{'fraction_non_alphanumeric': 0.03007518796992481, 'fraction_numerical': 0.02537593984962406, 'mean_word_length': 4.96358543417367, 'pattern_counts': {'":': 0, '<': 3, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Acceptability of a Fortified Atole Among Guatemalan Children who Attend Six Casa Del Niño Day Care Centers, and the Effects on Linear Growth and Hemoglobin Status

A corn and soy atole fortified with 21 vitamins and minerals, including higher levels of iron and zinc than other locally available options, has been provided to children from 6–84 months of age attending 6 Sociedad Protectora del Niño day care centers in Guatemala since August of 2013. Trained staff prepared and fed the children one serving consisting of 18.75g (~one tablespoon) of dry product mixed with 8 oz of water, brought to a boil and served as a warm beverage 5 days per week throughout the year. The objectives of this study were to assess the changes in mean height for age Z‐scores (HAZ) and hemoglobin (Hb) after 21 months of intervention, and to quantify the amount of atole consumed by the children on two different non‐consecutive days. Children were followed‐up for anthropometry and Hb every 6 months. To evaluate the amount of atole that children consumed, a waste study was performed in 3 randomly selected nurseries, on two non‐consecutive days, using graduated cylinders and food scales to measure the amount of atole prepared and not consumed. Multivariate mixed model analyses were performed to evaluate changes over time in Z‐scores and Hb. Mean Hb improved on average of 0.5g/dL throughout the intervention (t=11.43, df=1761.15, p<0.001). Mean HAZ improved significantly in those children with HAZ<‐2 SD at baseline, showing an average monthly increase of ~0.03 SD, (t=6.15, df=1324, p<0.001) over the course of the intervention. The waste study indicated that children consumed 98.5% of the served beverage/day. This micronutrient intervention is effective in improving Hb concentrations and a significant effect in the improvement in HAZ among stunted children was also noted. The product is highly acceptable to children, making this fortified atole a good alternative to address chronic undernutrition in similar institutions in Guatemala and other Central American countries where atole consumption is a common habit and practice.