Effect of Foxtail Millet (Setaria italica) Cookies Fortified with Mackerel Fish Flour on the Nutritional Status of Pregnant Women with Chronic Energy Deficiency.

associated with poor maternal nutritional status, anemia, and adverse birth outcomes. Food-based supplementation using locally available nutrient-dense ingredients, such as foxtail millet (Setaria italica) and mackerel fish, may provide a sustainable strategy to improve maternal nutrition. To evaluate the effectiveness of foxtail millet flour cookies fortified with mackerel fish flour in improving body weight, mid-upper arm circumference (MUAC), and hemoglobin levels among pregnant women with CED. A quasi-experimental study using a non-randomized pretest–posttest control group design was conducted among 40 pregnant women with CED selected through purposive sampling. Participants were allocated to an intervention group (n = 20), which received foxtail millet flour cookies fortified with mackerel fish flour, or a control group (n = 20), which received foxtail millet flour cookies without mackerel fish flour, for 90 days. Body weight, MUAC, and hemoglobin levels were measured at baseline and after the intervention. Between-group differences in changes from baseline were analyzed using the Mann–Whitney U test. After 90 days, participants in the intervention group experienced significantly greater increases in body weight (7.95 vs. 5.00 kg, p = 0.001), MUAC (2.09 vs. 2.02 cm, p = 0.035), and hemoglobin concentration (1.64 vs. 1.24 g/dL, p = 0.003) compared with the control group. Foxtail millet cookies fortified with mackerel fish flour were more effective than non-fortified foxtail millet cookies in improving maternal nutritional status, as reflected by greater increases in body weight, MUAC, and hemoglobin levels among pregnant women with CED. These findings support the use of locally sourced, nutrient-rich supplementary foods as a practical strategy to address maternal undernutrition in resource-limited settings