Choice of foods and ingredients for moderately malnourished children 6 months to 5 years of age

There is consensus on how to treat severe malnutrition, but no agreement on the most cost-effective way to treat infants and young children with moderate malnutrition who consume cereal-dominated diets. The aim of this review is to examine nutritional qualities of relevant foods and ingredients in relation to nutritional needs of children with moderate malnutrition and to identify research needs. Aspects considered include: nutritional qualities of foods and ingredients (energy density, macronutrient content and quality, minerals and vitamins, bioactive substances, antinutritional factors); influence of different food processing methods on nutrient content; nutritional values of main food groups (cereals, legumes, pulses, roots, vegetables, fruits and animal foods). Benefits of animal foods, which contain high levels of minerals important for growth, high-quality protein and no antinutritional factors or fibre are emphasized. In cereal-dominated diets, it is suggested that plant foods should be processed to reduce contents of antinutrients and fibre. Provision of high fat content to increase energy density is emphasized taking into account fat quality and the need to maintain nutrient density. A number of research needs are highlighted including calculation of min. quantity of animal foods needed to support acceptable child growth and development, nutritional gains of reducing contents of antinutritional factors and fibre in cereal- and legume-based diets, and to examine the role of fat quality, especially PUFA content and ratios, in children with moderate malnutrition.