Protein-quality evaluation of complementary foods in Indian children

Abstract

Background The types of food in complementary feeding of infants and young children are important for growth and development. Food protein quality, as measured by the Digestible Indispensable Amino Acid Score (DIAAS), requires the determination of true ileal digestibility of indispensable amino acids (IAAs) in children. Objectives First, the aim of this study was to measure the true ileal IAA digestibility of 4 (rice, finger millet, mung bean, and hen egg) commonly consumed complementary foods in children aged <2 y using the dual-isotope tracer method. Second, we calculated the DIAAS of complementary feeding diets and their relation to stunting in a representative Indian rural population. Design Rice, finger millet, and mung bean were intrinsically labeled with deuterium oxide (2H2O), whereas egg was labeled through oral dosing of hens with a uniformly 2H-labeled amino acid mixture. True ileal IAA digestibility was determined by the dual-isotope tracer technique. The DIAAS of complementary food protein was calculated in children aged 1–3 y from a nationally representative survey to evaluate its relation with stunting. Results True ileal IAA digestibility was lowest in mung bean (65.2% ± 7.1%), followed by finger millet (68.4 %± 5.3%) and rice (78.5% ± 3.5%), and was highest for egg (87.4% ± 4.0%). There was a significant inverse correlation of complementary food DIAAS with stunting in survey data (r = −0.66, P = 0.044). The addition of egg or milk to nationally representative complementary diets theoretically improved the DIAAS from 80 to 100. Conclusions The true ileal IAA digestibility of 4 foods commonly consumed in complementary diets showed that the DIAAS was associated with stunting and reinforces the importance of including animal source food (ASF) in diets to improve growth. This trial was registered at http://ctri.nic.in/clinicaltrials/login.php as CTRI/2017/02/007921.

Prevalence of Anemia and its Associated Factors among Chinese 9-, 12-, and 14-Year-Old Children: Results from 2014 Chinese National Survey on Students Constitution and Health

“…Tibambuya BA et al [31] also found that consumption of egg three or more times in a week could independently reduce the odds of anemia in pregnant women. Egg and cow's milk are ubiquitous globally and are known as top contributors for all nutrients as well as an exceptional protein source with a large range of micronutrients [32][33][34][35][36], and more importantly, egg is a fairly good source of iron [37] and milk is a good source of protein. Eggs and milk were widely used in previous nutritional intervention programs, such as the Lulin project [34], a randomized controlled trial conducted among young undernourished children in the Ecuadorian Andes, which showed dramatic effects on growth and stunting reduction via consuming eggs for just six months.…”

Association of Plasma Total Cysteine and Anthropometric Status in 6–30 Months Old Indian Children

“…The low intake of high-quality protein intake, as well as amino acid, is associated with poor childhood growth [ 9 , 10 , 11 , 12 , 13 , 14 ]. In a targeted metabolomics approach, Semba and colleagues [ 11 ] showed that 16 of 19 measured proteinogenic amino acids were significantly associated with stunting in Malawian children.…”

“…The low intake of high-quality protein intake, as well as amino acid, is associated with poor childhood growth [ 9 , 10 , 11 , 12 , 13 , 14 ]. We did not include dietary intake in this analysis, and thus, we cannot exclude that tCys concentrations were only a marker of the overall quality of the diet and the role of other dietary components remains unclear.…”

“…Young children grow rapidly and have additional nutritional demands to enhance optimal growth and development [ 7 ]. These demands are increased by environmental influences, such as a high burden of clinical and sub-clinical infections [ 8 , 9 , 10 ]. Intake of high-quality protein has been shown to promote childhood growth [ 9 , 10 , 11 , 12 , 13 ] with a suggested pathway via the production of insulin-like growth factor I (IGF-I).…”

“…These demands are increased by environmental influences, such as a high burden of clinical and sub-clinical infections [ 8 , 9 , 10 ]. Intake of high-quality protein has been shown to promote childhood growth [ 9 , 10 , 11 , 12 , 13 ] with a suggested pathway via the production of insulin-like growth factor I (IGF-I). Additionally, a sensing pathway, the mechanistic target of rapamycin (mTOR), has been described, which regulates energy balance and suppresses cellular growth in the case of amino acid deficiency [ 11 , 14 ].…”