ArticlePDF Available

Acceptance and Impact of Millet-Based Mid-Day Meal on the Nutritional Status of Adolescent School Going Children in a Peri Urban Region of Karnataka State in India

Authors:

Abstract and Figures

The study assessed the potential for use of millets in mid-day school meal programs for better nutritional outcomes of children in a peri-urban region of Karnataka, India, where children conventionally consumed a fortified rice-based mid-day meal. For a three-month period, millet-based mid-day meals were fed to 1500 adolescent children at two schools, of which 136 were studied as the intervention group and were compared with 107 other children in two other schools that did not receive the intervention. The intervention design was equivalent to the parallel group, two-arm, superiority trial with a 1:1 allocation ratio. The end line allocation ratio was 1.27:1 due to attrition. It was found that there was statistically significant improvement in stunting (p = 0.000) and the body mass index (p = 0.003) in the intervention group and not in the control group (p = 0.351 and p = 0.511, respectively). The sensory evaluation revealed that all the millet-based menu items had high acceptability, with the highest scores for the following three items: finger millet idli, a steam cooked fermented savory cake; little and pearl millet bisi belle bath, a millet-lentil hot meal; and upma, a pearl and little millet-vegetable meal. These results suggest significant potential for millets to replace or supplement rice in school feeding programs for improved nutritional outcomes of children.
Content may be subject to copyright.
nutrients
Article
Acceptance and Impact of Millet-Based Mid-Day
Meal on the Nutritional Status of Adolescent School
Going Children in a Peri Urban Region of Karnataka
State in India
Seetha Anitha 1, *, Joanna Kane-Potaka 1, Takuji W. Tsusaka 2,3 , Deepti Tripathi 4,
Shweta Upadhyay 5, Ajay Kavishwar 4, Ashok Jalagam 1, Nidhi Sharma 4and
Swamikannu Nedumaran 1
1International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Hyderabad 502324, India
2ICRISAT, Lilongwe 1096, Malawi
3Organization for Advanced and Integrated Research, Kobe University, Kobe 650-0047, Japan
4Akshaya Patra Foundation, Bangalore, Karnataka 560022, India
5United Nations Children’s Fund (UNICEF), Lilongwe 30375, Malawi
*Correspondence: s.anitha@cgiar.org; Tel.: +91-799-330-0346
Received: 7 July 2019; Accepted: 26 August 2019; Published: 3 September 2019


Abstract:
The study assessed the potential for use of millets in mid-day school meal programs for
better nutritional outcomes of children in a peri-urban region of Karnataka, India, where children
conventionally consumed a fortified rice-based mid-day meal. For a three-month period, millet-based
mid-day meals were fed to 1500 adolescent children at two schools, of which 136 were studied as
the intervention group and were compared with 107 other children in two other schools that did
not receive the intervention. The intervention design was equivalent to the parallel group, two-arm,
superiority trial with a 1:1 allocation ratio. The end line allocation ratio was 1.27:1 due to attrition.
It was found that there was statistically significant improvement in stunting (p=0.000) and the
body mass index (p=0.003) in the intervention group and not in the control group (
p=0.351
and
p=0.511
, respectively). The sensory evaluation revealed that all the millet-based menu items had
high acceptability, with the highest scores for the following three items: finger millet idli, a steam
cooked fermented savory cake; little and pearl millet bisi belle bath, a millet-lentil hot meal; and upma,
a pearl and little millet-vegetable meal. These results suggest significant potential for millets to
replace or supplement rice in school feeding programs for improved nutritional outcomes of children.
Keywords: school feeding program; mid-day meal; millets; sensory evaluation; undernutrition
1. Introduction
India has one of the world’s highest demographics of children suering from various types of
malnutrition, which is double that in Sub-Saharan Africa [
1
]. A total of 44% of children under the age
of five are underweight, while 72% of infants have anaemia [
2
]. In particular, the rate of undernutrition
from lack of micronutrients, especially iron deficiency anaemia, is high in India. According to India’s
National Family Health Survey [
3
], more than half the women (55%) have iron deficiency anaemia.
In addition, underweight, wasting, and stunting are also prevalent in children under five (36%, 21%
and 38%, respectively) [
3
]. These figures hint at serious long-term consequences for human capital
development and the productivity potential of the nation. More importantly, they also imply the denial
of basic human rights of children, such as access to food.
Nutrients 2019,11, 2077; doi:10.3390/nu11092077 www.mdpi.com/journal/nutrients
Nutrients 2019,11, 2077 2 of 16
India has one of the fastest growing youth populations in the world. The distribution of 10–19
year olds stands at 19.5% of the total population [
3
]. Adolescence is a critical stage in human life when
physical growth is high; so is the nutrient requirement.
India’s school feeding programs (SFP) known as the mid-day meal (MDM) programs are aimed
at improving nutrition intake, and enrolment and retention at school [
4
]. SFPs have been seen as
both a social safety net for vulnerable segments of the population and an educational intervention
to incentivize children to go to school, where their learning ability in the classroom is improved by
reduction in hunger. Under MDM programs, children at all public and government-assisted primary
schools are provided with a prepared mid-day meal containing a minimum of 450 kilocalories and
12 grams of protein per school day for primary school students and 700 kilocalories and 20 grams
of protein for grade 6–8 students for a minimum of 200 days a year [
5
,
6
]. Several studies have
demonstrated the positive impacts of mid-day meals [
7
,
8
]. The MDM comprises a freshly cooked
meal containing food grains, mainly rice (Oryza sativa L.), legumes and vegetables. In general, the
MDM in India provides cereal on a regular basis in adequate quantities, while pulses and vegetables
are inadequate due to their high prices [
9
]. In other words, the MDM’s major ingredient is a cereal,
particularly rice and wheat. Given the extent of undernutrition in children and adolescents, there is
scope to improve the nutrient content of MDMs by providing more nutritious food using crops that
are locally available and traditionally used.
The Global Hunger Index (GHI), 2018 report indicates that the level of hunger and undernutrition
is serious and it is 20.9% worldwide [
10
]. This underlines the need for sustainable crop substitutes to
mitigate hunger and to improve farmers’ incomes globally. The role of millets in achieving sustainable
means of nutritional security cannot be ignored as they are more climate change compliant crops than
cereals, such as wheat (Triticum aestivum L.) and rice, given the marginal conditions under which they
are grown and their high nutritional value [
11
]. The vital micronutrients and protein in millet grains are
considered to be equal to or superior to those in wheat, rice, maize (Zea mays L.) and sorghum (Sorghum
bicolor L.) grains [
12
]. In particular, the mineral content in millets is several folds higher than that in
wheat and rice [
12
] and can complement legumes for the amino acid profile, especially methionine.
On the other hand, as many other cereals and legumes, millets contain antinutrients, such as phytic
acid, which inhibits the absorption of minerals, leading to iron and zinc deficiencies [
12
]. Hence,
dephytinization practices must be imparted when promoting recipes containing millets, especially in
resource poor environments. Various processing methods and in-home food preparation techniques
can alter the phytic acid content and improve the bioavailability of micronutrients. Simply cooking
the millet ingredients can reduce the phytic acid to some extent. Some studies also show that pearl
millet exhibits goitrogenic eects on millet consuming population through iodine deficiency [
13
]. Since
there is not enough evidence, such as data on dietary iodine intake by the studied population, further
long-term studies are needed to assess the amounts of millets, varieties of pearl millet, and the extent of
their influence on goiter. In short, to maximize the benefits of millet-based food, preparation methods
need to be taken into account in designing nutrition intervention programs utilizing millets. While
millets are traditional grains of many countries including India, they are also recognized as “Smart
Food” since they are both climate stress resistant and naturally rich in micronutrients. In other words,
they are “good for you, the planet and the farmer” [
14
]. Considering these multiple benefits, millets
are arguably the best fit to fill the gap in agricultural food systems [11].
Over the decades, millets have become less and less common in India in terms of both production
and consumption [
15
], partly because of the limited knowledge on their use in preparing various foods.
At present, finger millet is used in Karnataka mostly to make finger millet rice ball, and pearl millet
is used in baking roti together with wheat. To meet the need for variety and taste for children, it is
important to use these grains in other forms of food in a culturally acceptable way.
Lately, these nutritional and drought-resistant properties of millets have drawn the attention of
research agencies and product developers globally, increasing the focus on improving millet varieties
and enhancing their use in modern processed food products. The current study was conducted
Nutrients 2019,11, 2077 3 of 16
to: (a) analyse the impact of regular consumption of millet-based recipe formulations on children’s
nutritional outcomes; (b) assess the acceptance of millet-based recipe formulations among children
especially as a staple; (c) evaluate the suitability of these formulations to be adopted in MDM.
2. Materials and Methods
Akshaya Patra operates the largest school feeding program in India supported by the Government
(https://karnataka.akshayapatra.org/), feeding over 1.7 million children across the nation. After briefing
the government, the millet-based feeding program to the selected Akshaya Patra beneficiary school
children was approved in writing by the Government of Karnataka, Department of Education and
Department of Agriculture. Along with this approval, meetings were held with school principal
and parents/guardians of children to discuss the purpose, procedures and risks involved in the
study. Informed written consent was obtained from the head of the schools and parents/guardians
of children involved in the study based on written and verbal information provided before the
program commenced.
Site: The study was conducted in four public schools in a peri-urban region of Bengaluru
(Thathaguni, Kagallipura, Allahali and Chensandra villages), Karnataka state of India, where children
came from low and middle income families.
Sampling framework: Figure 1provides the flow chart of the study including the sampling
framework. The study chose 400 children between the ages of 10 and 14 from four schools who
expressed interest in participating in the study for the three-month period from July to September
2018. Children with no history of food allergies and who attended school regularly were purposively
selected. All the sample children consumed rice in MDMs before the intervention. The intervention
was provided school-wise in light of feasibility of administration. Of the 400 children, 200 from two
randomly selected schools were chosen as the control group, and the other 200 (from the other two
schools) fell into the intervention group. The initial consent was obtained from all the 400 respondents
and the baseline assessment was conducted with all of them. Nonetheless, full attendance to school
throughout the study period was a requirement in order for the respondents to qualify for inclusion
into the end line assessment. As a result, 32% of the children in the intervention group and 46% of
them in the control group were excluded from the end line assessment as they did not attend school
regularly. The 400 participating children were given Smart Food identification cards to distinguish
them from other children consuming the same food but not part of the study. In the two intervention
schools, around 1500 children were fed with the same millet-based meals.
Consent obtained: Before starting the program, formal written consent was obtained from both
parents and the school management. Approval was also obtained from the State Government to
introduce millet-based food during the MDM program for our research.
Data collection: A survey instrument was designed, which was reviewed by a panel of nutrition
experts to examine the face validity, readability and clarity of wording and instructions. The instrument
had two parts: household dietary assessment to record family dietary intake [
16
] and a diet diary
to record the children’s dietary intake for three days, which was for normal week days, including
no special or fasting day nor weekends. These instruments were used to collect dietary data before
starting the intervention. The details follow.
Nutrients 2019,11, 2077 4 of 16
Figure 1. A flow diagram for the study.
2.2. Individual Dietary Assessment
The sample children were trained to fill out a diet diary for three week days of what they ate
from the time they woke up in the morning to the last item consumed before going to bed at night.
The timing of food consumption was recorded. The diet diary was used to provide the estimated
amount of food consumed, instead of weighed quantities consumed. For each food item, the amount
consumed was recorded in household measurement (spoons, ladles or cups), numbers or
dimensions, whichever was appropriate. The containers most commonly used in the communities
were large, medium and small serving spoons or ladles, and glasses, which were equated with the
standard measures. For food items such as roti, dosa, idli and vada, the dimensions and numbers were
recorded.
4 schools randoml
y
identifie
d
Control group
(n = 200): Children of 10-14
y
ears
p
ur
p
osivel
y
selected
Intervention group
(n = 200): Children of 10-14
years purposively selected
Usual MDM (n = 200) Fed with formulated millet-based
meal in MDM (n = 200)
Collection of diet diary (N = 200),
socio-economic (n=160), and
anthropometry data (n= 200)
Collection of diet diary (n = 200),
socio-economic (n=160), and
anthropometry data (n = 200)
n = 107
(
54%
)
n = 136
(
68%
)
2 schools randomly selected 2 schools randomly selected
Consent Consent
Baseline
End line
Selection
Analysis
Sample with 100%
attendance
Intervention Measurement
Measurement
Collection of socio-economic,
dietary and anthropometry data
(n = 107)
Collection of socio-economic,
dietary and anthropometry data
(n = 136)
3 months
Screening
Figure 1. A flow diagram for the study.
2.1. Household Dietary Assessment
Household dietary assessment was conducted in the households of randomly selected 10% of the
sample children. The one-day weighment method was followed to estimate nutrient intake [
17
19
].
The dietary patterns were recorded along with each recipe that was prepared during the entire day of
the visit. All the ingredients used in each recipe were weighed using a grocer’s scale, and the quantity
used to cook for the household members was documented. The numbers, thickness and dimensions
of the food items, such as steam cooked rice cake and wheat rotis, were recorded. The quantity
of food items served using various serving spoons was measured and recorded to estimate food
Nutrients 2019,11, 2077 5 of 16
intake. The food intake data was then used to calculate the nutrient intake using the DietSoft (India,
www.DietSoft.in/) online software [19] based on the Indian Food Composition Table [20].
2.2. Individual Dietary Assessment
The sample children were trained to fill out a diet diary for three week days of what they ate
from the time they woke up in the morning to the last item consumed before going to bed at night.
The timing of food consumption was recorded. The diet diary was used to provide the estimated
amount of food consumed, instead of weighed quantities consumed. For each food item, the amount
consumed was recorded in household measurement (spoons, ladles or cups), numbers or dimensions,
whichever was appropriate. The containers most commonly used in the communities were large,
medium and small serving spoons or ladles, and glasses, which were equated with the standard
measures. For food items such as roti,dosa,idli and vada, the dimensions and numbers were recorded.
Procurement of ingredients: Finger millet, little millet and pearl millet were procured from
wholesale markets. Other ingredients such as legumes, vegetables, oil, spices and salt were purchased
from local markets.
Selection of millets for recipe formulation: For the recipe formulation, millet varieties with high
nutrients were chosen. For example, pearl millet variety Dhanashakti was chosen for its high iron
content and amino acids which can complement legumes to make a complete amino acid profile [
21
].
Finger millet, regardless of variety, contains three times the calcium in milk. Finger millet and pearl
millet supply 50–100% of the daily value (DV) of methionine amino acid for children [
22
]. When mixed
with legumes such as pigeonpea, these millets provide a complete amino acid profile [
22
] and, when
combined with vegetables, they provide some major micronutrients. These millets were therefore
introduced in the form of common south Indian food items, namely, idli,khichdi,upma and bisibella
bath, in which rice was replaced by millets. The ingredients were selected considering their nutritional
value and the added advantage of using them to enhance the absorption of nutrients. For example, to
enhance iron absorption, the vitamin C content of the food was ensured by adding ingredients, such as
capsicum. We also considered the feasibility of cooking each of the recipes in a large cauldron where
the ingredients are untouched by humans right from the stage when the ingredients are added until
the filling of the thermal container (fully automated) which was then carried in a warmer container to
the schools through the established distribution system.
Nutrient analysis: Food consumed by the sample children was classified into meat, eggs, cereals,
pulses, green leafy vegetables, other vegetables, roots and tubers, milk and dairy products, fats and
oils, and sugars. Nutrients consumed were classified into energy, protein, vitamins, and minerals [
23
].
The daily food and nutrient intake of the children was estimated using published food composition
tables for Indian foods [
19
,
20
]. The average food and nutrient intake (for each item) was compared
with the recommended dietary allowances (RDA) for adequacy stipulated by the Indian Council of
Medical Research [24].
The formulated recipes were cooked, and both raw and cooked forms of food were analysed for
targeted nutrients including carbohydrates, protein, fat, calcium, iron, zinc, and magnesium by AOAC
method 19th edition [
25
]. The nutrient values per serving were then calculated based on the average
daily intake by the sample children.
Sensory evaluation: Sensory evaluation of aroma, appearance/colour and taste was conducted
among the sample children to determine the acceptability of each recipe [
26
]. The five-point hedonic
scale was adopted (1 being highly disliked and 5 being highly liked). For the children to express
their degree of like or dislike, relevant emoji pictures were used, and they were asked to score the
sensory attributes. The recipe was adjusted and finalized on the basis of the sensory evaluation and
nutritional values.
Anthropometric measurements: The height and weight of the sample children from both the
intervention and control groups were measured at the baseline and end line. The height, weight,
and age of each child were used in the calculation of the height for age Z-score (HAZ), which is an
Nutrients 2019,11, 2077 6 of 16
indicator of stunting, and body mass index Z-score (BMIZ) which is an indicator of underweight, using
the Epi Info 7 software (Centre for Disease Control, Atlanta, GA, USA) [
27
]. Based on the Z-scores,
the children were categorized as severely undernourished, moderately undernourished, normal, and
over-nourished when the Z-scores were below
3, between
3 and
2, between
2 and +2, and above
+2, respectively [28,29].
Dietary intervention: The dietary intervention program was conducted for three months in both
intervention schools. The meal was provided during mid-day in both intervention schools. The
cauldron-cooked food from the Akshaya Patra kitchen were distributed in thermal containers to these
two schools every day. To impart good practice on personal hygiene and to avoid food wastage,
teachers and nutrition experts conducted sessions on hygiene and the importance of millet nutrients
after the sensory evaluation and during the feeding program in focus groups and using interactive
posters. The children were monitored by teachers to avoid food wastage and also wash their hands
before eating. The average intake and wastage of food was estimated. Children were regularly
encouraged to give feedback on the millet-based food. The feedback was used to adjust the recipe
throughout the study period in terms of saltiness, spice and cooking qualities.
Data analysis: Descriptive statistics were used to present the nutritional values, participants’
profiles, sensory evaluation scores, undernutrition indicators, and costs per meal, while analysis of
variance was conducted to determine the day to day variation in dietary intake obtained from the diet
diary, and the paired ttest [
30
] was employed to examine the statistical significance of changes in
undernutrition indicators before and after the intervention program.
More specifically, the acceptance of the recipes was determined by the mean scores out of 5.0,
where the score of 3.0 represented neutral. That is, when the mean score was nearly 4.0, it is interpreted
that the recipe was moderately liked. Likewise, a mean score nearly 5.0 implied the recipe being highly
liked. As for the paired ttest on Z-scores for undernutrition, the confidence level of 99% was applied,
allowing only 1% occurrence of false identification of significant changes. Furthermore, since the
expected direction of change was definite (positive), the one-tailed p-value was adopted for rejection of
the null hypothesis of no change in the indicators. The statistical analysis was performed using Stata
15 (StataCorp, Texas City, TX, USA).
In addition to the recipe acceptance evaluation, cost analysis was performed to reinforce the
assessment of the suitability of the recipe formulations.
3. Results
Table 1shows the basic profile of the households from which the children participated in our
study. The average household size was about five persons in both the intervention and control groups.
The house ownership rate was slightly higher in the intervention group. All the households in the
study were headed by men and the majority of them were engaged in casual labour such as for
construction, showing a negligible dierence in proportion between the two groups. The studied
children depended on mid-day meals since 38% and 49% of the children in the intervention and control
groups, respectively, went to school without eating breakfast.
Table 2shows the gender composition of the children who participated in the study. In total,
56% of the participants were girls. The share of girls was slightly higher in the control group (63.6%)
compared to the intervention group (46.4%).
The household dietary assessment indicated that fortified rice was a major staple occupying 70%
of the weight of their diets, where it was eaten in dierent forms including blended rice (steam cooked
or toasted) and boiled rice with or without lemon juice, tamarind juice, or tomatoes. The remaining
30% comprised of watery pigeonpea stew as well as vegetables.
The baseline data showed that only 56% of the sample school children had breakfast everyday
(Table 3), and 16% of them had breakfast five days a week. The rest had breakfast four days a week or
less frequently.
Nutrients 2019,11, 2077 7 of 16
Table 1. Socioeconomic and demographic profile of households of the sample children.
Socio Economic and Demographic Profile Unit Intervention Group
n=160
Control Group
n=160
Household size (average) Headcount 5.0 5.3
Type of house
Rental % 68.7 80.0
Owned % 31.3 20.0
Sex of the household (HH) head
Men % 100 100
Women % 0 0
Main occupation of HH head
Employee % 12.5 16.8
Self employed % 11.8 8.7
Casual labor % 62.5 65.0
Farming % 0.0 0.0
No fixed jobs % 13.1 9.3
Eating habits
Children go to school without having any breakfast
(Yes/No) % of Yes 38.2 48.8
Children eat lunch at school (Yes/No) % of Yes 100 100
Households with rice as staple (Yes/No) % of Yes 100 100
Table 2. Gender balance of the sampled children.
Control Intervention Aggregate
Boys (%) 36.4 50.7 44.4
Girls (%) 63.6 49.3 55.6
Total (%) 100 100 100
Number of children who participated 107 136 243
Table 3.
Food habit related questions and children’s response during the baseline (a few selected
example questions).
Baseline Questions Asked
(Selected Examples) Response Number of
Children (n=320) Percentage
1. How frequently do you take
breakfast?
Everyday 181 56.6%
5 days a week 53 16.6%
2 to 4 days a week 49 15.3%
Rarely 12 3.8%
Not at all 22 6.9%
Not sure 3 0.9%
2. Which millet is commonly
used at your home?
Finger millet 320 100%
Finger millet, Sorghum and
pearl millet 58 18.1%
3. How do you describe your
dietary habit?
Vegetarian (Not vegan) 21 6.5%
Both vegetarian with
occasional non-vegetarian 300 93.5%
The baseline data showed that the meals consumed by household members provided 50 to 60%
of required calories, 50% of protein, 40 to 50% of iron, 60% of calcium, and 40–50% of zinc, based on
Nutrients 2019,11, 2077 8 of 16
RDA (Table 4). The majority of calories came from rice, protein from pigeonpea and other pulses like
chickpea and green gram, calcium from finger millet and legumes, and iron from vegetables.
Table 4.
Estimated average per capita macro and important micronutrient intake of the based on
household dietary assessment in comparison to RDA for adults and adolescents.
Nutrients
Amount of Nutrient
from Current Food
Average (SD)
RDA for Adults *
(Moderately Active)
RDA for Adolescent *
(10–14 years)
Men (60 kg) Women (55 kg) Girl Boy
Energy (Kcal) 1469 (211) 2730 2230 2010–2330 2190–2750
Protein (g) 28.72 (6.74) 60 55 36.8–49.0 36.3–43.3
Fat (g) 26.38 (12.77) 30 25 35–40 35–45
Iron (mg) 9.23 (3.17) 17 21 21–32 27
Calcium (mg) 441.8 (213.8) 750 750 800 800
Zinc (mg) 6.02 (1.55) 12 10 9–11 9–11
Source: Authors’ survey; * RDA is based on Recommended dietary allowance for Indians [24].
The diet diary confirmed that the adolescent children consumed rice-based lunch at school and
the remaining two meals at home. Although the average number of food groups consumed was four,
the consumption of vegetables and milk products was neither regular nor in adequate quantities. As a
result, the nutrient intake of the sample children in both control and intervention group was found
to be low compared to the RDA for that age group (Table 5). In particular, iron and calcium intake
was far from the RDA. This is because only 10% of the children consumed finger millet though it was
regularly consumed by the parents or adults at home, and all the children consumed milk provided by
the school once a day; thus, there was no other way they received enough calcium.
Table 5.
Estimated nutrient intake recorded in three-day diet diary compared to the recommended
dietary allowance (RDA) for adolescent girls and boys.
Nutrients
Average Intake (SD) * RDA for Adolescent (10 to 15 years)
Girls Boys Girls Boys
10–15
Years
10–15
Years
10–11
Years
11–12
Years
12–13
Years
13–14
Years
14–15
Years
10–11
Years
11–12
Years
12–13
Years
13–14
Years
14–15
Years
Energy (Kcal) 1681
(275)
1516
(366) 2010 2010 2330 2330 2330 2190 2190 2750 2750 2750
Protein (g) 36.04
(4.41)
32.03
(5.88) 36.8 40.0 44.5 49.0 52.8 36.3 39.6 43.7 49.8 54.7
Fat (g) 8.96
(0.55)
7.70
(0.74) 35 35 40 40 40 35 35 45 45 45
Iron (mg) 20.71
(3.42)
18.68
(4.56) 27 27 27 27 27 21 21 32 32 32
Calcium (mg) 334.61
(3.42)
285.50
(3.36) 800 800 800 800 800 800 800 800 800 800
Zinc (mg) 8.22
(1.26)
7.39
(1.68) 9 9 11 11 11 9 9 11 11 11
Source: Authors’ survey; * RDA is based on Recommended dietary allowance for Indians [24].
The sensory evaluation of recipes revealed that in general the sample children had a positive
perception of all the formulated recipes. The mean overall acceptability score ranged from 4.5/5 to 4.7/5,
depending on the recipe (Table 6). Finger millet idli,bisi belle bath and upma were equally preferred
recipes. There was no wastage of food during the intervention period, and the average per capita food
intake during the mid-day meals was estimated to be 350 g for millet-based meals and 200 g for sambar
(pigeonpea soup) which is mainly served with fortified rice in regular MDM or with finger millet idli
in the current study.
Nutrients 2019,11, 2077 9 of 16
Table 6. Preference and acceptability of recipes based on sensory attributes.
Name of the
Recipe
Taste
Mean (SD)
Appearance
Mean (SD)
Smell
Mean (SD)
Overall
Acceptability
Mean (SD)
Rank Based on
Overall Acceptability
Little millet bisi
belle bath 4.8 (0.6) 4.4 (0.8) 4.5 (0.9) 4.7 (0.7) 1
Pearl millet
Kitchadi 4.5 (0.9) 4.3 (1.0) 4.4 (1.0) 4.5 (1.0) 5
Finger millet idli
with Sambar 4.7 (0.8) 4.5 (0.9) 4.6 (0.7) 4.7 (0.8) 2
Little millet rice
with Rasam 4.5 (1.1) 4.4 (0.9) 4.5 (0.9) 4.6 (0.9) 4
Upma 4.6 (0.9) 4.5 (0.8) 4.6 (0.8) 4.7 (0.8) 2
Recipes were formulated to contain 60–100% millets. Other than millets, the recipes contained one
or more legumes, such as dehulled green gram, pigeonpea and groundnut. The recipes also contained
vegetables such as carrot, capsicum, and green peas. In terms of nutrient values, the recipes prepared
with finger millet were confirmed to be high in calcium, iron, zinc and magnesium, and sucient in
energy and the type of protein complementary with the protein in pigeonpea. The recipes made from
little millet and pearl millet were also high in iron, zinc, magnesium, energy and protein (Figures 25).
Table 7presents the Z-scores for stunting and BMI at the baseline and end line for the two groups.
On average, the sample children in both groups were within the “normal” range of undernourishment
at both the baseline and end line, even though the average values were largely below the population
average of zero. Between the two groups, the children in the intervention group were slightly more
undernourished on average, which is presumably due to the non-random attrition from the original
sample of 400 children.
made from little millet and pearl millet were also high in iron, zinc, magnesium, energy and protein
(Figures 2–5).
Figure 2. Protein, unsaturated fat and fibre content in millet-based meals in comparison with a
fortified rice-based meal.
Figure 3. Energy content of the millet-based meals in comparison with a fortified rice-based meal.
Table 7 presents the Z-scores for stunting and BMI at the baseline and end line for the two
groups. On average, the sample children in both groups were within the “normal” range of
undernourishment at both the baseline and end line, even though the average values were largely
below the population average of zero. Between the two groups, the children in the intervention group
were slightly more undernourished on average, which is presumably due to the non-random attrition
from the original sample of 400 children.
0
5
10
15
20
25
30
35
40
Fortified
rice
Sambar Fortified
rice with
Sambar
Little
millet
Bisi-bele
Bath
Pearl
Millet
Khichdi
Finger
millet
Idly with
Sambar
Pearl &
Little
millet
Upma
Pearl
Millet
Bisi-bele
Bath
Finger
millet
Upma
Pearl &
Ragi
millet
Poha
Nutritional value of millet-based food against fortified rice (g/
serving)
Protein Total fat Fibre
0
200
400
600
800
1000
1200
1400
1600
Fortified
rice
Sambar Fortified
rice with
Sambar
Little
millet
Bisi-bele
Bath
Pearl
Millet
Khichdi
Finger
millet
Idly with
Sambar
Pearl &
Little
millet
Upma
Pearl
Millet
Bisi-bele
Bath
Finger
millet
Upma
Pearl &
Ragi
millet
Poha
Energy (Kcal/serving)
Figure 2.
Protein, unsaturated fat and fibre content in millet-based meals in comparison with a fortified
rice-based meal.
Nutrients 2019,11, 2077 10 of 16
made from little millet and pearl millet were also high in iron, zinc, magnesium, energy and protein
(Figures 2–5).
Figure 2. Protein, unsaturated fat and fibre content in millet-based meals in comparison with a
fortified rice-based meal.
Figure 3. Energy content of the millet-based meals in comparison with a fortified rice-based meal.
Table 7 presents the Z-scores for stunting and BMI at the baseline and end line for the two
groups. On average, the sample children in both groups were within the “normal” range of
undernourishment at both the baseline and end line, even though the average values were largely
below the population average of zero. Between the two groups, the children in the intervention group
were slightly more undernourished on average, which is presumably due to the non-random attrition
from the original sample of 400 children.
0
5
10
15
20
25
30
35
40
Fortified
rice
Sambar Fortified
rice with
Sambar
Little
millet
Bisi-bele
Bath
Pearl
Millet
Khichdi
Finger
millet
Idly with
Sambar
Pearl &
Little
millet
Upma
Pearl
Millet
Bisi-bele
Bath
Finger
millet
Upma
Pearl &
Ragi
millet
Poha
Nutritional value of millet-based food against fortified rice (g/
serving)
Protein Total fat Fibre
0
200
400
600
800
1000
1200
1400
1600
Fortified
rice
Sambar Fortified
rice with
Sambar
Little
millet
Bisi-bele
Bath
Pearl
Millet
Khichdi
Finger
millet
Idly with
Sambar
Pearl &
Little
millet
Upma
Pearl
Millet
Bisi-bele
Bath
Finger
millet
Upma
Pearl &
Ragi
millet
Poha
Energy (Kcal/serving)
Figure 3. Energy content of the millet-based meals in comparison with a fortified rice-based meal.
Figure 4. Iron and zinc content in the millet-based meals in comparison with a fortified rice-based
meal.
Figure 5. Calcium and magnesium content in the millet-based meal in comparison with a fortified
rice-based meal.
Table 7. Undernutrition indicators for the sampled children at baseline and end line by treatment status.
Height for Age Z-Score BMI for Age Z-Score
Baseline End Line Baseline End Line
Treated
(n = 136)
1.548
(1.247)
1.474
(1.269)
1.487
(1.550)
1.321
(1.529)
Control
(n = 107)
1.207
(1.027)
1.163
(1.007)
1.002
(1.250)
1.006
(1.265)
NB: Means are presented and standard deviations are in parentheses. The end line is three months
after the baseline.
Lastly, and most importantly, Table 8 shows the one-tailed paired t test of the differences in Z-
scores between the baseline and the end line. The result indicates that the changes were positive and
statistically significant in the intervention group, and insignificant in the control group. The three-
0
10
20
30
40
50
60
70
80
Fortified
rice
Sambar Fortified
rice with
Sambar
Little
millet
Bisi-bele
Bath
Pearl
Millet
Khichdi
Finger
millet
Idly with
Sambar
Pearl &
Little
millet
Upma
Pearl
Millet
Bisi-bele
Bath
Finger
millet
Upma
Pearl &
Ragi
millet
Poha
Nutritional vlaue of millet-based food against fortified rice (mg/
serving)
Iron mg Zinc mg
0
200
400
600
800
1000
1200
1400
Fortified
rice
Sambar Fortified
rice with
Sambar
Little
millet
Bisi-bele
Bath
Pearl
Millet
Khichdi
Finger
millet
Idly with
Sambar
Pearl &
Little
millet
Upma
Pearl
Millet
Bisi-bele
Bath
Finger
millet
Upma
Pearl &
Ragi
millet
Poha
Nutritional value of millet-based food against fortified rice (mg/
serving)
Calcium Magnesium
Figure 4.
Iron and zinc content in the millet-based meals in comparison with a fortified rice-based meal.
Table 7.
Undernutrition indicators for the sampled children at baseline and end line by treatment status.
Height for Age Z-Score BMI for Age Z-Score
Baseline End Line Baseline End Line
Treated
(n=136)
1.548
(1.247)
1.474
(1.269)
1.487
(1.550)
1.321
(1.529)
Control
(n=107)
1.207
(1.027)
1.163
(1.007)
1.002
(1.250)
1.006
(1.265)
NB: Means are presented and standard deviations are in parentheses. The end line is three months after the baseline.
Nutrients 2019,11, 2077 11 of 16
Figure 4. Iron and zinc content in the millet-based meals in comparison with a fortified rice-based
meal.
Figure 5. Calcium and magnesium content in the millet-based meal in comparison with a fortified
rice-based meal.
Table 7. Undernutrition indicators for the sampled children at baseline and end line by treatment status.
Height for Age Z-Score BMI for Age Z-Score
Baseline End Line Baseline End Line
Treated
(n = 136)
1.548
(1.247)
1.474
(1.269)
1.487
(1.550)
1.321
(1.529)
Control
(n = 107)
1.207
(1.027)
1.163
(1.007)
1.002
(1.250)
1.006
(1.265)
NB: Means are presented and standard deviations are in parentheses. The end line is three months
after the baseline.
Lastly, and most importantly, Table 8 shows the one-tailed paired t test of the differences in Z-
scores between the baseline and the end line. The result indicates that the changes were positive and
statistically significant in the intervention group, and insignificant in the control group. The three-
0
10
20
30
40
50
60
70
80
Fortified
rice
Sambar Fortified
rice with
Sambar
Little
millet
Bisi-bele
Bath
Pearl
Millet
Khichdi
Finger
millet
Idly with
Sambar
Pearl &
Little
millet
Upma
Pearl
Millet
Bisi-bele
Bath
Finger
millet
Upma
Pearl &
Ragi
millet
Poha
Nutritional vlaue of millet-based food against fortified rice (mg/
serving)
Iron mg Zinc mg
0
200
400
600
800
1000
1200
1400
Fortified
rice
Sambar Fortified
rice with
Sambar
Little
millet
Bisi-bele
Bath
Pearl
Millet
Khichdi
Finger
millet
Idly with
Sambar
Pearl &
Little
millet
Upma
Pearl
Millet
Bisi-bele
Bath
Finger
millet
Upma
Pearl &
Ragi
millet
Poha
Nutritional value of millet-based food against fortified rice (mg/
serving)
Calcium Magnesium
Figure 5.
Calcium and magnesium content in the millet-based meal in comparison with a fortified
rice-based meal.
Lastly, and most importantly, Table 8shows the one-tailed paired t test of the dierences in
Z-scores between the baseline and the end line. The result indicates that the changes were positive and
statistically significant in the intervention group, and insignificant in the control group. The three-month
MDM program with millet-based recipes resulted in raising the mean Z-scores for stunting and BMI
by 0.07 and 0.166, respectively, compared to the control group.
Table 8.
Paired t test of the change in mean Z-scores for undernutrition indicators from the baseline to
the end line by treatment status.
Height for Age Z-Score BMI for Age Z-Score
[End
line–Baseline] t-Statistic p-Value [End
Line–Baseline] t-Statistic p-Value
Treated
(n=136) 0.074 5.204 0.000 0.166 2.817 0.003
Control
(n=107) 0.044 0.3842 0.351 0.004 0.028 0.511
NB:
indicates the change in mean. One-tailed p-values are presented. The end line was three months after
the baseline.
4. Discussion
The baseline result suggests that the children largely depended on mid-day meals for their calorie
intake and other nutrient requirements. A similar trend was seen in children who received mid-day
meals in Gujarat state [6].
The nutrient analysis of the millets-based meals formulated in this study shows that they are
superior to fortified rice-based meals in nutritional value, which is mainly due to the combination
of millets, legumes, and vegetables, providing balanced micro and macronutrients to the meal. As a
result, a significant reduction in the extent of undernutrition was observed in this study.
The preference for and acceptability of the formulated recipes were relatively high, which was
mainly due to the cultural suitability of the preparations. For example, when the children were
asked why they liked finger millet idli, they responded that finger millet at home was cooked in
the form of rice-finger millet balls, and that it resembled the taste. In other words, the formulated
food merely replaced or supplemented the rice component in the conventional recipes cooked in
Nutrients 2019,11, 2077 12 of 16
Karnataka. The baseline also showed that all the children were already familiar with finger millet
(Table 3) included in their food. It may be one of the reasons why their baseline RDA for calcium
reached 50–60%. The intake of other nutrients by the children did not meet RDA standards (Table 5),
which is in consonance with other studies conducted in India [31,32].
Pearl millet-based meals had high acceptability. Although an assessment of iron intake among
the children was beyond the scope of this study, [
33
] found that intake of high iron pearl millet-based
meals could reduce iron deficiency anaemia. Given the widespread iron deficiency anaemia among
school going children in India, providing pearl millet meals may be a feasible way of reducing dietary
iron deficiency anaemia [34].
However, it must be noted that several studies show that millets, as well as many other cereals
and legumes, contain antinutrients, such as phytic acid, which aects the micronutrient absorption [
12
].
Other studies show that pearl millet exhibits goitrogenic eects [
13
,
35
,
36
]. Various processing and
cooking methods have been suggested to mitigate the level of antinutrient contents in millets [
12
].
Furthermore, a recent study on breeding of pearl millet analysed the content of phytic acid and
goitrogenic C-glycosylflavones (C-GFs) in pearl millet grains, providing information on genes involved
in their biosynthesis. It was shown that large variability existed in both phytic acid and C-GFs contents,
implying immense potential for selecting germplasms that are low in these contents, which would help
maximize the benefits out of nutrients present in millet-based food [
37
]. In the current study, pearl
millet was included in MDM twice a week and there was no record of developing mineral deficiency
or thyroid related problems with the study sample. Yet, we suggest that care be taken when designing
millet-based dietary interventions, particularly for children, and that appropriate preparation and
cooking methods be imparted in consultation with culinary experts to mitigate the risk.
The children’s involvement in training sessions was intense with periodical feedback on the
cooking quality of the millet-based meals. This helped the chefs adjust the meals according to the tastes
and requirements of the children. The knowledge on nutritional benefits and interest in consumption
improved, which could be one of the reasons why the children consumed the millet-based meals
regularly for three months and never wasted any portion of their meal. A similar study conducted in
Malawi shows that intensive training for mothers on diversified nutrition, food safety and hygiene
improved the knowledge and nutritional outcome of undernourished children in three weeks’ time [
38
].
Table 9shows the costs of preparing the dierent types of meals discussed suggesting that there
is currently a cost implication in disseminating millet-based MDM programs. The cost per meal for
the recipes based on little millet, pearl millet, and finger millet was calculated to be 50%, 37% and
21% higher, respectively, compared to that of conventional meals based on rice. However, if the
rice-based meals were supplemented by additional ingredients to the levels of nutrition equivalent to
the millet-based meals, the cost disadvantage would cancel out. The cost per millet-based meal was
calculated based on the open market prices of the ingredients. If millet grains were subsidized as rice
is for MDM, then the cost per meal would decrease tremendously. The Department of Food and Public
Distribution allocates rice and wheat to various states and Union Territories at National Food Security
Act (NFSA) prices, i.e., INR 2 per kg (USD 0.029) of rice and INR 3 per kg (USD 0.043) of wheat [
39
]
under the national program of MDM. In Karnataka, the Public Distribution System (PDS) started
distributing finger millet and sorghum in 2014. The cost of millets diers across various markets.
For example, the farm gate price millet is approximately 50% less than the market price, but through
government procurement, the farmers receive 20–30% higher price than the MSP for finger millet and
sorghum compared to open market prices. Hence, selling farm produce through public procurement
scheme or regulated market would inevitably be the choice for farmers to sell their produce as long
as other issues such as late payment and procurement time periods are addressed. Considering the
current consumption of finger millet in parts of rural and urban Karnataka, the government is able to
procure 23% of the produced millets to distribute at the rate of 5 kg/household/month [
40
]. This might
still not be sucient if millets are introduced in school feeding programs. Successful provision would
Nutrients 2019,11, 2077 13 of 16
require strengthened value chains of these Smart Food crops, which are stress-resistant, nutrition dense,
and environmentally sustainable.
Table 9. Cost per meal for millet-based meal compared to rice in MDM, 2018.
Cost Per Meal for Millet-Based Meals Compared to Rice Meals in MDM *
Type of Meal in MDM Cost Per Meal
(INR)
% Increase in Cost for Millet-Based Meal
Compared to Rice-Based Meal
Rice-based meal ** 11.4 NA ***
Little millet-based meal 22.7 50
Pearl millet-based meal 18.2 37
Finger millet-based meal 14.6 21
* The cost is calculated based on market prices in Karnataka and is not applicable to all the other states. ** Rice is
subsidized by the government. *** NA =Not applicable.
Potential for additional millet consumption through MDM: Over the last two decades, the millet
consumption in India decreased from 12 kg to 9 kg per capita [
41
] mainly due to the availability of
subsidized rice and wheat through PDS, increased income, urbanization and changing tastes and
preferences of the consumers. However, with the introduction of good millet-based recipes preferred
by school children, the consumption of highly nutritious millets would increase. Using India’s largest
mid-day meal provider, Akshaya Patra as an example, Table 10 provides the information on additional
millet requirements under dierent feeding frequency scenarios in Karnataka and in 12 other states of
India. For Karnataka alone, feeding 480,000 school children with millet-based recipes would require
around 17,690, 5054 and 2527 metric tons (MT) of millets annually for feeding daily, twice and once a
week, respectively.
Table 10.
Required volume of millets for MDM programs under three dierent feeding frequency
scenarios.
Region Number of
Children
Feeding Scenarios
Daily Twice a Week Once a Week
Karnataka state 486,172 340.2 tonnes/week 97.2 tonnes 48.6 tonnes
17,690 tonnes/annum
(340.2 tonnes ×52 weeks)
5054.0 tonnes/annum
(97.2 ×52 weeks)
2527.2 tonnes/annum
(48.6 ×52 weeks)
12 states of India 1.76 million 741.2 tonnes/week 215.2 tonnes/week 107.6 tonnes/week
39,166 tonnes/annum
(741.2 tonnes ×52 weeks)
11,190.4 tonnes/annum
(215.2 tonnes ×52 weeks)
5595.2 tonnes/annum
(107.6 tonnes ×52 weeks)
Feeding 1.78 million children in 12 states of India would require about 39,166, 11,940 and 5595 MT
of millets annually for feeding daily, twice and once a week, respectively. This additional demand for
millets would encourage farmers to increase areas planted to these nutritious and climate resilient
Smart Food crops.
Nonetheless, MDM monitoring and evaluation reports indicate that mid-day meals in India are
largely made of major cereals (rice and wheat), with small amounts of vegetables and legumes because
of their high prices [
9
]. Since millets are nutritious, complementary to legumes, and are cheaper when
supplied through the PDS, millet-based recipes could provide the much needed balanced nutrition at
a lower cost compared to adding vegetables and legumes to the rice-based meals. Furthermore, the
additional cost in millet-based meals needs to be compared with the additional benefit arising from
the nutritional outcome. This requires further research on the long-term impacts, including potential
positive externalities to wider societies.
Strengths and limitations of the study: To our knowledge, this study gave the first controlled
behavioural intervention to assess the impacts of school meal interventions on the undernutrition
indicators among children in India. Nonetheless, there are mainly four limitations in this study. First,
Nutrients 2019,11, 2077 14 of 16
the MDM dietary intervention provided in the school only covered estimated 40–45% of the children’s
daily energy intake and, hence, the exact attribution to children’s growth would be dicult. The study
focused on providing a proof-of-concept by presenting evidence of the eect of consuming millet-based
food recipes in school MDM on children’s physical growth, rather than changing the full diets of the
children. Since nearly a half of the studied children skipped breakfast, they consumed about 17.5 meals
(2.5
×
7) per week on average, out of which five meals received intervention (i.e., 29% of all meals).
With complete changes in dietary habits, the positive impact may double or triple, assuming linear
relations. Second, our sampling framework included the purposive sampling element where only
children meeting certain criteria of good practices were selected into the sample. This suggests that the
positive eects found in this study may not represent children who are possibly less advantaged than
the sample children. If such segments were included into the study, the magnitude of the positive
eects may increase, though the exact quantification is left to further research. Third, the study did not
measure the impact of millets based meals on biochemical parameters such as blood haemoglobin,
which would potentially deepen the understanding of the channels of the observed positive impacts.
Fourth, the study did not monitor the iodine status of the children and recommends a long term study
to monitor the iodine status using dierent varieties of pearl millet.
5. Conclusions
This study, undertaken in the peri-urban area in Karnataka state of India, demonstrated three
important pieces of evidence: (1) that the introduction of millet-based meals in school feeding programs
can significantly improve the nutritional outcome of school going children compared to fortified
rice-based meals; (2) that these meals can be enjoyed by the children; (3) that it can be cost eective
if millets are given government pricing support as equally as rice. It is notable that the nutritional
benefits were positive in just a three-month period when other factors such as the health status of the
children was normal; and that these positive improvements were in comparison to fortified meals.
Additionally, of consequence is that the acceptability of the millet-based meals was high, which is
probably due to the eorts taken in designing the menu items in a culturally sensitive way. The ecacy
of adding millets to the meals was backed by science which provided the foundation and clarity for
ensuring that acceptability and nutritional benefits were realized.
The following key lessons were learnt on introducing millets in school meals: the importance of a
recipe design that is culturally sensitive and suitable to the cooking equipment/process; the value of
selecting both ‘type’ of millets to target specific nutrient needs and ‘variety’ of millets to significantly
increase the nutrient levels; the importance of using all ingredients (including legumes and vegetables)
in designing the menu to ensure a balanced meal, and selecting the right cooking methods and food
combinations to maximize bioavailability (absorption of the micronutrients); how hygiene and food
safety need to be maintained to ensure bioavailability of nutrients; and the significance of edutainment
in influencing children and teachers in accepting the meals. As the participants were school-going
children from a southern state of India, generalizability of the findings may be restricted to adolescent
populations in parts of South Asia where dietary habits and culinary culture have commonalities.
The study recommends future research and development initiatives such as clinical testing to
clarify the nutritional and health benefits; applied studies of other geographic/cultural areas that
have dierent taste preferences to build up suitable recipes; and testing the eectiveness of dierent
approaches to edutainment programs in schools around nutrition and millets to build knowledge
and a positive modern image around millets. It is also recommended that to maximize the benefits of
introducing millets into MDMs, the government include high micronutrient millets in the minimum
support price scheme; connect farmers directly to the supply chains for MDMs; and ensure the supply
of specific varieties of high iron millets.
Nutrients 2019,11, 2077 15 of 16
Author Contributions:
Conceptualization, S.A., J.K.-P., A.J., A.K. and D.T; methodology, S.A., T.W.T., D.T., J.K.-P.,
A.J., S.U.; implementation, S.A., D.T.; formal analysis, S.A., T.W.T; writing—original draft preparation, S.A., T.W.T.,
S.U., S.N.; writing—review and editing, S.A., T.W.T., S.U., J.K.-P., D.T., N.S., S.N., and A.J.; funding acquisition,
A.K., J.K.-P.
Funding: This research received no external funding.
Acknowledgments:
The authors thank the Government of Karnataka for approving to conduct this study which
was supported by Akshaya Patra, ICRISAT, and the Smart Food Endowment Fund.
Conflicts of Interest: There is no conflict of interest.
References
1.
Available online: https://thewire.in/government/photo-essay-indias-silent-emergency-malnutrition (accessed
on 20 May 2019).
2.
Save the Children. Malnutrition in India Statistics State Wise. 2016. Available online: https://www.
savethechildren.in/articles/malnutrition-in-india-statistics-state-wise (accessed on 28 September 2018).
3.
NFHS-4. National Family Health Survey (NFHS-4) 2015–2016; Ministry of Health and Family Welfare:
Karnataka, India, 2017; pp. 1–671. Available online: http://rchiips.org/nfhs/(accessed on 20 May 2019).
4.
Aliyar, R.; Gelli, A.; Hamdani, S.H. A review of nutritional guidelines and menu composition for school.
Front. Public Health 2015,3, 1–13. [CrossRef] [PubMed]
5. Sharma, R. Mid-Day Meal Scheme in India: The road Ahead. Dev. Ctry. Stud. 2015,5, 61–70.
6.
Patel, P.P.; Patel, P.A.; Chiplonkar, S.A.; Khadilkar, A.V.; Patel, A.D. Eect of mid-day meal on nutritional
status of adolescents: A cross-sectional study from Gujarat. Indian J. Child Health 2016,3, 203–207.
7. Dreze, J.; Goyal, A. Future of Mid-Day Meal Scheme. Econ. Political Wkly. 2003,XXXVIII, 4673–4683.
8.
Samal, J.; Dehury, R.K. Family Impact Analysis of Mid-Day Meal (MDM) Scheme in India with Special Focus
on Child Education and Nutrition. J. Dev. Policy Pract. 2017,2, 151–162. [CrossRef]
9.
Ramachandran, P. School Mid-Day Meal Programme in India: Past, Present, and Future. Indian J. Pediatr.
2019,6, 542–547. [CrossRef] [PubMed]
10. Available online: https://www.globalhungerindex.org/results/(accessed on 21 April 2019).
11.
Kumar, A.; Tomer, V.; Kaur, A.; Kumar, V.; Gupta, K. Millets: A solution to agrarian and nutritional challenges.
Agric. Food Secur.
2018
,7, 1–15. Available online: https://doi.org/10.1186/s40066-018-0183-3 (accessed on
20 May 2019). [CrossRef]
12.
Shobana, S.; Krishnaswamy, K.; Sudha, V.; Malleshi, N.G.; Anjana, R.M.; Palaniappan, L.; Mohan, V. Finger
Millet (Ragi, Eleusine coracana L.): A review of its nutritional properties, processing, and plausible health
benefits. Adv. Food Nutr. Res. 2013,69, 1–39. [PubMed]
13.
Osman, A.K.; Fatah, A.A. Factors other than iodine deficiency contributing to the endemicity of goiter in
Darfix province (Sudan). J. Hum. Nutr. 1981,35, 302–309. [PubMed]
14. Available online: http://www.smartfood.org/(accessed on 24 May 2019).
15.
Tsusaka, T.W.; Otsuka, K. The Changing Eects of Agro-Climate on Cereal Crop Yields during the Green
Revolution in India, 1972 to 2002. J. Sustain. Dev. 2013,6, 11–36. [CrossRef]
16.
Nahata, N.; Udipi, S.A.; Ghugre, P.; Thorat, A.; Salvi, A.; Boy, E. Vitamin A status of rural women from
Ahmednagar district, Maharashtra. Int. J. Health Sci. Res. 2017,7, 293–300.
17.
Mallikarjuna, K.R.; Hari Kumar, R.; Krishna, K.S.; Bhaskar, V.; Laxmaiah, A. Diet & nutrition profile of
Chenchu population—A vulnerable tribe in Telangana & Andhra Pradesh, India. Indian J. Med. Res.
2015
,141,
688–696.
18.
Thimmayamma, B.V.S.; Rao, D.H. A comparative study of oral questionnaire method with actual observation
of the dietary intake of preschool children. J. Nutr. Diet. 1969,6, 177–181.
19. DietSoft. 2019. India. Available online: http://dietsoft.in (accessed on 3 August 2018).
20.
Longvah, T.; Ananthan, R.; Bhaskarachary, K.; Venkaiah, K. Indian Food Composition Table; National Institute
of Nutrition, Indian Council of Medical Research: Hyderabad, Indian, 2017; pp. 1–578.
21.
Rai, K.N.; Patil, H.T.; Yadav, O.P.; Govindaraj, M.; Khairwal, I.S.; Cherian, B. A high-iron pearl millet variety.
Indian Farming 2014,64, 32–34.
22.
Seetha, A.; Govindaraj, M.; Kane-Potaka, J. Complementary nature of millets and legumes combinations for
amino acid profile, protein digestibility and micronutrients. (Unpublished data).
Nutrients 2019,11, 2077 16 of 16
23.
Walingo, M.K. Assessment of food and nutrient intake of beneficiary and non-beneficiary households in a
dairy development project of Vihiga District, Kenya. Afr. J. Food Sci. 2011,5, 453–459.
24.
ICMR (Indian Council of Medical Research). Nutrient Requirements and Recommended Dietary Allowances for
Indians. A Report of the Expert Group of the Indian Council of Medical Research; National Institute of Nutrition,
Indian Council of Medical Research: Hyderabad, Indian, 2010; p. 334.
25.
AOAC. The Ocial Methods of Analysis by AOAC International, 19th ed.; AOAC International: Rockville, MD,
USA, 2012; Volume 2.
26.
Koushika, N.M.; Kalpana, C.A. Formulation and Evaluation of Kodo millet (Paspalum scrobiculatum)
Incorporated Breakfast Recipes and Snacks. Indian J. Res. Food Sci. Nutr. 2017,4, 14–19. [CrossRef]
27.
Epi Info 7 Software (Centre for Disease Control, Atlanta, GA, USA). Available online: http://www.cdc.gov/
epiinfo (accessed on 6 June 2018).
28. WHO. Measuring Change in Nutritional Status; World Health Organization: Geneva, Switzerland, 1983.
29.
WHO. WHO Expert Committee on Physical Status. Physical Status: The Use and Interpretation of Anthropometry;
Report of a WHO Expert Committee; World Health Organization: Geneva, Switzerland, 1995; p. 463.
30.
Hsu, H.; Lachenbruch, P.A. Paired t Test. In Wiley Encyclopedia of Clinical Trials; John Wiley & Sons: Hoboken,
NJ, USA, 2008; pp. 1–3.
31.
Malhotra, A.; Passi, S.J. Diet quality and nutritional status of rural adolescent girl beneficiaries of ICDS in
north India. Asia Pac. J. Clin. Nutr. 2007,16, 8–16.
32.
Maliye, C.H.; Deshmukh, P.R.; Gupta, S.S.; Kaur, S.; Mehendale, A.M.; Garg, B.S. Nutrient intake amongst
rural adolescent girls of Warda. Indian J. Community Med. 2010,35, 400–402. [CrossRef]
33.
Finkelstein, J.L.; Mehta, S.; Udipi, S.A.; Ghugre, P.S.; Luna, S.V.; Wenger, M.J.; Murray-Kolb, L.E.;
Przybyszewski, E.M.; Haas, J.D. A Randomized Trial of Iron-Biofortified Pearl Millet in School Children in
India. J. Nutr. 2015,145, 1576–1581. [CrossRef]
34.
Rati, S.A.; Jawadagi, S. Prevalence of anemia among adolescent girls studying in selected schools. Int. J. Sci.
Res. 2014,3, 1237–1242.
35.
Moreno-Reyes, R.; Boelaert, M.; El Badawi, S.; Eltom, M.; Vanderpas, J.B. Endemic juvenile hypothyroidism
in a severe goiter endemic area of Sudan. Clin. Endxrinol. 1993,38, 19–24. [CrossRef] [PubMed]
36.
Gaitan, E.; Lindsay, R.H.; Reichert, R.; Ingbard, S.H.; Cooksey, R.C.; Legan, J.; Meydrech, E.F.; Hill, J.;
Kubota, K. Antithyroid and Goitrogenic eects of millet: Role of C—Glycosylflavones. J. Clin. Endocrinol.
Metab. 1989,68, 707–714. [CrossRef] [PubMed]
37.
Boncompagni, E.; Orozco-Arroyo, G.; Cominelli, E.; Gangashetty, P.I.; Grando, S.; Zu, T.T.K.; Sparvoli, F.
Antinutritional factors in pearl millet grains: Phytate and goitrogens content variability and molecular
characterization of genes involved in their pathways. PLoS ONE 2018,13, e0198394. [CrossRef]
38.
Seetha, A.; Tsusaka, T.W.; Munthali, W.; Musukwa, M.; Mwangwela, A.; Kalumikiza, Z.; Manani, T.;
Kachulu, L.; Kumwenda, N.; Musoke, M.; et al. How immediate and significant is the outcome of training
on diversified diets, hygiene, and food safety? An eort to mitigate child undernutrition in rural Malawi.
Public Health Nutr. 2018,21, 1156–1166. [CrossRef] [PubMed]
39.
Reddy, A.A.; Raju, S.S.; Suresh, A.; Kumar, P. Analysis of pearl millet market structure and value chain in
India. J. Agribus. Dev. Emerg. Econ. 2018,8, 406–424. [CrossRef]
40.
Rajashekar, S.C.; Raju, S. Introduction of Millets in PDS-Lessons from Karnataka; MS Swaminathan Research
Foundation: Chennai, Indian, 2017; pp. 1–59.
41.
Bhagavatula, S.; Rao, P.P.; Basavaraj, G.; Nagaraj, N. Sorghum and Millet Economies in Asia—Facts, Trends and
Outlook; International Crops Research Institute for the Semi-Arid Tropics: Patancheru, India, 2013; p. 80.
©
2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC BY) license (http://creativecommons.org/licenses/by/4.0/).
... Millet's cultivation can keep drylands productive and ensure future food and nutritional security. Anitha et al. (2019) [2] studied "Acceptance and Impact of Millet-Based Mid-Day Meal on the nutritional Status of Adolescent School Going Children in a Peri Urban Region of Karnataka State in India" and concluded that the introduction of millets-based meals in school feeding programs can significantly improve the nutritional outcome of school going children as compared to fortified rice-based meals, and it was also found that meals can be enjoyed by the children and it can be cost effective if millets are given government pricing support as equally as rice. Das et al. (2019) [5] studied "Growth and Instability in Area, production, Productivity and Consumption of Millets in India: An Analysis" and found that for pearl millet over the time (2001-01 to 2016-17) area under cultivation has decreased, production and productivity however have increased and in case of finger millet, both area under cultivation and production has decreased but productivity has increased. ...
... Millet's cultivation can keep drylands productive and ensure future food and nutritional security. Anitha et al. (2019) [2] studied "Acceptance and Impact of Millet-Based Mid-Day Meal on the nutritional Status of Adolescent School Going Children in a Peri Urban Region of Karnataka State in India" and concluded that the introduction of millets-based meals in school feeding programs can significantly improve the nutritional outcome of school going children as compared to fortified rice-based meals, and it was also found that meals can be enjoyed by the children and it can be cost effective if millets are given government pricing support as equally as rice. Das et al. (2019) [5] studied "Growth and Instability in Area, production, Productivity and Consumption of Millets in India: An Analysis" and found that for pearl millet over the time (2001-01 to 2016-17) area under cultivation has decreased, production and productivity however have increased and in case of finger millet, both area under cultivation and production has decreased but productivity has increased. ...
... Millet's cultivation can keep drylands productive and ensure future food and nutritional security. Anitha et al. (2019) [2] studied "Acceptance and Impact of Millet-Based Mid-Day Meal on the nutritional Status of Adolescent School Going Children in a Peri Urban Region of Karnataka State in India" and concluded that the introduction of millets-based meals in school feeding programs can significantly improve the nutritional outcome of school going children as compared to fortified rice-based meals, and it was also found that meals can be enjoyed by the children and it can be cost effective if millets are given government pricing support as equally as rice. Das et al. (2019) [5] studied "Growth and Instability in Area, production, Productivity and Consumption of Millets in India: An Analysis" and found that for pearl millet over the time (2001-01 to 2016-17) area under cultivation has decreased, production and productivity however have increased and in case of finger millet, both area under cultivation and production has decreased but productivity has increased. ...
... Millet's cultivation can keep drylands productive and ensure future food and nutritional security. Anitha et al. (2019) [2] studied "Acceptance and Impact of Millet-Based Mid-Day Meal on the nutritional Status of Adolescent School Going Children in a Peri Urban Region of Karnataka State in India" and concluded that the introduction of millets-based meals in school feeding programs can significantly improve the nutritional outcome of school going children as compared to fortified rice-based meals, and it was also found that meals can be enjoyed by the children and it can be cost effective if millets are given government pricing support as equally as rice. Das et al. (2019) [5] studied "Growth and Instability in Area, production, Productivity and Consumption of Millets in India: An Analysis" and found that for pearl millet over the time (2001-01 to 2016-17) area under cultivation has decreased, production and productivity however have increased and in case of finger millet, both area under cultivation and production has decreased but productivity has increased. ...
Article
Full-text available
In India 86 per cent of farmers are small and marginal who are facing financial insecurities. Indian women and children are facing malnutrition and hidden hunger problems. In the upcoming decades, the world agriculture production could decrease due to climate change. To address these major ongoing issues, the role of millets as a smart food is inevitable. India is the leading producer of millets in the world with 10.9 million tons in the year 2019 (Das et al., 2019) [5]. Bajra is having highest production among millets followed by sorghum and ragi in India (Gowri and Shivakumar, 2020) [6]. There is a declining trend in the area under millet cultivation of India from 1955 to 2019. The government institutes like IIMR and ICRISAT are continuously working to promote the production and productivity of millets by developing various technologies for the farmers & other stack holders. Government of India is also working on millets to improve the level of production and consumption of millets in India by introducing various schemes and policies like ICRP, INSIMP, NFSM, introducing millets as a midday meal and providing MSPs to major millets like bajra, sorghum and ragi. However, the demand of millets and its value-added products is very less. So, government should promote the health benefits of millets by organizing various awareness campaigns and should carry intensive consumer survey to assess their perception and knowledge on millets. Government should make provisions to introduce millets in the Public Distribution System to increase the demand for millets and run midday meal scheme in schools on large scale basis to eliminate the hidden hunger among the children. Government should also provide incentives and subsidies to new start-ups to promote millet based value-added food production.
... In Karnataka, the efficacy of adding millets to the mid-day meal programme had nutritional benefits on the health of the children compared to those who consumed fortified rice based mid-day meal. 29 Another RCT study revealed that consuming iron-biofortified (21-52 ppm) pearl millet improves iron status and some measures of cognitive functions in adolescents of Maharashtra. 30 ...
Article
Background: Micronutrient deficiency has long been recognized as a public health problem, particularly among vulnerable groups such as children, adolescents, pregnant and lactating women. Micronutrient deficiency could not be ruled out in spite of the implementation of various intervention strategies. Different interventions are being used to prevent and treat micronutrient deficiencies at the national and global level. The aim of this study is to systematically review the intervention strategies among different vulnerable age groups in India. Methods: The review was focused on identifying various interventions published based on the internet databases and the peer-reviewed papers from 2011 to 2021, on the predefined inclusive/exclusive criteria. The major intervention strategies implemented in India were recognized and evaluated based on dietary supplementation, micronutrient supplementation, knowledge interventions and food fortification among various age groups. Results: The results show that there are still considerable gaps in identifying the effective intervention strategies, research initiatives, programs and policies addressing to tackle micronutrient deficiencies in India. Multiple interventions are effective that could lead the road to innovations in approaches with diverse dietary intake, developing multiple micronutrient supplements, fortifying foods and nutrition interventions to address calcium, zinc, iodine, vitamin D and vitamin A deficiencies among the vulnerable population. Conclusion: Evidence-based multiple intervention studies covering a large population, in the long term cross-sectional, is the need for the hour to design policies and programs for improving the micronutrient status of vulnerable population in the community.
... In a 3-months RCT, millet-based mid-day meals were fed to 136 school children, with 107 control children from other schools receiving usual fortified rice-based mid-day meal. 28 The millet-based meals were providing balanced micro and macronutrients than the fortified rice-based meals. Furthermore, a significant improvement in stunting and body mass index (BMI) was observed in the intervention group but not in the control group suggesting the need for proper formulation of school meals. ...
Article
Full-text available
Micronutrient deficiencies, especially those of iron, vitamin A, zinc and iodine are most common around the world, particularly in children and adolescents. These deficiencies can be prevented through nutrition education and consumption of a healthy diet containing diverse foods, as well as food fortification and supplementation. Available evidence has suggested that instead of synthetic supplements, dietary diversification and modification by including micronutrient-rich foods with appropriate food preparation methods to increase bioavailability, is an effective strategy to treat deficiency state. Therefore, a literature search was conducted for studies i) developing nutritious food products and ii) evaluating food intervention effects. Twelve studies described formulation of snacks/recipes using micronutrient-rich foods and proper cooking methods to enhance bioavailability. Twenty-four food-based intervention trials in children (6 months–16 years) reported increase in micronutrient intakes. Of these, 4 studies reported improvements in all growth parameters except one study showing no improvement in height z scores, 6 studies observed positive changes in bone and muscle development, whereas one study found no effect of dairy intervention on bone mass accrual, 6 studies noted increases in biochemical parameters and/or decrease in infections, whereas two showed no change in serum levels, 4 studies noticed improved cognitive/scholastic performance. Thus, available literature indicates that supplementing snacks or small meals with high bioavailable micronutrient contents significantly increases micronutrient intake and help improving growth and development of children. Further research is warranted to devise food-based strategies for improving micronutrient quality of diets to lower the associated health risks.
... Additionally, many state governments (e.g., Odisha, Karnataka, Andhra Pradesh, Tamil Nadu, Sikkim, and Himachal Pradesh) are actively promoting consumption of nutritive coarse grains and legumes through the public distribution system 1 and programs aiming to improve school mid-day meals (https:// epds.nic.in/; (Anitha et al., 2019b(Anitha et al., , 2022). The Governments are also encouraging the establishment of farmer cooperatives, agribusiness setups, and small ventures that create and support value chains for traditional crops (crops other than major cereals, such as rice, maize, or wheat). ...
Article
Full-text available
Sorghum plays an important role in the mixed crop–livestock system of tribal farming communities in Adilabad District, a high climate risk-prone region in India. Currently, the local seed system is limited to landraces and hybrids that are primarily used for domestic grain and fodder purposes. This study aimed to understand the farmers' needs and context, and use this knowledge to deliver relevant, adoptable climate-smart sorghum crop technologies through farmer-participatory approaches (FPAs). We conducted an ex-ante survey with 103 farmer households to understand their preferences and constraints concerning sorghum, their staple food-crop. Farmers expressed taste as the most important characteristic, followed by stover yield, grain yield, drought adaptation, and pest resistance. They identified fodder deficit, loss of seed purity in landraces, and lack of diverse sorghum seed options as critical constraints. Therefore, we chose dual-purpose, open-pollinated sorghum varieties suitable for postrainy/rabi cultivation as the study site's entry point. Accordingly, sixteen popular rabi sorghum varieties were tested at ICRISAT station (2017–18 and 2018–19) for agronomic performance in field conditions under a range of treatments (irrigation and fertilization). The standing crop was also scored by farmer representatives. Additionally, the detailed lysifield study elucidated the plant functions underlying the crop agronomic performance under water stress (plant water use and stay-green score) and an important trait of farmer's interest (relation between stay-green score and in-vitro stover digestibility and relation between grain fat and protein content) The selected varieties– Phule Chitra, CSV22, M35-1 and preferred landrace (Sevata jonna)–were further tested with 21 farmers at Adilabad (2018–20). Participating farmers from both the trials and focus group discussions voiced their preference and willingness to adopt Phule Chitra and CSV22. This article summarizes how system-relevant crop options were selected for subsistence farmers of Adilabad and deployed using participatory approaches. While varieties are developed for wider adoption, farmers adopt only those suitable for their farm, household, and accessible market. Therefore, we strongly advocate FPA for developing and delivering farmer relevant crop technologies as a vehicle to systematically break crop adoption barriers and create a positive impact on household diets, well-being, and livelihoods, especially for smallholder subsistence farmers.
... It could also be processed into instant, low-cost, nutritious food suitable for households and commercial purposes. 20,21 Dairy milk is also important as a rich source of protein for the good health of children and adults. Dairy milk has been chosen as a carrier for supplementation of Vitamins A and D where these are generally deficient in the diet of children. ...
Article
Full-text available
Objective: The main aim of this study was to investigate levels of total aflatoxin and aflatoxin M1 in bokina, a home-made non-alcoholic beverage prepared from dairy milk, millet and sugar. Methods: Bokina, dairy milk and millet were purchased monthly over a period of 7 months from bokina producers at Ashaiman and Nima, in Ghana. Total aflatoxin and aflatoxin M1 levels in these samples were measured using a fluo-rometric procedure and High-Performance Liquid Chromatography. Results: Aflatoxin levels in bokina samples ranged from 1.0 to 21.0 ppb for Ashaiman samples and 1.0 to 23.0 ppb for Nima samples. Out of 21 samples from each site 1 from Ashiaman and 2 from Nima had levels total aflatoxin above the acceptable limit of 20 ppb. Similarly, total aflatoxin levels millet samples ranged from 1.0 to 55.0 ppb for Ashaiman and 5.0 to 53.0 ppb for Nima samples, with 2 samples from Ashiaman and 6 from Nima having levels above 20ppb. The levels of Aflatoxin M1 in milk ranged from 0.09 to 6.20 ppb for Ashaiman samples and 0.13 to 12.55 ppb for Nima samples. Out of the samples, 12 from Ashiaman and 10 from Nima (n=21) had levels of Aflatoxin M1 above the acceptable limit of 0.5 ppb. Conclusion: Bokina samples tested were contaminated with aflatoxin. All doses of aflatoxin have a cumulative effect on the risk of cancer. Therefore, farmers and bokina producers must be educated on good storage practices and monitored to protect the public from aflatoxin exposure and toxicity.
... It could also be processed into instant, low-cost, nutritious food suitable for households and commercial purposes. 20,21 Dairy milk is also important as a rich source of protein for the good health of children and adults. Dairy milk has been chosen as a carrier for supplementation of Vitamins A and D where these are generally deficient in the diet of children. ...
Article
Full-text available
Objective: The main aim of this study was to investigate levels of total aflatoxin and aflatoxin M1 in bokina, a home-made non-alcoholic beverage prepared from dairy milk, millet and sugar. Methods: Bokina, dairy milk and millet were purchased monthly over a period of 7 months from bokina producers at Ashaiman and Nima, in Ghana. Total aflatoxin and aflatoxin M1 levels in these samples were measured using a fluorometric procedure and High-Performance Liquid Chromatography. Results: Aflatoxin levels in bokina samples ranged from 1.0 to 21.0 ppb for Ashaiman samples and 1.0 to 23.0 ppb for Nima samples. Out of 21 samples from each site 1 from Ashiaman and 2 from Nima had levels total aflatoxin above the acceptable limit of 20 ppb. Similarly, total aflatoxin levels millet samples ranged from 1.0 to 55.0 ppb for Ashaiman and 5.0 to 53.0 ppb for Nima samples, with 2 samples from Ashiaman and 6 from Nima having levels above 20ppb. The levels of Aflatoxin M1 in milk ranged from 0.09 to 6.20 ppb for Ashaiman samples and 0.13 to 12.55 ppb for Nima samples. Out of the samples, 12 from Ashiaman and 10 from Nima (n=21) had levels of Aflatoxin M1 above the acceptable limit of 0.5 ppb. Conclusion: Bokina samples tested were contaminated with aflatoxin. All doses of aflatoxin have a cumulative effect on the risk of cancer. Therefore, farmers and bokina producers must be educated on good storage practices and monitored to protect the public from aflatoxin exposure and toxicity. Funding: The study was self-funded.
Chapter
Ensuring food and nutrition security to all is of prime importance. However, achieving it is an enormous challenge. Available data shows rise in hunger in many parts of the world. Agriculture in the present times faces several challenges, and versatile, less demanding, hardy, nutritious, sustainable crops such as small millets can play a role in mitigating this problem to some extent. Small millets are highly underutilized in comparison to major cereals. Overdependence on few plant species, viz., rice, wheat, maize, and potatoes has led to marginalization and neglect of small millets. Small millets are rich in energy, complex carbohydrates, micronutrients, and phytochemicals. Studies indicate that these can be effectively utilized to combat malnutrition including both undernutrition and overnutrition. Recent studies on children and adolescents showed that inclusion of small millets along with legumes and pulses in their diet brought about reduction in stunting, wasting, undernutrition, and improvement in height, weight, body mass index (BMI), and hemoglobin level. Owing to dietary fiber attributes, small millets can be utilized in dietary management of degenerative diseases like obesity, diabetes, and cardiovascular diseases (CVDs). These grains exhibit anticancerous property due to the presence of phytochemicals and being gluten free are highly useful for patients suffering from celiac disease. Therefore, these super foods have the potential of attaining food and nutritional security.
Article
Purpose The goal of the present study is to examine the degree of knowledge amongst Indian women about millet grain and its nutritional advantages. Millet is regarded to be five times more nutritious than rice and wheat. Despite the fact that millet contributes to 10% of India's food grain basket and has an annual production of 18 million tonnes, it is not consumed in the same proportion as mainstream cereals (that is rice and wheat). As a result, the study's primary objective is to determine the level of awareness and consumption pattern of millet amongst Indian women regarding millet grains. Design/methodology/approach The research was carried out in the city of Bengaluru in the state of Karnataka, India. For the purpose of study, a sample of 855 female respondents was approached using a non-probability sampling technique known as convenience sampling. The data were gathered through the use of a self-administered structured questionnaire. Findings According to the findings of the study, the vast majority of respondents consume millet for preserving overall health. Building self and family immunity is the most important factor with 4.11 mean scores and low standard deviation of 0.985. The results reveal that 80.6% of women in the study are aware of millet but only 62.7% of women are consuming millet. The motivating factors and demotivating factors leading to consumption and non-consumption behaviour, respectively have also been identified. The study also reveals that demographic factors such as age, qualification and income have a direct influence on millet consumption. Research limitations/implications The scope of research can be extended to explore the impact of millet consumption on long term health benefits of millet amongst the target respondents. Further, the study can be extended to explore the consumption pattern of millet among different target audience in various parts of India. The media interventions in creating awareness of millet consumption benefits need to be studied for increasing the consumption of millet. Practical implications Companies involved in producing Fast Moving Consumer Goods (FMCG) products can be encouraged to produce millet based foods like cereals, biscuits, ready to eat foods etc. Workshops can be organized to raise awareness on how the millet can replace traditional grains in the cooking process. Social implications Policy measures may include millet being promoted through technology dissemination, creating awareness about advantages of millet and including millet in the Public Distribution System (PDS). It is also important to promote the cultivation, maintenance and processing of the local variety of millet with competent marketing strategies so as to increase their cultivation comparable to the cash crops. Farmers should be educated on the importance of cultivation of minor millet. Originality/value The fast-paced lifestyle of urban Indians has a direct impact on their dietary preferences. The World Health Organization (WHO) recommends that people have a nutritionally balanced diet and engage in regular physical activity to reduce health risks. In India, as a result of women's increased participation in the workforce, women are forced to manage many tasks and obligations, which has detrimental effects on their health. The poor nutritional status of modern-day workers is attributed to a lack of education, lack of awareness and a general disregard for health-related concerns. There is a need to investigate if Indian women are aware of the nutritional benefits of millet grains that are higher in protein.
Background The demand for millet-based diets has increased significantly in recent years due to their beneficial effects on human health. Foxtail Millet (Setaria italica (L.) P.Beauv, previously known as Panicum italicum L., referred as FTM in this manuscript) seeds have been not only used as astringent and diuretic agents, but they are also used to treat dyspepsia and rheumatism. Recent studies have shown that solvent extracts from FTM seeds exhibited antioxidant and antiinflammatory activities. However, the nature and antiproliferative potential of phytochemical constituents of solvent extracts are not much explored. Objectives Major objectives of this study are to generate and characterize the phytochemical-rich fractions from Foxtail millet seeds, test the antioxidant activity and antiproliferative potential against cell lines representing carcinomas of the breast, and determine the mechanism(s) of cell growth inhibition. Methods Phytochemical-rich fractions were generated by extracting the seeds using 70% ethanol (FTM-FP) and 10% alkali (FTM-BP). Antioxidant potential was determined by ferric reducing antioxidant power (FRAP) assay and DPPH radical scavenging activity assays. The antiproliferative potential was determined using sulforhodamine-B assay. The impact on cell cycle and DNA fragmentation was analyzed by staining the cells with DAPI followed by analyzing the stained cells using NC-3000. Results Analysis of the results showed the presence of phenolics and flavonoids in the FTM-FP and FTM-BP fractions. Both fractions exhibited antiproliferative potential against breast cancer cell lines. Mechanistically, both fractions induced G2/M cell cycle arrest and increased the fragmentation of DNA, which lead to the accumulation of cells in the Sub-G1 phase. Conclusion In summary, results of this study demonstrated the potential of foxtail millet phytochemical fractions for retarding the proliferative potential of breast cancer cells.
Article
Full-text available
Pearl millet [Pennisetum glaucum (L.) R. Br.] is an important “orphan” cereal and the most widely grown of all the millet species worldwide. It is also the sixth most important cereal in the world after wheat, rice, maize, barley, and sorghum, being largely grown and used in West Africa as well as in India and Pakistan. The present study was carried out in the frame of a program designed to increase benefits and reduce potential health problems deriving from the consumption of pearl millet. The specific goal was to provide a database of information on the variability existing in pearl millet germplasm as to the amounts of phytate, the most relevant antinutrient compound, and the goitrogenic compounds C-glycosylflavones (C-GFs) accumulated in the grain.Results we obtained clearly show that, as indicated by the range in values, a substantial variability subsists across the investigated pearl millet inbred lines as regards the grain level of phytic acid phosphate, while the amount of C-GFs shows a very high variation. Suitable potential parents to be used in breeding programs can be therefore chosen from the surveyed material in order to create new germplasm with increased nutritional quality and food safety. Moreover, we report novel molecular data showing which genes are more relevant for phytic acid biosynthesis in the seeds as well as a preliminary analysis of a pearl millet orthologous gene for C-GFs biosynthesis. These results open the way to dissect the genetic determinants controlling key seed nutritional phenotypes and to the characterization of their impact on grain nutritional value in pearl millet.
Article
Full-text available
World is facing agrarian as well as nutritional challenges. Agricultural lands with irrigation facilities have been exploited to maximum, and hence we need to focus on dry lands to further increase grain production. Owing to low fertility, utilization of dry lands to produce sufficient quality grains is a big challenge. Millets as climate change compliant crops score highly over other grains like wheat and rice in terms of marginal growing conditions and high nutritional value. These nutri-cereals abode vitamins, minerals, essential fatty acids, phyto-chemicals and antioxidants that can help to eradicate the plethora of nutritional deficiency diseases. Millets cultivation can keep dry lands productive and ensure future food and nutritional security.
Article
Full-text available
Purpose The purpose of this paper is to examine the market structure and value chain of pearl millet grain and fodder in India. There is a decline in demand for human consumption, with an increase in demand for non-food uses like cattle and poultry feed, raw material for starch and breweries industry. This paper explores alternative channels, uses and value chains of pearl millet grain and fodder. The paper examines in what ways small farmers can benefit from the evolving alternative uses for pearl millet grain in cattle and poultry feed industry, breweries and starch industry. The paper also analyses the impact of aggregators in increasing the efficiency of the value chain. Design/methodology/approach The study collected primary data from farmers, traders, commission agents and exporters and importers with innovative marketing channels with aggregators (Self-Help Groups) and without aggregators to analyze the prospects for improvements in marketing channels and value chain. Findings Given that the production of pearl millet is scattered and thin, there is a lot of scope for market aggregators to increase scale economies to reduce market costs to supply in bulk to food and industrial uses. Although there was some demand for human consumption high-quality grain, most of the future demand will come from cattle and poultry feed industry, breweries and starch industry. To tap these larger potentials, farmers need to aggregate their produce and ensure regular supply in bulk quantity at least to compete the cost with alternative grains like maize and broken rice. Research limitations/implications The research is based on the field-level data collection and observations obtained from Western India. This paper provides insights how the value chain of pearl millet is working and what improvements are needed to make value chain more efficient and inclusive. Although the results are applicable to similar neglected crops and area, more caution is needed. Social implications Through the formation of farmer aggregators, farmers can enhance their bargaining power vis-a-vis industry. Originality/value Till now, there is no study that explored the pearl millet value chain in detail in India, and the paper tries to fill this literature gap.
Article
Full-text available
Objective The present study examined the impacts of training on nutrition, hygiene and food safety designed by the Nutrition Working Group, Child Survival Collaborations and Resources Group (CORE). Design Adapted from the 21d Positive Deviance/Hearth model, mothers were trained on the subjects of appropriate complementary feeding, water, sanitation and hygiene (WASH) practices, and aflatoxin contamination in food. To assess the impacts on child undernutrition, a randomised controlled trial was implemented on a sample of 179 mothers and their children (<2 years old) in two districts of Malawi, namely Mzimba and Balaka. Settings A 21d intensive learning-by-doing process using the positive deviance approach. Subjects Malawian children and mothers. Results Difference-in-difference panel regression analysis revealed that the impacts of the comprehensive training were positive and statistically significant on the Z -scores for wasting and underweight, where the effects increased constantly over time within the 21d time frame. As for stunting, the coefficients were not statistically significant during the 21d programme, although the level of significance started increasing in 2 weeks, indicating that stunting should also be alleviated in a slightly longer time horizon. Conclusions The study clearly suggests that comprehensive training immediately guides mothers into improved dietary and hygiene practices, and that improved practices take immediate and progressive effects in ameliorating children’s undernutrition.
Article
Full-text available
FORMULATION AND EVALUATION OF KODOMILLET (Paspalum scrobiculatum) INCORPORATED BREAKFAST RECIPES AND SNACKS Koushika.N.M* and Kalpana. C.A** Abstract Millets are small seeded annual cereal grains and are particularly low in phytic acid and rich in dietary fibre. Kodomillet or varagu (Paspalum scrobiculatum) is nutritionally superior to rice and wheat in terms of higher content of dietary fiber, less fat and high protein. The study was undertaken to incorporate kodomillet in commonly consumed recipes of south India and evaluate the acceptability of these recipes on the basis of organoleptic parameters and analyse their nutrient content. Kodomillet was incorporated in 14 recipes either as a whole grain or in a powder form at 30 percent and 50 per cent levels. The overall acceptability and mean scores for each recipe were analyzed by sensory evaluation through a formulated five-point scale and a panel of 30 semi trained panel members. The best acceptable recipe incorporated with varagu were analysed for selected nutrients using standardized methods. The findings of the study revealed that idli, puttu, adai, payasam, kozhukattai, laddoo and cutlet were best accepted when incorporated with varagu at 30 percent level and pongal had higher acceptability score at 50 percent level of incorporation. Kozhukattai incorporated with varagu at 30 percent level obtained the highest score among the recipes with the dietary fiber content of six gram.
Article
Full-text available
Objective: To evaluate the effect of mid-day meal (MDM) on the nutritional status of adolescents and compare it with healthy comparison group. Settings and Design: A cross-sectional study on apparently healthy adolescents (10-14 years) receiving MDM and not receiving MDM (comparison group) was conducted in two cities (Ahmedabad and Patan) of Gujarat, Western India, from January 2012 to March 2014. Materials and Methods: A total of 401 adolescents (200 boys) were selected randomly, using computerized random number generation, from two private and two municipal/government schools. Anthropometric measurements were performed. Height, weight, and body mass index Z scores were computed using ethnic data. Diet was recorded by 24 h recall and nutrient intakes were computed (C-diet V-2.1) as a percentage of the recommended dietary allowance (RDA). Student’s t-test and Chi-square tests were used to compare differences in nutritional status. Results: Percentage of stunting (24% boys and 19% girls) and wasting (17% boys and 18% girls) was significantly higher in adolescents receiving MDM (p<0.001), while the percentage of risk of being overweight, i.e., BMI for age Z (BAZ) >1 or above 85th percentile (18% boys and 12% girls) was predominant in non-MDM receiving adolescents (p<0.001). Compared to non-MDM, MDM receiving adolescents consumed significantly reduced quantity of nutrients (p<0.05). On comparing RDA based on the 24 h dietary recall, it was seen that MDM receiving boys met 60% energy, 78% protein, 50% calcium, and 53% of micronutrient requirements while MDM receiving girls met 59% energy, 67% protein, 44% calcium, and 48% of micronutrient requirements. Non-MDM receiving adolescents had close to RDA or above intake for the most nutrients (p<0.05 for all). Conclusion: Although MDM scheme restricted the percentage of stunting to some extent, the percentage of wasting was critical in terms of public health significance. MDM receiving adolescents were vulnerable to energy, protein, and micronutrient deficiencies.
Article
The National Programme for Nutrition Support for Primary Education was initiated in 1995 with two major objectives: universalisation of primary education and improvement in nutritional status of primary school children. The Central Government provided 100 g of wheat /rice per day free of cost to children studying in classes I-V in all Government, local body and Government aided primary schools. Kerala, Orissa, Tamil Nadu, Chattisgarh and MP provided hot cooked meals using the cereals provided but all other states and UTs provided 3 kg cereals/month to children with 80% attendance. By 2001, over 100 million students in 7,92,000 schools were covered under the programme. There was some improvement in enrolment but the programme had no impact on classroom hunger. In 2001 the Supreme Court of India ruled that Mid-day meal (MDM) is a legal entitlement for all school children and that the government should provide a hot cooked mid-day meal for 200 d to all primary school children. In the last decade, universal primary education and MDM have been achieved. MDM is providing hot cooked meals every day to about 100 million children. Cereal content of MDM is adequate but pulse and vegetable content of MDM are inadequate; these lacunae have to be addressed. School health services in co-ordination with MDM can identify under-nourished, normal and over-nourished children by using Body mass index (BMI) for age, and provide appropriate counseling and care. If this practice is institutionalized and routinely followed, there can be substantial improvement in nutritional status of children.
Article
The school lunch programme in India was first implemented in 1925 by the Madras Municipal Corporation for disadvantaged children. At present, the school lunch programme in India is known as mid-day meal (MDM) scheme. It was started with an objective to enhance enrolment, retention and attendance rates, and simultaneously improve nutritional levels among children. MDM not only impacts the well-being of each child but also affects the overall prosperity of families. Hence, a family impact analysis of the MDM scheme of India would be instrumental in charting out the future directions of this programme. For this study, no primary research has been carried out, rather this paper is based on secondary literature pertaining to MDM with relation to child nutrition and education. The checklist developed by the Family Criteria (Ad Hoc) Task Force of the Consortium of Family Organizations (COFO) for assessing the intended and unintended impact of public policies, proposals and social programmes on families is used. This checklist, which was later revised by the Policy Institute for Family Impact Seminars, outlines six principles to guide analyses of the family supportiveness of policies and programmes: (1) family support and responsibilities, (2) family membership and stability, (3) family involvement and interdependence, (4) family partnership and empowerment, (5) family diversity and (6) support of vulnerable families. There are a good number of intended consequences of MDM scheme which include enrolment, retention, attendance, eradication of school hunger, family stability, improvement of malnutrition, employment to women of disadvantaged communities, improvement of girl child education, etc. However, it also has some unintended consequences, including food contamination or food poisoning. Social discrimination can also be seen as an intended or unintended consequence of MDM.