There is a lot to be learned from previous generations as Professor Andrew Tomkins explains...
1. Fermented foods
It appears that for centuries people have been using fermentation in the preparation of cereals. Fermented maize (kenkey) is widely used in Ghana and other foods are used throughout Africa. Fermented legumes are often used in Indonesia and other Asian countries. The advantage of the fermentation process is that naturally occurring bacteria cause a simple chemical process, which makes the food slightly more acid. This improves the taste and also has the advantage that diarrhoea–causing germs cannot grow so easily in the fermented food.
When food is stored in warm conditions germs multiply in the food, increasing the risk of diarrhoea. Because of lack of time and fuel, mothers are usually not able to prepare fresh food throughout the day, especially for feeding young children who need several meals a day. Food is usually stored for up to a day – allowing germs to multiply.
In a recent study in Ghana, it was found that the number of diarrhoea causing organisms in food prepared using fermentation was less than half that in food which had been prepared freshly and then left lying around. The fermentation process also breaks down some of the fibre in the food and increases the absorption of iron. Most people prefer the taste of fermented food. It is important to recognise that the fermentation process that is traditionally used only lasts 48 hours. This is enough to allow the chemical process to develop, but not enough to allow the development of alcohol.
Why have people stopped using fermented food? A recent study in Kenya suggests that health-workers tend to feel that fermented foods are traditional and therefore not “modern” and should be discouraged. Recent research suggests the opposite; old technologies may be very useful for improving the bacterial quality of foods prepared in unhygienic conditions. Obviously, if one was fortunate enough to live in a community where the water was completely pure and the food was uncontaminated, there would be no need for fermentation. However it seems as though a traditional technology which has been used for improving food hygiene over the centuries, is in danger of being thrown out as a response to too much enthusiasm about modern things.
DISCUSSION POINT
Do people in your area use fermented foods? What do mothers think about using this food for young children? Are there any steps you could take to encourage its use?
2. Germinated flours – or ‘Power Flour’
Germination is also receiving considerable attention. Dietary bulk is a major problem for children who have to rely on cereals for their main energy and protein source. Young children often find it difficult to chew and swallow thick porridge. Mothers may add liquid to porridge and other foods to feed to young children. This means that the child eats less food and more water, and may not receive enough energy for healthy growth. The use of germinated flour can bring a dramatic improvement.
Grains can be germinated by leaving them in water for a day. During the sprouting process, they develop high concentrations of amylase. It has been known for years that amylase can break down the starches into sugars. Thus, germinated foods are more attractive because of their sweet taste. The flour can then be dried, ground up and stored.
MAKING POWER FLOUR…
Soak cereal grains (maize, rice, millet) for up to one day in a covered pot or bucket. Legumes such as mung beans, haricot beans and cowpeas can also be germinated. They need longer soaking – up to two days. Dry the grains well in the sun.
(If sorghum is the main cereal, this can also be used to make power flour but it must be cooked for a few minutes after adding to porridge.)
Mill as usual for ordinary grains. A high protein flour can be made from cereal grains on their own, or from one of the following legume and cereal mixes…
1 part legume : 3 parts cereal
1 part legume : 2 parts cereal
Store in dry conditions.
Power flour is easy to make and can have a dramatic improvement on the diets of young children. In some countries it is produced commercially, eg: Tanzania, where it is known as Kimea, and India where it is known as ARF (amylase-rich flour).
If this flour is not available in your area, try producing it yourself. If clinics and health workers are encouraging mothers to use this flour, women’s groups could produce the flour for sale in small quantities. Experiment with different grain and legume mixes and let us know the results.
A small teaspoonful of this flour when added to a bowl of thick porridge made up from ungerminated flour (without further cooking), will cause a great reduction in the thickness, making it much more like a soup. This is much easier to feed to children, especially those who are sick for any reason. There are various approaches to using germinated foods and it would be interesting to hear from readers about their experiences.
3. Cereal-based oral rehydration solution
It is now well known that death from acute diarrhoea can be avoided by effective oral rehydration. A lot of emphasis was given initially to the use of special packets of glucose and electroytes as prepared by WHO and UNICEF. These are good, but there has been even more interest raised in the use of cereal-based oral rehydration. This is a technology which has been around for centuries.
MAKING THE SOLUTION…
Use a small quantity (about 25 to 50 grams) of whatever cereal or flour is available – rice, potatoes, maize, etc. Add about a litre of water, mash thoroughly and boil, stirring to prevent lumps. Salt can be added in the right amount – a level teaspoon would do – and when the solution is cooled it can be given immediately.
During the cooking there is a breakdown of the starches into small molecules of sugar-like substances. These are then broken down by the intestinal cells into sugars. The presence of sugars in the intestine stimulates the absorption of salt and water into the body and there is rapid rehydration. The advantage of cereal-based oral rehydration over packets is that the presence of starch-breakdown products appears to decrease the stool volume, as well as stimulate the absorption of sodium and water.
A variety of cereals and other substances have been used including rice, maize, wheat, plantain, potato and carrots. It would be interesting to hear from people who have experience with different food substances. It is important to find out exactly how much of the cereal you need to make a liquid oral rehydration in your own community. Try it and see!
Professor Andrew Tomkins has recently been appointed as head of the new Centre for International Child Health at the Institute of Child Health, Guildford St, London. Information on these and other aspects of maternal and child health is held in the Resource Centre which also contains a display of TALC materials. Visitors always welcome.
