Pregnancy: an amaranth–chickpea flatbread improves nutritional indicators in a trial in Ethiopia

A six-month dietary comparison

The trial included 306 pregnant women with mild to moderate anemia in Hawela Lida district. They were recruited before 12 weeks of pregnancy. The study, conducted from September 2024 to February 2025, was cluster-randomized: interventions were assigned to groups rather than individuals.

Each of the two arms included 153 participants. The experimental group received 200 grams per day of amaranth–chickpea flatbread for six months, while the control group received corn flatbread. The abstract does not specify the amount of corn flatbread or whether energy intake was equivalent. In total, 293 participants completed the study.

Measurable differences, but in indirect indicators

At the end of follow-up, mean upper arm circumference reached 26.1 centimeters in the amaranth–chickpea group, compared with 24.3 centimeters in the corn group. The adjusted difference was 1.72 centimeters, with a 95% confidence interval ranging from 1.48 to 1.96.

Weight gain during pregnancy was also higher: 8.4 kilograms versus 6.1 kilograms. The adjusted difference was 2.23 kilograms, with a 95% confidence interval of 1.92 to 2.54. Mean BMI was 23.8 versus 21.9 kg/m².

These measurements serve as indirect indicators of nutritional status. Greater weight gain or a higher BMI does not, on its own, prove a healthier pregnancy. Their interpretation depends in particular on initial nutritional status and the stage of pregnancy.

The effect cannot be attributed to amaranth alone

The intervention combined amaranth and chickpea. This trial therefore cannot isolate the effect of amaranth or determine how much of the result is attributable to the energy provided or the nutritional composition of the flatbread.

The population studied also limits the applicability of the result: these were pregnant women with anemia in an Ethiopian setting. The data do not support promising the same benefit to pregnant women without anemia or those living in a different dietary environment.

What the abstract does not allow us to conclude

No serious adverse events are reported in the abstract. This does not demonstrate an absence of all adverse effects. The dossier also provides no results on changes in anemia, obstetric complications or newborn health.

The full text was not consulted. Details of randomization, the composition of the flatbreads, funding and conflicts of interest therefore remain unverified. The findings are of interest for research on maternal nutrition, but they are not sufficient to establish a general recommendation.

What we can take away

This trial supports a benefit of amaranth–chickpea flatbread on anthropometric indicators in the population studied, not an effect specific to amaranth or a demonstrated benefit for the baby.