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Title: Sufficient protein quality of food aid varies with the physiologic status of recipients

item CALLAGHAN, MEGHAN - Washington University
item OYAMA, MOMO - Washington University
item MANARY, MARK - Children'S Nutrition Research Center (CNRC)

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/20/2016
Publication Date: 3/1/2017
Citation: Callaghan, M., Oyama, M., Manary, M. 2017. Sufficient protein quality of food aid varies with the physiologic status of recipients. Journal of Nutrition. 147(3):277-280.

Interpretive Summary: Protein quality describes how well food provides for the body's essential amino acid needs which vary through the life cycle and during different physiological states. The variation in amino acid requirements due to physiological status is overlooked in normal methods when determining protein quality so this research developed new patterns that reflect the amino acid needs during different physiological states of food aid recipients. These new scoring patterns can now be used in the evaluation of food aid products to ensure that they are optimized for the needs of specific vulnerable populations.

Technical Abstract: Protein quality scores use the amino acid (AA) requirements of a healthy North American child. AA requirements vary with physiologic status. We estimated AA requirements for healthy North American children, children with environmental enteric dysfunction, children recovering from wasting, and children with an acute infection. The protein quality of food aid products was then calculated to determine whether it was sufficient in all these groups, and we found that it may not be adequate for all of them. Physiologic status is important when assessing the protein quality of food aid. Rates of weight gain from 8 published trials treating children with moderate acute malnutrition were abstracted, and protein quality scores from the corresponding food aid products were calculated with the use of the digestible indispensable amino acid score (DIAAS). Two DIAAS values were calculated, one in healthy children aged 1-3 y as a reference population and the other in malnourished children aged 1-3 y as a reference population. These data were used to calculate the best fit regression line between weight gain and protein quality. The slope of the regression line was greater when malnourished children were used as a reference population than when healthy children were used (0.128; 95% CI: 0.118, 0.138 compared with 0.097; 95% CI: 0.090, 0.105 measured in g/kg-1/d-1/DIASS U-1). These findings suggest that adjusting AA requirements for physiologic status may more accurately estimate the minimum protein quality of food aid products.