Nutritional significance and therapeutic potential of Moringa oleifera: The wonder plant

Moringa oleifera is a multi-purpose plant and a comprehensive source of dietary components such as proteins, essential amino acids, vitamins, antioxidants, etc. The plant is also a rich source of other bioactive components, including flavonoids, glucosinolates, isothiocyanates, alkaloids, terpenoids, phenolics, etc. Incorporating M. oleifera in diet can improve the nutritional status of pregnant and nursing mothers and helps to combat malnutrition and iron deficiency anemia (IDA) among children. The phytochemicals and secondary metabolites, especially the polyphenolic compounds from Moringa, have a significant free-radical scavenging effect attributed to this plant's therapeutic potential. Investigations targeting to explore M. oleifera for its nutritional makeup, novel bioactive components, and analysis of their health-promoting attributes have received much attention. This review demonstrates an overview of recent (past ten years) advancements and patenting activity in discovering different parts of M. oleifera plant for providing adequate nutritive and bioactive components. The pharmacological potential and action mechanisms of M. oleifera in many diseases like diabetes mellitus, cancer, hypertension, ulcer, etc., are also discussed. PRACTICAL APPLICATIONS: Moringa oleifera is a vital plant that has a varied set of nutritional and therapeutic properties. The indigenous components of Moringa can treat humankind of its diseases and contribute to overall health. The qualitative and functional characteristics of its components indicate possible commercial exploitation of this high-value plant by utilizing its plant parts in many proprietary medicines and nutraceuticals. In conclusion, the Moringa plant needs to be used commercially. It can lead to tremendous economic development if the industries and researchers exploit its potential for highly nutritional super food and therapeutic application by undertaking further research to corroborate earlier studies.

A complementary food supplement from local food ingredients to enhance iron intake among children aged 6-59 months in Benin

Nutritious complementary feeding is often not affordable in Benin, and iron deficiency exists. This research aimed at formulating an affordable and sensory acceptable complementary food supplement using local food ingredients to increase iron intake among children aged 6-59 months in Benin. The complementary food supplement was formulated to ensure that 10 g would cover 25% of the estimated average requirements for iron for children aged 6 to 12 months. Adansonia digitata fruit pulp, Moringa oleifera leaf powder, and Cochlospermum tinctorium root powder were used to compose the complementary food supplement, which was mixed with maize and sorghum ogi porridges before being presented to the mothers and children for the acceptability test. The mineral contents of Adansonia digitata fruit pulp in mg/100 g dw were 9.9 ± 0.1 for iron and 0.9 ± 0.1 for zinc. The iron and zinc contents of Moringa oleifera leaf powder and Cochlospermum tinctorium root powder in mg/100 g dw were 34.1 ± 2.2 and 26.8 ± 2.7 and 9 ± 0.0 and 0.9 ± 0.0, respectively. The complementary food supplement contained, in mg/100 g dw, 17.4 ± 1.1 of iron and 1.2 ± 0.1 of zinc. The maize and sorghum ogi porridges enriched with the complementary food supplement at substitution rates of 15% and 16% (in dry weight), respectively, were acceptable to 85% of children for sorghum ogi porridge and 87% for maize ogi porridge. The present study demonstrated the potential of local food ingredients in the formulation of an iron-rich and acceptable complementary food supplement for children aged 6-59 months in Benin.

Evaluation of the anti-aging and antioxidant action of Ananas sativa and Moringa oleifera in a fruit fly model organism

aging is an inevitable biological complex process. It involves the gradual loss of cellular vitality due to accumulative damage to cellular macromolecules by reactive oxygen species (ROS). These ROS are highly implicated in health, disease, and lifespan. The biochemical pathways involved in the aging process are highly influenced by both exogenous (environmental factors) and endogenous stress factors. These cellular processes are the same in most organisms including the fruit fly, nematode, yeast, mammalian cell line, and rodents. These model organisms have been extensively used in the screening of potent antioxidant botanicals for anti-aging bioactivity. Moringa oleifera and Ananas sativa are great sources of health-promoting nutrients and antioxidants, however, their anti-aging impact is still an evolving area of research interest. Therefore, this review focused on their anti-aging mode of action and some other anti-aging nutriceuticals in different model organisms including the fruit fly. PRACTICAL APPLICATIONS: Staying forever young and healthy is everyone's right. Aside from genetic trait, healthy feeding is peculiar to the world's longest-living people. Ananas sativa (pineapple) and Moringa oleifera leaves are highly valued fruit and herb with nourishing, antioxidant, and medicinal properties. Their extract exhibit antioxidant, anticancer, anti-inflammatory, and anti-aging activities. The ancient Greeks, Egyptians, and Romans used Moringa seed oil for cosmetics and perfumes. Moringa tea leaves is consumed for its nutritive and medicinal value. Its antioxidant potency endorses its use for anti-aging and other health-promoting purposes. The bioactive compound in pineapple, bromelain, promotes wound healing and it is a component of postsurgical applications due to its anti-inflammatory property. Consumption of Ananas fruit provides the recommended daily allowance of vitamin C, a potent antioxidant. To identify new anti-aging bioactive compounds of therapeutic importance, and understanding the mode of action of these nutriceuticals will contribute to new anti-aging research prospects.

Effectiveness of interventions to manage acute malnutrition in children under 5 years of age in low- and middle-income countries: A systematic review

Background

Childhood malnutrition is a major public health concern as it is associated with significant short- and long-term morbidity and mortality.

Objectives

To comprehensively review the evidence for the management of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) according to the current World Health Organization protocol using facility- and community-based approaches as well as the effectiveness of ready-to-use therapeutic food (RUTF), ready-to-use supplementary food (RUSF), prophylactic antibiotic use and vitamin A supplementation.

Search methods

We searched relevant electronic databases till 11 February 2019. No date or language restrictions were applied.

Selection criteria

We included randomised controlled trials (RCTs) and quasi-experimental studies including controlled before-after (CBA) studies and interrupted time series (ITS) studies.

Data collection and analysis

Two review authors independently screened studies for relevance, extracted data, assessed risk of bias and rated the quality of the evidence using the GRADE approach. We carried out statistical analysis using Review Manager software and set out the main findings of the review in "Summary of findings" tables.

Main results

This review summarises findings from a total of 42 studies (48 papers) including 35,017 children. Thirty-three of the included studies were RCTs; six studies were quasi-experimental and three studies were cost studies. Majority of the studies were judged to be at high risk of bias for blinding of the participants, personnel and outcome assessment. Majority of the outcomes were rated as either moderate or low quality. Outcomes were downgraded mainly due to study limitations, high heterogeneity, imprecision and small sample size. Community-based strategies to screen and manage SAM/MAM versus no community-based strategies (two studies): Integrated community-based management probably improves recovery rate by 4% [risk ratio (RR): 1.04; 95% confidence interval (CI): 1.00 to 1.09; one study; 1,957 participants; moderate-quality outcome], and reduces weight gain by 0.8 g·kg^-1·day^-1 [mean difference (MD): -0.80 g·kg^-1·day^-1; 95% CI: -0.82 to -0.78; one study; 1,957 participants; moderate-quality outcome] compared with no community-based strategies, while mortality was similar between the two groups (RR: 0.93; 95% CI: 0.60 to 1.45; one study; 1,957 participants; moderate-quality outcome). Facility-based strategies to screen and manage uncomplicated SAM versus other standard of care (four studies): There was no evidence of effect on recovery (RR: 1.00; 95% CI: 0.80, 1.25; one study; 60 participants; very-low-quality evidence) and mortality (RR: 1.21; 95% CI: 0.75 to 1.94; two studies; 473 participants; low-quality outcome). Facility-based management with RUTF versus F100 ("catch-up" formula to rebuild wasted tissues containing 100 kcal and 2.9 g protein per 100 ml) for SAM (three studies): There was no evidence of effect on weight gain (MD: 2 g·kg^-1·day^-1; 95% CI: -0.23 to 4.23; three studies; 266 participants; very-low-quality outcome) and mortality (RR: 1.20; 95% CI: 0.34 to 4.22; two studies; 168 participants; low-quality outcome). Community-based management of SAM with standard RUTF compared with other foods (14 studies): There was no evidence of effect on recovery rate when standard RUTF was compared to non-milk/peanut butter-based RUTF (RR: 1.03; 95% CI: 0.99 to 1.08; five studies; 5743 participants; I² 50%; moderate quality outcome), energy-dense, home-prepared food (RR: 1.14; 95% CI 0.95 to 1.36; four studies; 959 participants; I² 75%; low quality outcome), or high oleic RUTF (RR: 1.06; 95% CI: 0.85 to 1.31; one study; 141 participants; moderate quality outcome). Standard RUTF may improve weight gain by 0.5 g·kg^-1·day^-1 (MD: 0.5 g·kg^-1·day^-1; 95% CI: 0.02 to 0.99; three studies; 3,069 participants; low-quality outcome) when compared with non-milk/peanut butter-based RUTF and by 5.5 g·kg^-1·day^-1 when compared with F100 (MD: 5.50 g·kg^-1·day^-1; 95% CI: 2.92 to 8.08; one study; 70 participants; low-quality outcome). There was no evidence of effect on mortality when standard RUTF was compared with other foods (RR: 0.99; 95% CI: 0.69 to 1.41; nine studies; 7,667 participants; low-quality outcome). RUSF for MAM compared with other foods (14 studies): There was no evidence of effect on recovery rate when standard RUSF was compared with local/home made food (RR: 0.92; 95% CI: 0.64 to 1.33; three studies; 435 participants; low-quality outcome) and whey RUSF (RR: 0.96; 95% CI: 0.92 to 1.00; one study; 2230 participants; high-quality outcome); while standard RUSF may improve recovery by 7% when compared with corn-soy blend (CSB) (RR: 1.07; 95% CI: 1.02 to 1.13; six studies; 5,744 participants; low-quality outcome). There was no evidence of effect on weight gain when standard RUSF was compared with local home made food (MD: -0.75 g·kg^-1·day^-1; 95% CI: -2.03 to 0.43; one study; 73 participants; low-quality outcome) and whey RUSF (MD: -0.16 g·kg^-1·day^-1; 95% CI: -0.33 to 0.01; one study; 2,230 participants; high-quality outcome); while standard RUSF may improve weight gain by 0.49 g·kg^-1·day^-1 when compared with CSB (MD: 0.49 g·kg^-1·day^-1; 95% CI: 0.10 to 0.87; five studies; 4,354 participants; low-quality outcome). There was no evidence of effect on mortality when standard RUSF was compared with other foods (RR: 0.98; 95% CI: 0.57 to 1.68; eight studies; 8,310 participants; moderate-quality outcome). Prophylactic antibiotic versus no antibiotic (three studies): Prophylactic antibiotic therapy for uncomplicated SAM improves recovery rate by 6% (RR: 1.06; 95% CI: 1.03 to 1.08; two studies; 5,166 participants; high-quality outcome), probably improves weight gain by 0.67 g·kg^-1·day^-1 (MD: 0.67 g·kg^-1·day^-1; 95% CI: 0.28, 1.06; two studies; 5,052 participants; moderate-quality outcome) and probably reduces mortality by 26% (RR: 0.74; 95% CI: 0.55, 0.98; three studies; 6944 participants; moderate quality outcome) compared to no antibiotics group. High-dose vitamin A versus low-dose vitamin A (two studies): There was no evidence of effect on weight gain (MD: 0.05 g·kg^-1·day^-1; 95% CI: -0.08 to 0.18; one study; 207 participants; moderate-quality outcome) and mortality (RR: 7.07; 95% CI: 0.37 to 135.13; one study; 207 participants; moderate-quality outcome).

Authors’ conclusions

Limited data show some benefit of integrated community-based screening, identification and management of SAM and MAM on improving recovery. Facility-based screening and management of uncomplicated SAM has no benefit on recovery and mortality, while the effect of F100 for SAM is similar to RUTF for weight gain and mortality. Local food and whey RUSF have similar effects as standard RUSF on recovery rate and weight gain in MAM, while standard RUSF has additional benefits to CSB. Prophylactic antibiotic administration in uncomplicated SAM improves recovery rate, weight gain and reduces mortality, while limited data suggest that high-dose vitamin A supplementation is comparable with low-dose vitamin A supplementation for weight gain and mortality among children with SAM.

Current Status and Potential of Moringa oleifera Leaf as an Alternative Protein Source for Animal Feeds

The increased consumption of livestock, poultry, and fish products in people's diet threatens to drive production toward the use of more and more conventional crops in animal feeds. In this context, alleviating the tightening grain crop supply and ensuring the healthy development of animal husbandry through innovations in protein feedstuff production remain considerable challenges. Moringa oleifera is a miracle tree species with abundant nutrients, high protein biological value, and good feeding effect. As a new protein feedstuff, M. oleifera has great potential in alleviating the feeding crisis. Here, we review available literature regarding the characterization of M. oleifera in the field of animal husbandry in terms of nutrient content, digestion, and absorption characteristics, and feeding effects and present current challenges in using M. oleifera as animal feed.

Effectiveness of Interventions for Managing Acute Malnutrition in Children under Five Years of Age in Low-Income and Middle-Income Countries: A Systematic Review and Meta-Analysis

Childhood malnutrition is a major public health concern, as it is associated with significant short- and long-term morbidity and mortality. The objective of this review was to comprehensively review the evidence for the management of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) according to the current World Health Organization (WHO) protocol using facility- and community-based approaches, as well as the effectiveness of ready-to-use therapeutic food (RUTF), ready-to-use supplementary food (RUSF), prophylactic antibiotic use, and vitamin A supplementation. We searched relevant electronic databases until 11 February 2019, and performed a meta-analysis. This review summarizes findings from a total of 42 studies (48 papers), including 35,017 children. Limited data show some benefit of integrated community-based screening, identification, and management of SAM and MAM on improving recovery rate. Facility-based screening and management of uncomplicated SAM has no effect on recovery and mortality, while the effect of therapeutic milk F100 for SAM is comparable to RUTF for weight gain and mortality. Local food and whey RUSF are comparable to standard RUSF for recovery rate and weight gain in MAM, while standard RUSF has additional benefits to CSB. Prophylactic antibiotic administration in uncomplicated SAM improves recovery rate and probably improves weight gain and reduces mortality. Limited data suggest that high-dose vitamin A supplementation is comparable with low-dose vitamin A supplementation for weight gain and mortality among children with SAM.

Effect of complementary foods fortified with Moringa oleifera leaf powder on hemoglobin concentration and growth of infants in the Eastern Region of Ghana

Complementary foods that are deficient in both macronutrients and micronutrients coupled with a high burden of infections during the complementary feeding period are major underlying causes of child malnutrition in developing countries. Among the recent efforts to combat malnutrition by improving the quality of complementary foods in the developing world is the use of Moringa oleifera leaf powder (MLP) as a food fortificant. We conducted a randomized controlled trial to test the effect of feeding MLP-fortified complementary food on hemoglobin concentration and growth of infants and young children after 4 months of feeding. Infants aged 8-12 months were randomly assigned to receive one of three study foods; Weanimix a cereal-legume blend formulated with Moringa (MCL-35g), MLP sprinkled on infants' usual complementary foods (MS-5g) and the control food Weanimix without Moringa (CF-35g). Blood samples for hemoglobin determination as well as dietary intake and anthropometric data were collected at baseline and endline for 237 infants who completed the study. Data analysis was performed with SPSS (version 20) and comparisons were done by analysis of covariance (ANCOVA). There were no significant differences in hemoglobin concentration or growth indicators at endline between the three study groups. Findings of this study indicated that feeding infants a 5 g daily dose of MLP, either as part of a cereal-legume blend or as a supplement which was sprinkled on infants' usual complementary foods for 4 months, did not significantly improve infants' hemoglobin concentration or growth indicators.

Leaf Protein and Mineral Concentrations across the "Miracle Tree" Genus Moringa

The moringa tree Moringa oleifera is a fast-growing, drought-resistant tree cultivated across the lowland dry tropics worldwide for its nutritious leaves. Despite its nutritious reputation, there has been no systematic survey of the variation in leaf nutritional quality across M. oleifera grown worldwide, or of the other species of the genus. To guide informed use of moringa, we surveyed protein, macro-, and micro- nutrients across 67 common garden samples of 12 Moringa taxa, including 23 samples of M. oleifera. Moringa oleifera, M. concanensis, M. stenopetala, an M. concanensis X oleifera hybrid, and M. longituba were highest in protein, with M. ruspoliana having the highest calcium levels. A protein-dry leaf mass tradeoff may preclude certain breeding possibilities, e.g. maximally high protein with large leaflets. These findings identify clear priorities and limitations for improved moringa varieties with traits such as high protein, calcium, or ease of preparation.