Effect of amaranth flatbread on maternal anthropometry during pregnancy: Evidence from a cluster-randomized controlled trial in Southern Ethiopia.

In 30 seconds

This parallel-group, cluster-randomized controlled trial assessed daily amaranth-chickpea flatbread in pregnant women with mild-to-moderate anemia in Southern Ethiopia. Participants received 200 g/day of amaranth-chickpea or maize flatbread for six months; 293 of 306 completed the study. At endline, the intervention group had higher mean MUAC, BMI, and gestational weight gain than controls. The largest adjusted difference was in gestational weight gain: adjusted β = 2.23 kg (95% CI: 1.92-2.54). These anthropometric outcomes were used as proxies for nutritional status.

Key findings

• Mean MUAC was 26.1 ± 1.2 cm with amaranth flatbread versus 24.3 ± 1.4 cm with maize; adjusted β = 1.72 (95% CI: 1.48-1.96).
• Mean BMI was 23.8 ± 1.5 kg/m2 versus 21.9 ± 1.6 kg/m2; adjusted β = 1.89 (95% CI: 1.62-2.16).
• Mean gestational weight gain was 8.4 ± 1.2 kg versus 6.1 ± 1.4 kg; adjusted β = 2.23 (95% CI: 1.92-2.54).
• No serious adverse events were reported, and sensitivity analyses using categorical nutritional-status definitions were consistent with the primary analyses.

Why it matters

Maternal undernutrition is a public health concern in the study setting, and the trial found improvements across three anthropometric indicators with a food-based intervention. The results add controlled-trial evidence that a nutrient-rich traditional food may support maternal nutritional status in a resource-limited context, while the measured outcomes remain proxies rather than direct evidence of improved pregnancy outcomes.

What to keep in mind

The trial enrolled pregnant women with mild-to-moderate anemia in one district, so findings may not generalize to other populations or settings. Outcomes were anthropometric proxies; the abstract does not report pregnancy outcomes.