic acids. Both flavonoids and tannins are more abundant in the peels (Ozcal and Dinc, 1993).

Effect of feeding juice, rind and mixture of pome-granate on final weight, weight gain, daily food in-take, and food efficiency ratio in hepatotoxic rats:-

Administration of CCl4, subcutaneously, to rats in the

first two days of experimental period decreased final weight, weight gain, weight gain percent and FER at p<0.05 &0.001 in control (+ve) group and also admin-istration of drug decreased final weight, weight gain, weight gain percent and FER at p<0.05 &0.01 in drug group compared to control (- ve) group. Feeding pome-granate juice or rind decreased final weight, weight gain, weight gain percent and FER at p<0.05 &0.001 in juice and rind groups compared to control (- ve) group. Feed-ing pomegranate mixture of juice and rind decreased weight gain percent and FER at p<0.05 &0.01 respec-tively in mixture group compared to control (- ve) group as shown in table (3).

Administration of drug increased weight gain, weight gain percent and FER in drug group compared to con-trol (+ve) group. Feeding pomegranate juice or rind increased weight gain, weight gain percent and FER in juice and rind groups compared to control (+ ve) group. Feeding pomegranate mixture of juice and rind increased final weight, weight gain, weight gain percent and FER in mixture group compared to control (+ ve) group also as shown in table (3).

Fruit and vegetable are an important source of essential elements. Mineral nutrients and phenolics are natural component of many fruit and play an important role in nutritive value (Malik et al., 2005). The intake of poly-phenols, sugar and caloric intake in pomegranate enhance health and has been inversely correlated to the incidence of several chronic diseases (Susanne et al., 2006).

Effect of feeding juice, rind and mixture of pomegran-ate on serum amino transferase, alkaline phophatase en-zymes and total bilirubin in hepatotoxic rats:-

Administration of CCl4, subcutaneously, to male rats in the first two days of experimental period increased se-rum amino transferase (ALT&AST), alkaline phophatase enzymes and total bilirubin at 0.01 & 0.001 in control (+ve) group while administration of drug increased al-kaline phophatase enzymes and total bilirubin at p<0.05 in drug group compared to control (- ve) group. Feed-ing pomegranate juice or rind increased serum amino transferase(ALT&AST),and alkaline phophatase en-zymes at p<0.05 in juice and rind groups compared to control (- ve) group. Feeding pomegranate mixture of juice and rind increased serum amino transferase (ALT&AST), alkaline phophatase enzymes and total bilirubin at p<0.05 in mixture group compared to control (- ve) group.

Administration of drug, juice, rind and mixture of pome-granate juice and rind decreased serum amino transferase (ALT&AST), alkaline phophatase enzymes and total bilirubin compared to control (+ ve) group as shown in table (4).

Lee et al., (2005) recorded that CCl4 causes changes around the central vein in the liver and oxidative damag-es with the leakage of marker enzymes such as GOT and

GPT in the serum. Pomegranate fruits contains proan-thocyanidins, anthocyanins (glycosides of delphinidin, peonidin and cyanidin) and flavonoid glycosides, phy-tochemicals that have all been shown to have antioxidant and antiproliferative activities (Noda et al., 2002).

Effect of feeding juice, rind and mixture of pome-granate on serum total protein, albumin, globulin ,al-bumin/globulin ratio (A/G) and urea in hepatotoxic rats:-

Administration of CCl4, subcutaneously, to male rats in the first two days of experimental period decreased total protein, albumin, globulin at 0.001,0.05&0.01, respec-tively but increased urea in control (+ve) group while administration of drug decreased albumin and (A/G) ra-tio at p<0.05 in drug group compared to control (- ve) group. In addition, Feeding pomegranate juice increased (A/G) ratio at p<0.05 in juice group but Feeding pome-granate rind decreased albumin and increased (A/G) ra-tio at p<0.05 in rind group compared to control (- ve) group. Feeding pomegranate mixture of pomegranate juice and rind decreased serum albumin at p<0.05 in mixture group compared to control (- ve) group.

Administration of drug, juice, rind and mixture of juice and rind increased serum total protein and globulin but decreased (A/G) and urea ratio compared to control (+ ve) group as shown in table (5).

CCl4 has been extensively studied as a liver toxicant, and its metabolites such as trichloromethyl radical and trichloromethyl peroxy radical are involved in the patho-genesis of liver and kidney damage (Lee et al., (2005). The fruit rich concentrations of diverse bioflavonoids are free radical scavenging activity and inhibition of lipoxy-genase (Aviram and Rosenblat 2003 and Sudheesh and Vijayalakshmi 2005).

Effect of feeding juice, rind and mixture of pome-granate on serum lipid patterns in hepatotoxic rats:-

Administration of CCl4, increased serum cholesterol, triglyceride ,LDLc ,VLDLc and cholesterol/HDLc at 0.05,0.01 & 0.001 but decreased HDLc in control (+ve) group while administration of drug increased triglyc-eride, LDLc and cholesterol / HDLc at p<0.05 in drug group compared to control (- ve) group. In addition, Feeding pomegranate juice or rind increased triglycer-ide, LDLc and Cholesterol/HDLc at p<0.05 in juice and rind groups compared to control (- ve) group. Feeding pomegranate mixture of juice and rind increased serum triglyceride and cholesterol / HDLc at p<0.05 in mixture group compared to control (- ve) group.

Administration of drug, juice, rind and mixture of pome-granate decreased cholesterol, triglyceride, LDLc, VLD-Lc and cholesterol / HDLc but increased HDLc com-pared to control (+ ve) group as shown in table (6).

It is known that, the increased serum oxidative stress could be the result of glycation and glycooxidation of LDLc

by glucose, or/and the decreased capability of the HDLc to protect LDLc against oxidation (Knott et al., 2003). LDLc oxidation plays a key role in early atherosclerosis. The uptake of oxidized LDLc via scavenger receptors, by the monocytes promotes cholesterol accumulation and foam cell formation, which leads to the development of atheromatous plaques (Chisolm and Steinberg, 2000). Polyphenols and ascorbic acid in pomegranate could ef-fectively protect LDLc against oxidation resulting from high capability to scavenge free radicals and reduced the LDLc susceptibility to macrophage-mediated oxidation (Schubert et al., 1999). Pomegranate possesses potent antioxidant activity that is associated to its antiathero-genic properties and inhibition of cyclooxygenases and lipoxygenases (Aviram et al., 2000 and Kaplan et al., 2001).

Effect of feeding juice, rindand mixture of pomegran-ate powder on some liver cholesterol, total lipids and triglyceride in hepatotoxic rats:-

Administration of CCl4, increased liver cho-lesterol and total lipids at 0.001 &0.01 and decreased triglyceride at 0.05 in control (+ve) group while admin-istration of drug decreased triglyceride at p<0.05 in drug group compared to control (- ve) group. In addition, Feed-ing pomegranate juice decreased triglyceride at p<0.05 in juice group compared to control (- ve) group. Feed-ing of pomegranate rind or mixture showed the values of cholesterol, total lipids and triglyceride nearly as the values of control (- ve) group. Administration of drug, juice, rind and mixture of pomegranate decreased liver cholesterol and total lipids compared to control (+ ve) group. Administration of pomegranate rind and mixture increased triglyceride compared to control (+ ve) group as shown in table (7).

The capacity of the antioxidants in pomegranate may be due to the reduction in the oxidative stress by inhibiting the formation of Ox-LDL, macrophage lipid peroxida-tion and cholesteryl ester accumulation by attenuation of cholesterol influx and esterification and by an enhanced macrophage cholesterol efflux. The flavonoids from pomegranate are effective in reducing lipids from serum and tissues (Aviram and Rosenblat 2003). Pomegranate arils, juice and rind exhibited always a higher activity of antioxidants as compared to their aqueous and ethyl ac-etate extracts. In particular, the activity was higher in the juice and rind due to the presence of tannins, as shown by Gil et al., (2000).

Effect of feeding juice, rind and mixture of pome-granate powder on liver glutathione, glutathione per-oxidase and malondialdehyde in hepatotoxic rats:-

Administration of CCl4, decreased liver glutathione, and glutathione peroxidase at 0.001 and increased malon-dialdehyde at 0.01 in control (+ve) group compared to control (- ve) group. Administration of drug and feeding of juice or rind decreased liver glutathione and glutathi-


Hussein. E.A



one peroxidase at 0.05 and increased malondialdehyde at 0.05 compared to control (- ve) group. Feeding of pome-granate mixture of juice and rind showed decreased liver glutathione peroxidase at 0.05 and increased malondial-dehyde at 0.05 compared to control (- ve) group.

Administration of drug, juice, rind and mixture of pome-granate juice and rind increased liver glutathione, and glutathione peroxidase and decreased malondialdehyde compared to control (+ ve) group as shown in table (8).

Increased oxidative stress was shown not only in serum, but also in the monocytes and macrophages by increas-ing cellular levels of peroxides and decreasing levels of macrophage resulting in reduced glutathione (Sies,1999) and Ozdemir et al., 2005). The free radical reduced the mean liver detoxificant enzymes mainly catalase and peroxidase during the catalytic cycle (Halliwell and Gut-teridge 2000). The pomegranate extract containing el-lagic acid and gallic acid acts as a potent free radical scavenger, reducing the levels of hydrogen peroxide and superoxide anion and, consequently, lipid peroxidation and enzyme inactivation, restoring enzyme activity and also de novo synthesis of these enzymes with increase in catalase and glutathione peroxidase activities (Sudheesh and Vijayalakshmi 2005).

Pomegranate rind reduced cellular levels of basal lipid peroxides and the susceptibility of the macrophages cells to oxidation and increased macrophage GSH con-tent. These effects could be attributed to the free radi-cal scavenging capacity of rind (Rosenblat et al., 2006). Flavonoids increase the intracellular glutathione level by transactivation of the gamma-glutamylcysteine syn-thetase catalytical subunit promoter (Kaur et al., 2006 and Faria et al., 2007).

Histopathological results of liver:Liver of control (-ve ) group showed normal hepato-cytes with normal architecture and normal portal veins and artery (pict1) while liver of control (+ve) showed loss of hepatic architecture, areas of hemorrhage, and necrosis(pict 2). Liver of drug group showed activation of Kupffer cells(pict 3). Liver of pomegranate juce group retains normal hepatic architecture with few areas of hemorrhage (pict 4). Liver of rind group showed vacu-olization of focal hepatocytes(pict 5) but liver of mixture group showed some apparent normal hepatocytes with presence of slight cytoplasmic vacuolations (pict 6).

Lee et al., (2005) indicated that the liver protective and antioxidative effects of certain plant extracts against CCl4-induced liver injury possibly involve mechanisms related to free radical scavenging effects. Singh et al., (2002) described the hepatoprotective and antilipid per-oxidative effects of ellagic acid against CCl4-induced hepatotoxicity in rat liver. The effects of various phe-nolic compounds such as caffeic acid, chlorogenic acid, cyanarin, and cyanaroside in Pomegranate fruits protecte rat hepatocytes against toxicity.

It is recommended to drink pomegranate juice and con-sume dried rind in human diet for their antioxidant ef-fects.

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Table (1): Chemical composition of juice, rind and peels of pomegrnate fruit.

SampleVariables Juice Rind Peel

Protein(g/100) 0.19 1.01 0.99

Fat (g/100) 0.05 0.78 1.13

Carbohydrate (g/100) 15.81 81.32 80.99

Ash (g/100) 0.51 5.11 6.48

Moisture(g/100) 83.44 11.78 10.41

Table (2): Some phenolic acids of juice, rind and peels (µg/g) of pomegrnate fruit.

SampleVariables Juice Rind Peel

Caffeic 15.52 14.11 221.71

Gallic 70.11 6890.24 4307.81

Catechol 58.15 12.87 3511.25

Chlorogenic 240.18 2718.31 3618.20

Vanillic 31.85 853.41 35.11


Hussein. E.A



Table (3): Mean values ± SD of body weight gain, food intake and food efficiency ratio (FER) of control and CCl4 treatedrats.

GroupsVariables Control

(-ve)

CCl4

Control(+ve) Drug Juice Rind Mixture

Initial weight(g)

115.33±2.55a

115.55±2.60a

116.33±2.77 a

116.50±2.41a 117.30±2.99a

119.11±2.14a

Final weight(g)

175.80±9.88a

150.71±8.44b*

163.14±8.33 b*

159.61±7.51b* 158.17±7.78b*

172.60±7.60a

Weight gain(g)

60.47±3.14a

35.16±2.71 c***

49.81±4.32 b*

43.11±4.50b*

40.87±4.16b*

53.49±7.11a

Weightgain percent

52.43±3.51a

30.42±3.61 c***

42.81±5.22 b*

37.01 ±3.11b*

43.74±3.41b*

44.60±6.91b*

Food intake (g/d)

14.75±1.11 a

13.60±1.21 a

13.71±1.13 a

13.75±1.21a

13.88±1.41a

14.55±1.01a

FER 0.067±0.001a

0.043± 0.002 e***

0.060±0.003 b**

0.051±0.002 d***

0.049±0.001 c***

0.061±0.002b**

Significant with control group * P<0.05 ** P<0.01 *** P<0.001Mean values in each row having different superscript (a, b, c, d) are significant.

Table (4) The Mean values ± SD of serum amino transferase (ALT & AST), alkaline phophatase enzymes (Alk-phos), and total bilirubin of control and CCL4 treated rats groups


(-ve)

CCl4


ALT(µ /ml)

45.15±5.03 c

85.89±7.11 a**

50.68±6.80 bc

61.31±4.14 b

59.17±5.11 b*

45.34±6.30 b*

AST(µ /ml)

25.14±2.16 c

45.88±4.81 a ***

29.15±3.11 bc

33.17±3.01 b*

35.10±3.18 b*

31.11±3.07 b*

Alk-phos(µ /ml)

37.11±3.71 c

59.30±5.31a**

43.12±5.81 b*

45.44±5.31b*

46.91±5.22 b*

44.19±4.01 b*

Bilirubin(mg/dl)

0.43±0.01 c

1.87±0.35 a***

0.68±0.08b*

0.41±0.07 c

0.39±0.06c

0.78±0.05b*

Significant with control group * P<0.05 ** P<0.01 *** P<0.001Mean values in each row having different superscript (a, b, c, d) are significant

Table (5) The Mean values ± SD of serum total protein, albumin, globulin, albumin/globulin ratio (A/G) and urea of control and CCL4 treated rats groups


(-ve)

CCl4,


T. protein(g/dl)

6.99±1.03 a

3.67±0.61b***

5.88 ±0.99a

5.11±03.88 a

5.35±0.87 a

5.78±0.91 a

Albumin(g/dl)

3.21±0.41 a

2.31±0.32b*

2.55 ±0.42 b*

2.49±0.391 a

2.59±0.40 b*

2.65±0.42 b*

Globulin(g/dl)

3.78±0.35 a

1.36±0.66 c**

3.33 ±0.41 a

2.62±0.26 a

2.76±0.955 a

3.10±0.18 a

A/GRatio

0.84±0.01 c

1.69±0.31a

0.76 ±0.03 b*

0.95 ±0.08 b*

0.93 ±0.09 b*

0.85 ±0.07 c

Urea (mg/dl)

34.38±5.17 b

53.14±3.18 a**

43.17±4.32 b

40.22±4.61b

42.51±4.81b

39.41±3.69 b


Table (6) The Mean values ± SD of serum lipid patterns of control and CCL4 treated rats groups


(-ve)

CCl4,


cholesterol(mg/dl)

97.11±7.11 b

159.33±11.20a**

105.13±10.30 b

110.41±11.10 b 103.22±9.71b

99.11±8.33 a

Triglyceride (mg/dl) 78.97±6.91c

95.31±8.13 a**

88.11 ±9.11 b*

85.31 ±8.11 b*

86.14±7.41 b*

84.45±9.13 b*

HDLc(mg/dl)

35.32±5.20 a

20.33±3.41 b**

31. 41 ±2.99 a

30.15±0.26 a

29.41±2.88 a

31.17±2.91 a

LDLc(mg/dl)

46.01±6.11 c

119.94±12.45 a***

56.10 ±6.25 b*

63.20 ±9.03 b*

56.59 ±6.19 b*

51.05 ±6.71 b

VLDLc(mg/dl)

15.79 ±2.45 b

19.06±2.33 a*

17.62±1.99 b

17.06±1.81 b

17.22±1.14 b

16.89±1.31 b

Cholesterol/HDLc 2.74±0.11c

7.83±2.41a***

3.34±0.61b*

3.66±0.49b*

3.50±0.51b*

3.17±0.67 b*



Hussein. E.A



تاأثري تناول �لرمان على �لت�صمم �لكبدي يف �لفئر�ن

عصام عبد احلافظ حسني

قسم التغذية و علوم األطعمة - كليه االقتصاد املنزلي - جامعه املنوفية

اج��ري ه��ذا البحث على فاكهة الرمان حيث مت التحليل الكيميائي لعصير و لب والقش��رة اخلارجية للرمان كما متت دراس��ة تأثيره علي التسمم الكبدى في الفئران. وقد مت تقسيم اثنني وأربعني من فئران التجارب إلى اجملموعة الضابطة السالبة وخمس مجموعات معاجلة براب��ع كلوري��د الكربون إلحداث التس��مم الكبدي وه��ي الضابطة املوجبة و الدوائي��ة وعصير ولب وخليط من العصي��ر واللب لفاكهة

الرمان.

و أظهرت النتائج الكيميائية أن عصير الرمان يحتوي على قيم مرتفعة من الرطوبة وحمض الكافييك والكاتيكول عن لب الرمان بينما اظهر لب الرمان ارتفاع محتواه من البروتني والدهون و الكربوهيدرات وحمض الفانيلك باملقارنة بالعصير والقشرة اخلارجية للرمان. وقد

أظهرت قشرة الرمان اخلارجية ارتفاع احملتوى من الرماد و حمض الكافييك وحمض الكلوروجينك باملقارنة بالعصير ولب الرمان.

كم��ا اظه��رت كال من اجملموع��ة الضابطة املوجبة والدوائية وعصير ولب الرمان انخفاض في الوزن النهائي و الوزن املكتس��ب ونس��بته ونس��بة كفاءة الطعام بينما أظهرت اجملموعة اخملتلطة انخفاض في نس��بة الوزن املكتسب ونس��بة كفاءة الطعام باملقارنة باجملموعة

الضابطة السالبة.

وقد أظهرت اجملموعات الدوائية والعصير واللب واخملتلطة انخفاض في البيلروبني الكلي و اليوريا و )ALT&AST, alkaline phosphatase( و الكوليسترول واجلليسريدات الثالثية و الليبوبروتني منخفض الكثافة و الليبوبروتني االكثر انخفاضا في الكثافة ونسبة الكوليسترول/ الليبوبروتني منخفض الكثافة في الس��يرم و الكوليس��ترول و الدهون الكلية و املالوندايالدهيد ف��ي الكبد بينما ظهر ارتفاع في الوزن املكتسب ونسبته ونسبة كفاءة الطعام والبروتني الكلي واجللوبيولني و الليبوبروتني مرتفع الكثافة واجللوتاثيون واجللوتاثيون بيروكسيداز

في الكبد باملقارنة باجملموعة الضابطة املوجبة.

وأظه��ر الفح��ص الهس��توباثولوجى وجود نقص أو اختف��اء في التغييرات املرضية الت��ي يحدثها رابع كلوريد الكرب��ون في الفئران عند تغذيتها على عصير ولب وخليط من عصير ولب الرمان.

Table (7) The Mean values ± SD of liver cholesterol, total lipids and triglyceride in control and CCL4 treated rats.

GroupsVariables

Control(-ve)

CCl4,

Control(+ve)

Drug Juice Rind Mixture

Cholesterol(mg/g)

4.17±0.81 b

8.33±1.14a***

5.01±0.71 b

5.31±0.84 b

4.89±0.75 b

4.68±0.71 b

Total lipids(mg/g)

42.36±4.32 b

55.71±5.01 a**

49.11±5.30 b

48.31±4.21 b

49.77±4.23 b

45.11±4.98 b

Triglyceride (mg/g)

3.31±0.41 a

2.17±0.45 b*

2.91±0.11 b*

2.607±0.13 b*

3.01±0.50 a

3.11±0.39 a


Table (8) The Mean values ± SD of some liver glutathione (GSH), glutathione peroxidase (GPX) and malondialdehyde(MDA) in control and CCL4 treated rats.

GroupsVariables

Control(-ve)

CCl4,

Control(+ve)

Drug Juice Rind Mixture

Liver GSH(mg /g)

3.99±0.51a

1.99±0.05c***

2.71±0.13 b*

2.31±0.11b*

2.11±0.20 b*

3.23±0.40a

Liver GPX(µg /mg)

49.51 ±5.88a

30.11±3.41 c***

42.81±4.70 b*

38.31±3.50 b*

39.11±3.55 b*

41.10±7.01 b*

Liver MDA(nmol/g)

43.64±3.71 c

92.11±10.14a***

55.11±6.01 b*

60.31±8.14 b*

61.14±7.99 b*

62.33±8.36 b*



Hussein. E.A



Chemical, microbiological, physical and sensory evaluation of some soy-based formulas prepared for infants and young children with acute diarrhea.

Shafika A. Zaki*, Ahmed T. El- Akel*, Laila El- Mahdy**and Nadra S. Y. Hassan**

AbstractBackgroung: Diarrhea would result in an increased loss of sodium, potasium and chlorine into the bowel lumen, causing water loss. In turn this could lead to dehydra-tion and reducing the concentration of such electrolytes in the plasma. Thus, the relation between diarrhea and malnutrition seemed to be very strong,. Objective: Six soy-based formulas were prepared for infants and young children with acute diarrhea. Materials and Methodes: The available local materials included yellow carrots, rice, potato starch powder and orange. The formulas were subjected for chemical, microbiological, physical and sensory evaluation. Resultes: The chemical evaluation showed that the prepared formulas contained low mois-ture content (5.67%). The contents of protein, fat, ash, fiber, carbohydrates and total pectin were 23.42 - 33.20, 6.47 - 7.50, 2.40 - 4.50, 3.90 - 5.98, 51.02 - 63.81 and 2.22 - 2.67%, in respective order. The energy provided from/100g formula ranged from 400.54 to 407.15 kcal. Concerning minerals, calcium, sodium, potassium, iron and zinc contents were 70.01 - 138.20, 110.45 - 153.10, 215.90- 320.50, 17.79 - 28.54 and 8.96 -13.36 mg/100g, respectively. The prepared formulas had 288.46 - 630.80 IU/100g vitamin A, 40.00 mg/100g vitamin C and 0.24 - 0.30 mg/100g thiamin. Formulas contained 0.70 - 0.85 mg/100g phytic acid, 1.50- 1.90 mg/g trypsin inhibi-tor and 0.05 - 0.08 IU/mg urease. The microbiologi-cal examination proved that the total microbial counts were low (30 cfu/g formulas) and all formulas were free from coliform group and yeast & moulds. According to Egyptian standardsization all formulas considered mi-crobiologically safe for infants. The sensory evaluation demonstrated the over all acceptability of all the pre-pared formulas concerning taste, color, odor, texture and acceptability. Among these formulas, formula 2 had the highest total score, followed by formula 4. Conculosion: The proposed formulas were well accepted, microbio-logicaly safe besides its high nutritive value.

Key words: acute diarrhea, infant, soy formula, cereals, nutritive value, antinutritional factors, safety, acceptabil-ity.

IntroductionAcute diarrhea disease appeared to be the leading cause of morbidity and mortality among children below two years of age, particularly in the developing countries (Bern, et al., 1992 and World Health Report, 1995).

In the developing countries, children less than five years of age appeared to be susceptible to 1.6 to 2.3 episodes of diarrhea each year and the peak of diarrhea prevalence proved to be common among children aged 6-11 months and then would be decreased with increasing age (Chen, et al., 1991 and Ise, et al., 1994).

In Egypt, on average a child under three years of age found to suffer 3 bouts of acute diarrhea per year.Acute diarrhea used to be the leading cause of death, account-ing for about half of all children deaths, under three years of age (WHO, 1996).

Diarrhea would result in an increased loss of sodium, po-tasium and chlorine into the bowel lumen, causing water loss (Baqui, et al., 2005). In turn this could lead to dehy-dration and reducing the concentration of such electro-lytes in the plasma (Wakwe and Okon, 1995).

Thus, the relation between diarrhea and malnutrition seemed to be very strong, (Vella, et al., 1995). So, the identification of optimal feeding regimens might reduce the nutritional deficits commonly found among children with diarrhea. The malabsorption problems that develop diarrhea could lead to deficiencies of many vitamins and minerals.

According to WHO / UNICEF (1983), children could continue eating their normal diets during diarrhea epi-sodes. However, the composition of the introduced diets during diarrhea episodes still be controversial and has been the topic of extensive research.

The use of soy-based, lactose-free formula during diar-rhea episodes could be safe and might reduce the sever-ity of diarrhea (Berger, et al., 2005). Although significant from the perspective of nutritional compromise, the du-ration of diarrhea had been reported to be shorter in in-fants receiving soy protein – based formula (Santosham. et al., 1991 and Allen, et al., 1994).

The duration of liquid stools might be further reduced by adding additional soy polysaccharide fiber (Brown. et al., 1993) or by resuming mixed –staple diet (Maulen-Radovan et al., 1994). During diarrheal episodes, feed-ing infants a soy-based formula with sucrose has a better outcome than feeding infants a soy-based formula with lactose (Fayad et al., 1999).

Some foods would worsen the diarrhea, but others might be recommended which could improve the nutritional status and general wellbeing of the child. Examples of such recommended foods included banana, rice, apples, potato, carrot and toast (El-sayed, 2006).

Thus, the objective of the present study was directed to develop some low price soy- based formulas, with lo-cally available ingredients to help in reducing acute diar-rhea among infants and young children.

Materials and MethodsMaterialsThe raw materials used for formulating the proposed for-mulas for diarrhea included yellow carrot, defatted soy flour, rice, potato starch powder and orange.

All of these materials were purchased from the local market at Giza, except the defatted soybean flour that was obtained from Food Technology Research Institute, Agricultural Research Center, Giza, Egypt.

Vitamins C&E, calcium and amino acids (methionine and cystine) were obtained from CID Co. for Pharma-ceuticals and Chemicals Industries, Giza, Egypt.

The main components for all the formulas were deffat-ted soy flour and carrot, their percentages ranged from 35- 50% of the composition. The composition of the pre-pared formulas for acute diarrhea illusrated in (Table 1).

For each 100g of the different formulas, vitamins C&E, calcium and amino acids (methionine and cystine) were added with different percentage for supplementation (Table 2).

MethodsThe preparation techniques of the different formulas:

The formulas were prepared in the soya plant at the Food Technology Research Institute (FTRI), Agricultural Re-search Center, and Giza, Egypt. Yellow carrots were washed with distilled water, peeled, cutted into slices and dried in a hot air at 50-60oc for 48 hours according to AOAC (2005).

The dried slices were grinded to a fine powder.

The fresh oranges were washed, peeled, cutted into slic-es, and then mixed in a home mixer. Rice was cleaned

and grinded to a fine powder.

The used materials with the supplemented components used for each formula were mixed in the blender for10-20 minutes. The mixtures of the used materials were cooked within the extruder barrel approximately for 30 seconds at135-145oc. Then, the formulas were cooled, packed in polypropylene bags and stored at room tem-perature in a dry place.

Chemical analysis:Moisture, crude protein, fats, fiber and ash of the pre-pared formulas were determined according to AOAC (2005). Total carbohydrates were estimated by differ-ences. The energy values of the six formulas were also calculated by using the factors described by FAO/ WHO (1985).

Minerals including calcium, iron, sodium, potassium, zinc, copper, magnesium and manganese contents were determined according to the method of AOAC (2005) using Unicom 1900 Atomic Absorption Spectrophotom-eter.

Thiamine was measured with HPLC as described by Bognar, (1992) using Beckman HPLC.

Vitamin A and Ascorbic acid were determined according to the method of AOAC (2005).

Trypsin inhibitors were determined according to the method of Shaohong et al., (2008). Phytic acid was ex-tracted according to the procedure described by Owen, et al., (1996). Urease activity was determined according to the method described in María et al., (2003).

Total pectins were determined according to the proce-dure of AOAC (2000).

Microbiological examinationTotal bacterial count (TBC) was determined using Tryp-tic glucose yeast agar medium according to (NMKL, 1999).

Yeasts& molds counts were determined using Malt ex-tract agar medium according to AOAC (2005).

Coliform group was determined using Mac Conkey agar medium according to (NMKL, 2005).

Physical properties:Physical properties including water absorption index and water solubility index were determined according to

Chemical, microbiological, physical and sensory evaluation of some soy-based formulas prepared

for infants and young children with acute diarrhea.Shafika A. Zaki*, Ahmed T. El- Akel*, Laila El- Mahdy**and

Nadra S. Y. Hassan***Food Science and Technology Department, Faculty of Agriculture, Cairo University.

** Food Technology Research Institute, Agriculture Research Center, Giza, Egypt.



(Mercier and Feillet, 1975).

Sensory evaluation:Sensory properties of the porridges made from the six formulas were evaluated by ten panel members of the staff of Special Food Department, Food Technology Re-search Institute, Ministry of Agriculture. The panelists were asked to evaluate the porridges for their taste (30), odor (20), color (20), texture (15) and overall acceptabil-ity (15) according to the method described by Emam, (1996).

Statistical analysis:The obtained data of the sensory evaluation were sta-tistically analyzed for standard deviation and one way ANOVA test according to (SPSS, 1998).

Results and Discussion:Chemical composition of the different formulas:

Moisture content of the six prepared formulas were low, being 5.67, 6.08, 7.00, 6.30, 6.16 and 7.00 for the six formulas in ascending order. This low level of moisture could reflect the good preparation techniques and in-crease their shelf life. The moisture contents of differ-ent formulas under investigation were found to be within the range reported by El-Anany (1999), Abd El wahed (2002), Afoakwa et al., (2004) and Allam (2007) who found that moisture contents of some prepared infant formulas varied from 5.7 to 7.4%. This moisture content is within the recommended limits not exceeding 7% as set by the Egyptian Standards (2005).

The gross chemical analyses of the prepared formulas were carried out and illustrated in Table (3). Data pre-sented in Table (3) revealed that nutrient contents of the prepared formulas showed some differences.

Protein content of the prepared formulas ranged from 23.01(formula 5) to 33.20% (formulas 1). The high pro-tein contents of infant formulas might be due to the defat-ted soy flour. In this respect, the protein content in some weaning foods formulated by Darwish et al., (1990) ranged from 10.3 to 18%. Ismail et al. (2000) found that the protein contents of other weaning foods prepared from available cereals and legumes in the Egyptian local market were in the range of 17.1 - 22.0%. The prepared formulas showed protein contents following the recom-medations to be over 15% on dry weight basis (Egyptian Standards, 2005).

Fat contents varied from 6.47 to 7.50 %. The lowest fat content was found in formula (2) and the highest value

recorded for formula (3).These values are slightly lower than those obtained by Osundahunsi and Aworh (2003) as the ether extract contents for weaning blends prepared from some cereals and legumes ranged between 8.2 and 9.4% fat. Such differen could be related to the kinds of different commodities.

Ash fluctuated between 2.40 and 4.50 %. The highest values of ash contents were shown in formulas 6, 5 and 3, being 4.50, 4.30 and 2.90 %, respectively. While all the other formulas showed close values ranging from 2.40 to 2.59%. In this respect, Osundahunsi and Aworh (2003) noted that ash content ranged from 1.7 to 2.5 % for different prepared complementary foods containing soy flour and carrot. Ismail et al., (2000) reported that ash content of different baby foods prepared from some cereals and legumes ranged from 1.3 to 2.9%. Ash con-tents of different formulas depended on the used ingre-dients.

Fiber ranged from 3.90 to 5.98 %. Formula 1 had the highest percentage of fiber (5.98%), while formula 2 showed the lowest content of fiber (3.90%). These could be attributed to the variations in the used materials as well as their ratios in different formulas. Both fiber and ash contents are in accordance with the required levels, being not less than 3 and 1 % respectively. (Egyptian Standards, 2005).

Carbohydrates differed from 51.02 (formula 1) to 63.81 % (formula 2). Such difference would be related to the kinds of used commodities. The presence of rice flour at high level in the formula increased carbohydrates con-tents.

The total pectin contents of the six formulas were 2.40, 2.47, 2.22, 2.67, 2.37 and 2.22% in ascending order. Mc-Clug, et al. (1980) found that adsorbent such as pectin af-fect the absorption of nutrients and enzymes, especially if used for a prolonged time and this would be consid-ered a great disadvantage.

The estimated energy showed close values, being 402.58, 407.15, 402.78, 406.74, 400.30 and 400.85 provided from 100g of the formulas in ascending order. These val-ues according to FAO/WHO (1985) would cover wean-ing requirement as the minimum level of energy was set to 400 Kcal/100 g product.The energy values are close to those reported by El-Sherefa et al., (2000) who found that energy values ranged from 403 to 406 Kcal/ 100g formula.

Concerning minerals of the prepared formulas, the ob-tained results are shown in Table (4). Data pertaining calcium content clearly demonstrated that formula 1 had the highest amount of calcium (138.20 mg/100g). On the other hand, formula 2 showed the lowest content (70.01 mg/100g).Calcium content of the prepared formula re-flected the high content of calcium of the added soybean flour as formula 1 contained 50% soy flour, 50% carrot.

Regarding sodium contents, the results in Table (4) showed that sodium content of 100 g formula fluctuated from 110.45 to 153.10 mg/100g formula. These results were in the same line with Abd El- Wahed (2002) who found that sodium contents ranged from 103.0 to 201.86 mg/100g of some prepared baby formulas.

Wide variations in potassium content were observed in the prepared formulas (215.90 to 320.50 mg/100g).

According to FDA (1985), potassium contents in the different formulas meet the infant requirement (200 mg /100g products). The contents of both sodium and potas-sium appeared to be very important for diarrhea. Sodium deficiency was seen with severe diarrhea or vomiting and potassium deficieny occur when there has been pro-longed failure to eat and in pathologic conditions such as severe diarrhea (Baqui, et al., 2005). Data in the same Table also demonstrated that iron content of the formulas varied from 17.79 to 28.54 mg/100g formula. This could be attributed to the addition of soy flour, for its high iron content. In this respect, Ismail et al., (2000) found that iron content ranged from 8.6 to 15.5 mg/100g in some baby food blends prepared from defatted soy flour, hav-ing high iron value.

With regard to zinc, Table (5) also declared that the zinc content ranged from 8.96 to 13.36 mg/100g. These val-ues are higher than those obtained by Allam (2007) who found that zinc content of baby formulas containing oth-er cereals and legumes were in the range of 3.2 to 4.6 mg/100g.

The prepared formulas under study would satisfy in-fants> needs as they have a relatively high requirement for zinc because of their rapid growth and impaired zinc absorption that could result in inadequate zinc supply to the body (Rameh, et al., 2004).

Concerning vitamins contents (A, C and B1) the pre-pared formulas were subjected to chemical analysis and the obtained results are shown in Table (5). Data pre-sented in (Table 5) Showed that vitamin A content of the six prepared formulas was in the range of 288.46 to 630.89 IU/100g. Formulas No. 1 and 4 contained high amouns of vitamin A, being 630.80 and 605.90 IU/100g, respectively. The high vitamin A contents of the pro-posed infant formulas could be ascribed to the addition of yellow carrot that is rich in carotene. In this respect, Baqui, et al., (2005) found that the body>s ability to ab-sorb vitamin A during diarrhea was reduced and would lead to acute vitamin A deficiency and consequently the repeated episodes could lead to blindness and signs of xerophthalmia.

Vitamin B1 contents of the six prepared formulas were in the range of 0.24 to 0.30 mg/100g. National Research Center (1997/1998) set the requirements of thiamin for the infant during the first and second six months (0.2 and o.3 mg /100g, respectively).

The prepared formulas had 40.00 mg of vitamin C /100g formula. According to National Research Center, (1989) the requirements of vit.C for infants is 0 to 5 and 5-12 months accounted to 30 and 35 mg, respectively.

Microbiological examination:

The prepared formulas were subjected to detection of to-tal bacterial count, yeast& moulds counts and coliform group.

The results revealed that the total bacterial count of the formulas were 150, 30, 350, 130, 50 and 330 cfu/g for-mula, in respective order. However, in all the prepared formulas yeast & moulds and Coliform were not detect-ed. Thus, the formulas were free from coliform group bacteria as well as yeasts & molds. These results are in the same line with those recommended standards by Egyptian Standards (2005), which stated that total bac-terial count should not be more than 1000 organisms/g for baby foods, which could be prepared without boiling. Total count of moulds& yeasts were not more than 100 cell/g formulas and the formulas were free from coliform and other pathogens as required by the same organiza-tion.

These findings indicated that the use of such formulas would be safe for infants.

Anti- nutritional factors:

Phytic acid (PA), trypsin inhibitor (TI) and urease (U) contents of the prepared formulas illustrated in Table (6). Slight differences in phytic acid, trypsin inhibitor and urease contents among formulas were noticed.

Phytic acid ranged from 0.70 to 0.85 mg/100g. Trypsin inhibitor ranged from 1.50 to 1.90 mg/g.Urease ranged from 0.05 to 0.08 IU/mg.

The present data are in the same line with those found by Bakry, (1997) who reported that the treated legume flours had lower trypsin inhibitor activity compared with the raw materials. The applied treatments led to the de-crease in the trypsin inhibitor contents of the treated in-gredients, as it was decreased to 2.58 TIU/mg soybeans.

In this respect, Zahran, (2000) reported that extrusion process decreased trypsin inhibitor activity of defatted soy bean flour from 40.75 to 3.25 TIU/mg.

Physical characteristics of the formulas:

The physical characteristics of the tested formulas in-cluding WAI and WSI were evaluated and recorded in Table (7). WAI (Water absorption index). WSI (Water solubility index).





Water absorption index (WAI).

From data in Table (7) it could be observed that the high-est values among the tested formulas were noticed in formula 1& 4, then formulas 6. On the contrary, the low-est WAI value was observed in formula 5, followed by formulas 2 and 3.

In this respect, Salama et al., (1997) noticed that water absorption was decreased with increasing legume flour in blends. Abd EL-Hady et al., (1997) assured that WAI was lowered with adding the defatted soybean to rice in the extrudates.

Water solubility index (WSI).

Data in Table (7) demonstrated that the lowest value was found in formula 5, followed by formula 2 then formu-las 3 and 4. However, the highest WSI value was seen for formula 6, followed by formula 1. The high values of WSI for the prepared formulas might be ascribed to increasing the solubilization of cereal starch.

Generally, the increase in WSI for baby food formulas considered to be a desirable character because it would refect the easy digestion for the used materials. In this respect, Hussein, (1987) found that WSI was increased by adding legume to rice, and such increment resulted from the degradation of starchy materials in blends by extrusion process. The increase in WSI for baby food mixtures would be a desirable characteristic for the easy digestion of these materials. The obtained results are in the same line with those of Youssef et al (1990) who re-ported that water solubility index % of these products ranged between 20.3 to 37.3%.

In this respect, several studies demonstrated that WSI and WAI values were decreased with increasing in the quantity of added protein. Where as starchy materials exhibited a higher WAI compared to protein rich sources as the WAI depended on the availability of hydrophilic groups, which bind water molecules and on the gel form-ing capacity of macromolecules (Mansour et al. (1995), Hamza (1997) and Abd-El Wahed (2002)).

Sensory Evaluation:

Sensory evaluation of the prepared formulas for diarrhea considered to be one of the most important tests affecting the acceptability.Sensory attributes included taste, odor, color, texture and acceptability (Table 8). Concerning taste as major criterion affecting the quality and accept-ability of any product, results of Table (8) showed that formula 2 and 4 recorded the highest scores, followed by formulas 1, 3 and 6. On the contrary, formula 5 had the lowest score. The results of the color of different formu-las indicated that formulas No. 5, 2 and 6 had the high-est scores, followed by formulas No. 4 and 3. However, formula No. 1 recorded the lowest value.

Generally, formulas 2 and 4 had the highest total score (88.50 and 83.00, respectively), followed by formulas 1, 3 and 6. However, formula 5 had the lowest scores (76.00).

In this respect, Allam (2007) found that the supplementa-tion of some food mixtures with proteineous and starchy materials improved their quality characteristics for taste and acceptability. It is worthy to mention that all the for-mulated products were organoleptically accepted.

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Table (1) Composition of the prepared formulas for infants with acute diarrhea.

Ingredients %

Formulas

1SC

2SCR

3SCRO

4SCP

5SCRP

6SCROP

Defatted soy flour (S) 50 40 40 45 35 35

Carrot (C) 50 40 40 45 35 35

Rice (R) --- 20 10 ---- 20 10

Orange (O) ---- ---- 10 ---- ---- 10

Potato starch powder (P) ---- ---- ---- 10 10 10

Table (2) Supplementation of the different formulas.

Supplement (For100g formula)

Formulas

1SC

2SCR

3SCRO

4SCP

5SCRP

6SCROP

Vitamin C(mg) 39.88 39.95 39.96 39.87 39.96 39.79

Vitamin E( mg) 4.00 4.00 4.00 4.00 4.00 4.00

Calcium (mg) 362.00 430.00 375.00 374.00 404.00 404.00

Methionine+ cystine(mg) 1501.23 1193.57 1369.51 1570.74 1181.97 1352.01

Vanilla (g) 0.03 0.03 0.03 0.03 0.03 0.03

Sugar sucrose (g) 5.00 5.00 5.00 5.00 5.00 5.00

Table (3): Proximate composition of formulas prepared for infants with acute diarrhea.

Composition (%)Formulas

1SC

2SCR

3SCRO

4SCP

5SCRP

6SCROP

Protein 33.20 23.42 26.79 30.74 23.01 26.35

Fat 7.30 6.47 7.50 7.10 6.86 6.97

Ash 2.50 2.40 2.90 2.59 4.30 4.50

Fiber 5.98 3.90 5.78 4.60 4.20 4.00

Carbohydrates 51.02 63.81 57.03 54.97 61.63 58.18Total pectin 2.40 2.47 2.22 2.67 2.37 2.22

Table (4): Minerals contents of the prepared formulas for infants with acute diarrhea.

FormulasMineralscontents

(mg/100g)

6SCROP

5SCRP

4SCP

3SCRO

2SCR

1SC

96.8096.82126.06125.0570.01138.20Ca

153.10110.45120.05130.78143.25141.80Na

295.40240.50246.60215.90320.50201.25K

28.5418.5422.9022.5017.7923.60Fe

10.048.9612.6612.1110.0613.36Zn

60.2033.3047.6036.5554.8030.81Mg

Table (5): Vitamins contents of the prepared formulas for infants with acute diarrhea.

Vitamins Formulas

1SC

2SCR

3SCRO

4SCP

5SCRP

6SCROP

V.AIU/100gm 630.80 399.72 288.46 605.90 405.98 397.88

V.Cmg/100g 40.00 40.00 40.00 40.00 40.00 40.00

V.B1mg/ 100g 0.29 0.26 0.30 0.27 0.24 0.29





Table (6) Anti-nutritional factors of the prepared formulas for acute diarrhea.

Anti-nutritional factors

formulas

1SC

2SCR

3SCRO

4SCP

5SCRP

6SCROP

Phytic acid (PA) g/100g 0.85 0.80 0.75 0.85 0.73 0.70

Trypsin inhibitor (TI)

(mg/g)1.90 1.60 1.60 1.50 1.70 1.70

Urease (U) IU/gm 0.07 0.06 0.08 0.05 0.06 0.07

Table (7): Physical characteristics of formulas.

PhysicalFormulas

1SC

2SCR

3SCRO

4SCP

5SCRP

6SCROP

WAIgm gel/gm dry sample

4.27 3.66 3.61 4.24 3.27 3.94

WSI % 28.24 24.77 26.14 27.70 20.07 33.81

Table (8): Mean score values of organoleptic attributes of formulas for infants with acute diarrhea.

Organoleptic attributes

Formulas

1SC

2SCR

3SCRO

4SCP

5SCRP

6SCROP L.S.D

Taste (30) 21.87± 4.05bc

27.75 ± 1.91a

23.00 ± 3.78 bc

24.63 ± 3.16ab

20.88 ± 2.99 c

22.00 ±2.45 bc 3.07

Odor (20) 16.37 ±3.20

16.62 ±2.77

16.87 ±2.69

17.63 ±1.68

15.38 ± 2.77

17.25 ±2.49 -----

Color (20) 13.16 ±3.73 c

15.83 ±2.75 ab

14.00 ±3.27 bc

14.33 ± 3.33 bc

17.25 ± 2.70 a

15.83 ±2.69 ab 2.59

Texture (15) 12.50 ± 1.51

13.75 ±1.03

12.25 ±1.16

11.88 ±1.35

12.38 ±1.51

12.25 ±1.16 -----

Acceptability (15) 11.75 ±1.16 b

13.00 ±1.31 a

11.75 ± 1.83 b

12.13 ± 1.13 ab

10.00 ± 0.53 c

11.16 ± 1.13 bc 1.14

Total scores (100) 77.63 ±7.74 bc

88.50 ± 4.66 a

79.75 ±6.86 bc

83.00 ±4.75 ab

76.00 ±5.29 c

79.25 ± 6.90 bc 6.28

�لتقييم �لكيماوى و �مليكروبيولوجى و �لطبيعى و�حل�صى لبع�ض �خللطات �ملحتويه على �ل�صويا �ملعدة للر�صع و�صغار�لأطفال لعالج �لأ�صهال �حلاد

شفيقه عبد احلميد زكى* – أحمد توفيق العاقل *– ليلى ضياء الدين املهدى** – نادرة سيد يوسف**

* قسم الصناعات الغذائية – كلية الزراعة – جامعة القاهرة- اجليزة - مصر

** معهد بحوث تكنولوجيا األغذية – مركز البحوث الزراعية – اجليزة- مصر

مت اعداد س��ته خلطات غذائية حتتوى على دقيق الصويا لتغذية ا لرضع وصغاراألطفال املصابني باآلس��هال احلاد وقد شملت املواد احمللية املتوفرة األرز- اجلزر األصفر- البرتقال- نش��ا البطاطس.وقد مت تقييم اخللطات املعدة بواس��طة األختب��ارات الكيماويه و امليكروبيولوجيه

والطبيعية واحلسيه.

وق��د بني التحليل الكيماوى ان اخللطات احتوت على نس��بة منخفضة من الرطوبة )5.67- 7.00٪( كما تراوحت نس��ب البروتني و الدهن والرم��اد واأللي��اف و الكربوهي��دات و البكتني )23.42 -33.20 ، 6.47 – 7.50 ، 2.40 – 4.50 ، 3.90 – 5.78 ، 51.02 – 63.81، 2.22 – 2.67٪ ( على

التوالى.

وكذلك تراوحت السعرات احلرارية للخلطات املعدة من 400.3 – 407.15 سعر حرارى.

وبالنس��به لألم��آح املعدنية فقد كان محتوى اخللطات من الكالس��يوم – الصوديوم – البوتاس��يوم – احلديد – الزن��ك ) 70.10 – 138.20 ،110.45 – 153.10، 215.90 – 320.50 ، 17.79 – 28.54 ، 8.96 – 13.36 ( ملجم / 100 جم على التوالى.

بينما تراوحت نس��ب الفيتامينات فى اخللطات بني )288.46 – 630.80 وحدة دولية/100 جم فيتامني أ( ، ) 40.00 ملجم/100 جم فيتامني ج( ، ) 0.24 – 0.30 ملجم/100جم ثيامني(.

كما وجد ان اخللطات احتوت على حمض الفيتك )0.70 – 0.85 ملجم/100جم( ، مضاد التربسني )1.50 – 1.90 ملجم/جم( ، واليوريز)0.05 – 0.08 وحدة دولية/ملجم(.

أثبتت نتائج التقييم امليكروبيولوجى خلو اخللطات من بكتريا القولون والفطريات واخلمائر وان العد الكلى للبكتريا منخفض ) 30- 350 ( وتعتبر اخللطات آمنة و مطابقة للمواصفات القياسية املصرية.

أوضحت نتائج التقييم احلس��ى قبول اخللطات بالنس��بة للطعم و اللون و الرائحة وحجم احلبيبات و القابيلية وكانت افضلها اخللطة الثانية ثم الرابعة.

لذلك نوصى بان اخللطات املعدة آمنة ميكروبيولوجيا و مقبولة باألضافة الى أنها قيمة غذائية عالية.

الكلمات الدالة: األسهال احلاد – الرضع – خلطات الصويا – احلبوب- القيمة الغذائية- مضادات التغذية – القابيلية.



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