PROTEIN ENERGY DEFICIENCY IN CHILDREN

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INTRODUCTION

Protein Energy Malnutrition (PEM) continues to be the major nutritional problem resulting from undernutrition that affects children in most of the developing world (Muller and Krawinkel 2005). The most recent estimates show that more than one billion people worldwide are undernourished (Food and Agriculture Organization (FAO) 2009). Africa is home to over 70 million undernourished children (World Food Programme (WFP) 2008). In this region, poverty causes food shortages and most vulnerable populations survive predominantly on starchy staples such as maize, wheat, rice, sorghum, millet and cassava, with little or no meat and dairy products (Mayer, Pfeiffer and Beyer 2008). The protein nutritional quality of these staple foods is poor and lysine is the most limiting amino acid (United States Department of Agriculture (USDA) 2008).
The health consequences most pronounced in children suffering from PEM include higher susceptibility to infectious and metabolic diseases, impaired physical and cognitive development and increased mortality rates because of their higher nutritional requirements due to high growth velocities (Stipanuk 2006). The problem is further compounded by the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) epidemic that has increased the number of vulnerable children. An estimated 91% of new infections among children worldwide and 14.1 million AIDS orphans are in sub-Saharan Africa (Joint United Nations Programme on HIV/AIDS/ World Health Organization (UNAIDS/WHO) 2009).
Strategies that have been used to address protein deficiencies include food diversification (FAO 1997), fortification of food with indispensable amino acids, supplementation with good quality protein, improvemement of protein quality by plant breeding and genetic engineering, and minimising the damage to the nutritional value of protein during food processing and storage (Friedman 2004) Cereals constitute the most suitable vehicle for delivering proteins to at-risk populations because of their widespread consumption, stability and versatility (Bulusu, Laviolette, Mannar and Reddy 2007). In developing countries where a single cereal is often the primary staple, they contribute 70 to 90% of the total dietary protein (Lasztity 1984). The production  of novel cereal-based food products designed to provide additional proteins to the daily diet has increased (Vitali, Dragojevic and Sebecic 2008). These products include nutritionally improved biscuits designed to reduce the risk of developing nutrient deficiency diseases.
Some reasons for their increased popularity are their low cost compared to other processed foods, varied taste, ease of availability and longer shelf-life (Sudha, Vetrimani and Leelavathi 2007). To augment the protein quality, the concept of cereal-legume complementation by blending cereal and legume flours can be applied (Hooda and Jood 2005, FAO/WHO 1994).

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1 INTRODUCTION 
2 LITERATURE REVIEW .
2.1 SORGHUM AND BREAD WHEAT .
2.1.1 Sorghum grain morphology
2.1.2 Chemical composition of the sorghum grain .
2.1.3 Distribution of proteins in the sorghum grain
2.1.4 Kafirin proteins
2.1.5 Amino acid composition of sorghum protei
2.1.6 Digestibility of sorghum proteins
2.2 WHEAT.
2.2.1 Morphology of the wheat grain .
2.2.2 Chemical composition of wheat grain .
2.2.3 Types of protein in wheat
2.2.4 Amino acid composition and protein digestibility of wheat
2.3 PROTEIN ENERGY DEFICIENCY IN CHILDREN
2.3.1 Functions of proteins in human nutrition
2.4 FOOD PROCESSING AND LYSINE AVAILABILITY IN FOOD
2.4.1 Milling of cereal grains
2.4.2 Thermal Processing
2.4.3 Soy beans
2.5 STRATEGIES TO PREVENT PROTEIN DEFICIENCIES
2.5.1 Dietary diversification
2.5.2 Amino acid fortification of cereals
2.5.3 Plant breeding and biofortification .
2.5.4 The principle of complementation
2.6 TECHNOLOGY OF BISCUIT PRODUCTION
2.6.1 Cereal-legume blend biscuits .
2.7 ANALYTICAL METHODS FOR PROTEIN QUALITY IN CEREAL-LEGUME COMPLEMENTED FOODS
2.7.1 Bioassays for protein quality .
2.7.2 In vitro methods
2.8 EVALUATION OF SENSORY CHARACTERISTICS IN BISCUITS
2.8.1 Methods for evaluation with children
2.8.2 Evaluating long term acceptability of foods
2.9 CONCLUSIONS
3 HYPOTHESES AND OBJECTIVES
3.1 HYPOTHESES .
3.2 OBJECTIVES
4 RESEARCH 
4.1 Effect of fortifying sorghum and bread wheat with soy protein on the nutritional
properties of biscuits
4.2 Effects of compositing sorghum and bread wheat with soy on the sensory
characteristics and consumer acceptability of biscuits
4.3 Effect of compositing with soy on the protein nutritional quality of sorghum biscuits
determined by rat bioassay
5 GENERAL DISCUSSION
5.1 METHODOLOGIES
5.2 RESEARCH FINDINGS
5.3 INTEGRATING FORTIFIED SORGHUM AND BREAD WHEAT BISCUITS
INTO SCHOOL FEEDING PROGRAMMES IN AFRICA
6 CONCLUSIONS AND RECOMMENDATIONS 
7 REFERENCES
8 APPENDIX.

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