VI NUTRITIONAL IMPORTANCE OF TRADITIONAL MILK PRODUCTS IN THE NATIONAL DIET.

1. SOUTHERN AND EASTERN AFRICA - GENERAL.

In considering the contribution of traditional dairy products in the diets of the people in the countries of Southern and Eastern Africa it is important to look at the overall availability of milk. Very often figures obtained by relating the estimated amounts of milk produced in a given country with the human population are taken as the per capita milk consumption statistics (see Table 3). These figures may be useful as general indicators of the level of milk availability to the general populace but have limited value as criteria for assessing the nutritional role of milk in national diets.

To evaluate accurately the contribution of milk to the nutrition status of the people we need to be aware of the traditional role of milk in the diets of different communities within a region or country. Whereas the majority of the urban and semi-urban populations consume purchased milk, the majority of the rural population (who form at least 80% of the total population within southern and eastern Africa) consume home-produced milk. This means that in the urban sector the level and pattern of milk consumption within households relates very closely to the availability of market milk and milk products, income levels and distribution, age groups and cultural backgrounds of the urban dwellers.

In the rural areas, milk consumption levels and patterns depend on the degree of pastoralism or non-pastoralism within a given community. Therefore depending on the geographical distribution of traditional cattle herds one is bound to encounter, within a given country in the region, areas where milk and milk products constitute a major component in the diet while in some non-pastoral communities the consumption of milk particularly among adults, may be non-existent. Table 29 adopted from Schneider (1984), gives a general overview of the distribution of pastoralism within the major rural peoples of Eastern Africa. Included also is an arbitrary indication of the role of milk in their diets. Generally as the number of cattle kept per person decreases so does the dependency on milk as a source of dietary energy. At an average yield of 1 kg milk per day containing 700 kcal, about four milking cows are required to meet the energy requirement of an adult person requiring 2600 kcal/day. These levels can only be achieved in strictly pastoral communities owning large numbers of cattle per head. Households with less cattle per head have to rely on other foodstuffs apart from milk and meat or blood to meet their nutritional requirements. A review of some published information will serve to elaborate this point further.

In a study of the role of milk in the diet of pastoralists of South Darfur, Sudan, Kerven (1987), found that 25 per cent of the energy needs were met by milk, implying the consumption of the equivalent of 1 litre of milk per day containing about 700 kcal per litre. In another report, Kerven (1987a) showed that milk (in the form of traditional dairy products) contributed 51 per cent and 63 per cent of the total calorific intake of individual and group Maasai ranchers respectively. This translates into about 1.9 and 2.3 litres of milk per day. These figures are consistent with average milk consumption figures of 0.84 and 1.75 litres/day reported for small scale (35 cattle per household) and large scale (367 cattle per household) Maasai group ranches in Kenya (Leeuw et al 1984). Similar figures have been reported recently by Majubwe (1987) who found milk consumption in four immigrant Maasai settlements in Morogoro, Tanzania, owning an average of between 104 and 221 cattle per household to be between 1.8 litres and 2.7 litres per person per day. Most of the milk was consumed as fermented milk or buttermilk - a by-product of butter making. These milk consumption figures are very high by any standards. However an analysis of the nutrient profiles of such high levels of milk consumption (Kurwijila, 1988a) show that while the needs for protein in general and essential amino acids are more than adequately satisfied, the supply of iron, niacin, vitamin C, vitamin A, thiamine and energy are never fully met by a purely milk diet on which some pastoralists attempt to subsist entirely, particularly in the rainy season when milk is plentiful (Kerven, 1987). Due to changing circumstances especially the seasonal nature of the milk supply and frequent droughts, most pastoralists, including the Maasai in eastern Africa, now include substantial amounts of grain in their diets (Kerven 1987a, 1987b; Majubwa, 1987; Grandin, 1987). The transition from a diet completely dependent on dairy products among different communities in southern and eastern Africa becomes inevitable as pastoralists pass through various phases of pastoralism to settled mixed farming agricultural systems as illustrated in Table 29.

In Tanzania, an analysis of the distribution of the per capita milk supply by regions showed from the Livestock and Human Population Census 1978, that 5 out of 17 administrative regions had per capita milk (consumption) supply of less than 5 kg, while only four regions had consumption figures above 40 kg (112 ml/day) (Mpelumbe et al 1978, Kurwijila, 1988).

While these general figures of milk availability show very low milk supply levels and wide regional variations - a fact that is true also for most countries within southern and eastern Africa - pockets of high milk consumption among pastoralists and agro-pastoralists do exist. These diets will benefit from the addition of grains and legumes to supply energy and part of the protein while those diets of non-pastoralists which are predominantly of cereal and starchy foods (Table 29) stand to gain by the addition of highly nutritious dairy products. This strategy can achieve both goals as milk released from the pastoral diet can be processed in situ and sold or exchanged for grains as is frequently done between cattle-owning and non cattle-owning households in agro-pastoral and mixed farming communities.

Adapted from Schneider (1984) and expanded by Kurwijila (1989).

(1) Agriculture lacking or insignificant

(2) Agriculture important in varying degrees

(3) Agriculture important.

2. SOUTHERN AND EASTERN AFRICA - ETHIOPIA.

There are various reports dealing with human nutrition in Ethiopia. However, the importance of traditional milk products in the diet of the people, especially those of the pastoralists and agro-pastoralists, is not given the required attention.

The Ethiopian diet as a whole, is rich in carbohydrates but poor in proteins, fats and vitamins. The annual estimated consumption of 19 to 30 kg per head is much below the 62.5 kg per capita given by the Food and Agricultural Organization of the United Nations (FAO) as the average milk intake to be maintained for a balanced diet (FAO, 1974–1977). The nutritional problem differs from region to region and likewise from season to season. In the highlands, with a crop-livestock farming system, the number of milking cows per household does not exceed 1.5. They are local zebu with low milk production and the milk off-take for home consumption is about 1 to 3 litres per day, depending upon the season and stage of lactation. Excepting for calves and children, the nutritional aspect of milk is not given much importance.

On the other hand, in the pastoral and agro-pastoral areas milk and milk products play an important role in the diet of the people. Amongst these cattle herders, milk and cereal (maize and sorghum) form the basic diet. Where as in the highlands, cereals and legumes are the important food commodities. During the dry season, when milk production is at its lowest, the pastoralists suffer from malnutrition. On the whole, it can be concluded that the nutritional importance of milk and milk products in the diet of the nation can not be over-stated.

3. WEST AFRICA - MALI.

In general, the principal food items are cereals (millet and rice), milk and meat. The daily milk consumption pattern varies from region to region and from season to season. There are differences also between children and adults, males and females and the various social classes (Wagenaar-Brouwer, 1986). According to the World Bank (1983 Ann. 24), the Malians on average are only provided with 85 per cent of their calorie requirements. The pastoralists, where milk forms the greater portion of their diet, have poorer nutritional status as compared to the agro-pastoralist whose basic diet is grains (Wagenaar-Brouwer, 1986). According to some estimates, the average annual consumption per capita is about 18 kg (liquid milk equivalent) over the whole country. This amount is about one third of what FAO recommends as the per capita average milk consumption to be maintained for a balanced diet (ILCA Bulletin, No. 4 1979).

4. SOUTHCONE COUNTRIES OFLATIN AMERICA.

According to the amount of milk destined for use in traditional milk products and information on raw milk marketing (Table 16) national milk consumption per capita very much depends on the traditional dairy product and the amount of raw milk sold direct to the consumer.

In Chile for example, from the 40 per cent (around 400 million litres) of milk which remains at the farm it is estimated that 10 per cent (40 million litres) go to feed the calves, to be used by the family and normal losses at the farm. Around 30 per cent of total milk production is destined for the preparation of traditional dairy products and to be sold directly to the consumer. Consequently traditional dairy products contributes around 30 per cent of the milk consumption average coming from national milk production.

On the other hand, in the case of Brazil almost half of its milk consumption derived from the national production comes from traditional dairy products.

In other countries such as Bolivia, Peru and Paraguay most of milk produced is used to make traditional dairy products. Therefore the traditional milk product sector is the main contributor to the milk consumption of those countries considering only their own milk production, that is, not taking into account imported milk. The precise contribution of traditional milk products is not known because there have been no studies or available statistics about this sector in most of the countries.

However, from experience we know that traditional dairy products do have a great nutritional importance in the diet of those countries. Generally speaking, the dietary advantages of traditional milk products are the following:

1. Traditional products satisfy the consumption habits of countries throughout the region. That means that most of the population enjoy consuming milk through those products, even though sometimes they don't like milk itself. In that way nutritional requirements such as calcium, protein etc., are satisfied,

2. The rural population and that of the nearest towns have a good supply of dairy products, normally at lower prices (at the farm) than the dairy products of industrial processing. Normally these populations do not have much opportunity to consume industrial products due to supply and cost problems,

3. For people who have good access to the industrial dairy products (i.e. people in the cities) the availability of traditional dairy products allow them to have more varieties of dairy products so that they consume milk through those products too in a more enjoyable way, so increasing their total milk consumption,

4. Traditional dairy products do not reduce the nutritive characteristics of natural milk. Most of those products are made from raw milk so there are no losses of milk nutrients because of the processing. In addition for most of them, nutrient concentration takes place during processing (e.g. cheese varieties, sweetened condensed milk, etc.) so they normally have higher nutritive values than fluid milk,

5. The manner of consumption of those products is very traditional and they are an important part of the normal diet of a country. They are part of traditional dishes and some of those are normally included at certain meals, for example, in Paraguay, soup is almost a daily part of lunch and dinner meals and cheeses are added to it. Traditional dairy products are included in the eating habits throughout the region.

Semi-hard cheese types are usually consumed at breakfast and tea time with a piece of bread or cracker biscuits. They are also consumed at lunch or dinner time together with some Italian dishes and traditional soups and finally they may be used for special cocktails with some wine and fried potatoes, etc.

Fresh cheese is consumed at breakfast and tea time in the same way as semi-hard cheeses but at lunch too it may be eaten with some special salads.

Sweetened condensed milk is consumed at breakfast and tea time in place of marmalade or inside tarts, cakes, biscuits etc.

So it does not require any special publicity campaign to increase milk consumption through the use of those products. It is only necessary to have them available at a reasonable price to have them consumed by most of the country's population whose diet is deficient in milk nutrients.

Nevertheless, traditional dairy products at the moment have some problems directly connected with their general poor microbiological quality.

In this respect, in general there is a consumption risk for those products (e.g. cheese) for the main population (very young and old people), since they are made mainly from raw milk, without heat treatment and of poor bacteriological quality. Fortunately, some products do not have these problems e.g. sweetened condensed milk which is heat treated for a long time to evaporate off the required amount of water.

In general there are no precise statistics on the outbreak of food poisoning and other illnesses related to food consumption. Many people know by experience the risk involved in the consumption of dairy products made from raw milk.

Another problem which could affect milk consumption is related to the absence of standardization of those products and at the moment people are asking for the best quality in food and particularly uniformity of each product variety.

The main problems related to the nutritional aspects of traditional dairy products are the consequence of faults in milk production, dairy processing, transport and general management.

5. MIDDLE EAST - SYRIA.

Milk is a well known product all over the country and forms with its products a very important component of the people's diet in most regions of Syria. At the breakfast especially, milk is considered one of the main dishes because every family used to have a few head of sheep, cows or goats to produce their own needs of milk and its products.

People in Syria consider milk as the most nearly perfect single food but its great nutritional importance lies probably in the ability of the consumer to mix milk with other foodstuffs and its ability to improve a mixed diet.

The nutritional importance of milk in the national diet is due mainly to its contribution of high animal protein, its exceptional richness in calcium and its generous supply of vitamin A and of riboflavin and other members of the vitamin B complex.

Also, the chief importance of milk and its products from a nutritional point of view lies in its great contribution of calories and the fat soluble vitamins, as well as supplying a considerable part of the daily needs of people for vitamin C.

Cream (koshtah) has been considered as the most valuable part of milk due to its content of fat, for use in different types of food dishes, especially sweet dishes such as knafch and katayef, as well as being the raw material for producing butter (zobdeh) and ghee (samneh).

Butter (zobdeh) is very important in the national diet because the people eat it either as it is with jams or sweet food or as ghee or butter oil for cooking. Ghee is used only for cooking, more specifically in frying meats or vegetables.

Yoghurt (laban) or drained yoghurt (labaneh), are very important foodstuffs, especially yoghurt when it is used as a refreshing drink in summer time when weather gets hot. It is more important for patients who suffer from stomach disorders or pains.

Cheese as well are considered a very important part of the daily diet in the country because it contains a very high level of nutrients, vitamins and minerals such as calcium and also because of its ability to keep for a long time.

In the case of the minor Syrian milk products such as sheninah, shenglish (sorke) and keshkeh they also have very great nutritional importance in the national diet as breakfast dishes due to their content of energy, protein and minerals, and it is quite normal to see these products in every house in the cities or the villages.

6. ASIA

6.1 INDIA AND NEIGHBOURING COUNTRIES.

The composition of milk makes it an ideal balanced food for humans especially infants and its importance as a supplement to the average diet cannot be over emphasised. Traditionally in areas where milk production is abundant, milk and milk products are regularly consumed by almost all sections of the population. For example, the average Punjabi diet can compare well with some of the best diets in the world. However, the same cannot be said of the major sections of the population. Recognising the proper role that milk can play in the nutrition of the people, efforts are being made to increase milk production significantly. Supplementary feeding programmes for infants and expectant mothers, and school children, have always included milk powder as one of the ingredients.

There is hardly any major difference in the nutritive values of cow and buffalo milk except for the greater calorific value of buffalo milk due to its higher fat content.

Although 46 per cent of the milk produced in the country is consumed as liquid milk and as such milk plays an important role in the national diet, there is considerable need and scope for increased consumption of milk. The expenditure elasticity of demand for milk is very high in India, 1.46 for the rural population and 1.3 for the urban population.

The daily allowances of nutrients for an Indian adult male (doing moderate work) recommended by the Indian Council of Medical Research are given below.

The average diet of the poorer sections of the population is deficient in several nutrients and most of these can be made up by supplementing the diet with milk. As against the recommended level of 200 ml of milk, the average per capita intake was 168 ml, in 1988. Except in the case of high and middle income groups it is less than the recommended levels. Milk plays a major role as a source of proteins in the average Indian diet contributing some 10 per cent of the protein intake. These data are indicative of the important part that milk plays in the nutrition of the population.

In India most milk is boiled before consumption. It is to this practice that the absence of milk-borne diseases in India is to be mainly attributed. Heating to first boil results in destroying most of the organisms. Denaturation of proteins as well as its flocculation due to the neutralisation of the electric charges occurs to some extent on boiling milk. A partial precipitation of calcium salts and phosphates also occurs, the diffusible calcium being reduced from 26 per cent to 20 per cent.

Among the vitamins in milk, A is the most resistant, and C the most vulnerable to heat treatment. While hardly any vitamin A is destroyed by boiling, about 22 per cent of vitamin C is lost when milk is boiled. The loss of vitamin C is dependant both on the time of treatment and the exposure to light. A slight reduction in the thiamine (B1) content of milk occurs. Riboflavin (B2) is hardly affected. The availability of calcium and vitamins (except vitamin C) is not affected by boiling. Most of the enzymes of milk are destroyed during boiling and the digestibility of milk increases.

Hot milk is widely consumed before going to bed as a nightcap. The milk is usually flavoured with condiments such as almonds, cardamom, dry dates etc.

In the Indian households the life of milk is extended from 12 to 24 hrs by repeated boiling. The simplest way of preserving milk for human consumption in a tropical country is to allow it to sour with the aid of lactic cultures, checking putrefactive changes while giving to milk an acid taste which is particularly refreshing in a hot climate. The product thus achieved, dahi, is widely consumed in the country along with meals. The digestibility of milk constituents improves. Dahi can also be consumed by people who suffer from lactose intolerance. Almost every household in the country consumes dahi. Due to fermentation of milk a greater amount of phosphorus and calcium is made available to the digestive system by their precipitation in the lower intestines due to the acid condition induced by Lactobacillus sp.; and the consumption of sour milk also results in increased efficiency of the body to cope with a sudden influx of lactic acid in the system.

It is reported that when the food is supplemented with 250 g of dahi a day, the status of thiamine improves. Dahi also increases the pyruvic acid and the lactic acid among children on a typical poor rice diet. Thus, dahi in its different forms, lassi, kadhi, shrikhand etc. also contributes significantly to the average diet.

Makkhan and ghee contribute as much as one third of the fat in the Indian diet. Ghee is produced mainly for consumption directly as food and as an ingredient of food preparations including sweets. Over the centuries Indians have cultivated a liking for the aroma and flavour of ghee, and a preference for its use over vegetable oils, the other traditional cooking medium for the preparation of specific food items. The vegetarian habits of many Indians preclude from their diet hard animal fats such as tallow or lard used in the West and thus ghee forms an important source of fat in an otherwise vegetarian diet. For most uses, its wholesome flavour is the chief attraction. For table use it is served in melted form and mixed with rice or lightly smeared on chapatis. It is widely used for shallow frying and deep frying of food materials. Innumerable Indian sweetmeats based on cereals, milk solids, fruits and vegetables are cooked, by preference, in ghee. Buttermilk or lassi as described earlier is a by-product in the preparation of makkhan. It is estimated that about 55 kg of buttermilk is produced for every kg of ghee. While most of this is consumed by the villagers and their families, a good quantity is either given away or fed to cattle. The reason for this is the lack of market value for the product in rural parts. Buttermilk is rich in milk protein and calcium and forms a valuable human food.

Ghee and makkhan are important carriers of vitamins A, D, E & K. They also contain small amounts of essential fatty acids e.g. arachidonic and linoleic.

Considerable losses of Vitamin A and carotene occur during cooking, the loss of the latter being more rapid. Below 125°C Vitamin A is fairly stable but above this temperature it is rapidly destroyed. It is found that 10–20 per cent of carotene is lost during the normal cooking operations.

6.2 HIMALAYAN REGION - NEPAL AND BHUTAN.

The very fact that malnutrition continues to increase throughout the world shows that policies have been inadequate. The supply of extra food to meet the needs of expanding populations is an enormous problem for the planners of agricultural development in the least developed nations of the world. In countries which have a predominantly agricultural economy the malnourished will normally be found among families of subsistence farmers and particularly landless labours who do not have enough milk and milk products in their diet. Milk and milk products are main sources of protein, fat, lactose and minerals. The traditional milk products are rich in fat and protein. Chhurpi which is solid hard casein, contains 81 per cent protein and 11 per cent fat. Sher or shergum in Nepal, has a high percentage of protein. The composition has never been analysed in Nepal and Bhutan. Sher or shergum is known as ‘dartsi’ in Bhutan. This product is widely used in curry, being cooked with green chilli and vegetables. If it is ripened it will have a more cheesy taste. In Bhutan, the ripened and smoked cheese which is packed in leather or calf skin bag has a similar nutritional value to non-traditional cheese. The most of the composition may match with non-traditional cheese. This type of cheese is called ‘churtsi’ in Bhutan. It is more expensive than other traditional milk products. Traditional butter and ghee have a great nutritional value. Both are used in cooking the foods. The normal traditional butter may contain on average 18–25 per cent moisture, 75.5 to 85.5 per cent fat; 1 to 1.5 per cent non-fatty acids and solids and 0.2 to 0.5 per cent oleic acid. The composition may differ according to the manufacturing process. Traditional butter and ghee are the main source of energy. Dahi and lassi, are also of great importance in the diet. In Nepal, dahi is consumed with rice and other suitable food. Lassi is drunk and is mainly used in the villages. Lassi contains more water than dahi. Dahi and lassi both contain fat, protein, lactose, ash, calcium, phosphorus. So it has a great nutritional value. The average composition of khoa is given in Table 32.

These figures indicate the important nutritional value of khoa.

The traditional products sar, malai and tar have a similar nutritional value to non-traditional cream but the protein content may be greater.