1 Division of Human Nutrition, Wageningen University, the Netherlands; 2 International Center for Tropical Agriculture (CIAT), Cali, Colombia; 3 Cell Biology and Immunology Group, Wageningen University, the Netherlands; 4 Medical Research Council (MRC) International Nutrition Group, London School of Hygiene & Tropical Medicine, London, United Kingdom and MRC Keneba, The Gambia; 5 London School of Hygiene & Tropical Medicine, London, United Kingdom.
Introduction: Biofortified yellow cassava can increase vitamin A intake, but it’s unknown whether additional food-based recommendations (FBR) are needed to fulfil nutrient adequacy. We evaluated whether a school lunch with yellow cassava, can theoretically ensure a nutritionally adequate diet for schoolchildren in Kenya and what additional FBR are needed, by using the OptiFood linear programming tool. Method: Dietary intakes of 150 children aged 7-9 years, Kibwezi district, Kenya, were assessed using a quantitative multi-pass 24-hour recall. Linear programming model parameters were derived, including a list of foods consumed, median serving sizes, distribution of frequencies and cost of each food. Food-based dietary recommendations were formulated using OptiFood for three scenarios: the normal daily diet including 1) no school lunch; 2) a standard school lunch with cooked maize and beans; or 3) a school lunch of cooked yellow cassava. The target for nutrient adequacy was set at 100% of the WHO/FAO recommended nutrient intake (RNI) for 13 nutrients. The scenario meeting 100% RNI for most nutrients was further modeled and nutrient dense foods were added to achieve nutrient adequacy. Results: Scenario 3 achieved 100% RNI for 6 nutrients compared to scenario 1 (4 nutrients) or scenario 2 (5 nutrients). When maximizing the coverage of RNI for each nutrient, the addition of nutrient-dense foods to scenario 3 did not result in coverage of 100% RNI for, riboflavin, niacin, folate, vitamin B12 and vitamin A (range 30-83% of the RNI) nor achievement of 30 energy% from fat. Conclusions: Introduction of yellow cassava will likely improve the nutrient adequacy of diets consumed by school children in Kenya, but alternative interventions are needed to ensure dietary adequacy. OptiFood is a useful tool to assess whether introduction of a biofortified crop contribute to nutrient adequacy and what additional dietary recommendations are needed to fill remaining nutrient gaps.