Protein-quality evaluation of complementary foods in Indian children

Author:

Shivakumar Nirupama1ORCID,Kashyap Sindhu2,Kishore Satvik2ORCID,Thomas Tinku3ORCID,Varkey Aneesia2,Devi Sarita2ORCID,Preston Thomas4ORCID,Jahoor Farook5,Sheshshayee M S6ORCID,Kurpad Anura V12ORCID

Affiliation:

1. Department of Physiology

2. Division of Nutrition

3. Department of Biostatistics, St. John's Medical College, St. John's National Academy of Health Sciences, Bangalore, India

4. Scottish Universities Environmental Research Center, East Kilbride, United Kingdom

5. USDA/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX

6. Department of Crop Physiology, University of Agricultural Sciences, Bangalore, India

Abstract

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.

Funder

Douglas Bomford Trust

Bill and Melinda Gates Foundation

Publisher

Oxford University Press (OUP)

Subject

Nutrition and Dietetics,Medicine (miscellaneous)

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