Protein-quality evaluation of complementary foods in Indian children

Shivakumar, N., Kashyap, S., Kishore, S., Thomas, T., Varkey, A., Devi, S., Preston, T. , Jahoor, F., Sheshshayee, M.S. and Kurpad, A. V. (2019) Protein-quality evaluation of complementary foods in Indian children. American Journal of Clinical Nutrition, 109(5), pp. 1319-1327. (doi: 10.1093/ajcn/nqy265) (PMID:30920607) (PMCID:PMC6499502)

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.

• Item Type: Articles
• Additional Information: Supported by the Wellcome Trust/DBT India Alliance through the Margdarshi fellowship to AVK, and partly by a grant (prime award number: OPP1133329) from the Bill and Melinda Gates Foundation to FJ and AVK. The research was within the Collaborating Center of the International Atomic Energy Agency at St. John’s Medical College.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Preston, Professor Tom
• Authors: Shivakumar, N., Kashyap, S., Kishore, S., Thomas, T., Varkey, A., Devi, S., Preston, T., Jahoor, F., Sheshshayee, M.S., and Kurpad, A. V.
• College/School: College of Science and Engineering > Scottish Universities Environmental Research Centre
• Journal Name: American Journal of Clinical Nutrition
• Publisher: Oxford University Press
• ISSN: 0002-9165
• ISSN (Online): 1938-3207
• Copyright Holders: Copyright © 2019 American Society for Nutrition
• First Published: First published in American Journal of Clinical Nutrition 109(5):1319-1327
• Publisher Policy: Reproduced under a Creative Commons License