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Title: Consumption of animal-source protein is associated with improved height-for-age z scores in rural Malawian children aged 12-36 months

Author
item KAIMILA, YANKHO - University Of Malawi
item DIVALA, OSCAR - University Of Malawi
item AGAPOVA, SOPHIA - Washington University School Of Medicine
item STEPHENSON, KEVEIN - Washington University School Of Medicine
item THAKWALAKWA, CHRISSIE - University Of Malawi
item TREHAN, INDI - Washington University School Of Medicine
item MANARY, MARK - Children'S Nutrition Research Center (CNRC)
item MALETA, KENNETH - University Of Malawi

Submitted to: Nutrients
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/20/2019
Publication Date: 2/25/2019
Citation: Kaimila, Y., Divala, O., Agapova, S.E., Stephenson, K.B., Thakwalakwa, C., Trehan, I., Manary, M.J., Maleta, K.M. 2019. Consumption of animal-source protein is associated with improved height-for-age z scores in rural Malawian children aged 12-36 months. Nutrients. 11(2):480. https://doi.org/10.3390/nu11020480.
DOI: https://doi.org/10.3390/nu11020480

Interpretive Summary: Diet is a determinant of stunting, acute malnutrition and poor gut health in global health, and plant-based diets have poor protein quality and low levels of micronutrients. This study assessed the diets of children in rural Malawi and found that plants comprised most of the diet, and that the foods consumed, the dietary diversity and protein quality were not associated with stunting, acute malnutrition and poor gut health; however animal protein consumption was associated with reduction in stunting in children aged 12–36 months. These findings support the notions that factors other than diet are very important in child growth and development and that animal-source food consumption in this vulnerable population promotes linear growth.

Technical Abstract: Linear growth faltering, caused by insufficient diet, recurrent infections and environmental enteric dysfunction (EED), continues to plague young children in low- and middle-income countries (LMICs). Diets in LMICs are primarily plant based, and thus have poor-quality protein and low levels of essential micronutrients. The aim of this study was to assess the association of the type and protein quality of food consumed with stunting, EED and acute malnutrition in children aged 6-36 months in Limera and Masenjere, two rural Southern Malawian communities. This is a secondary analysis of two randomized controlled trials that tested the effects of common bean and cowpea flour on stunting in children aged 6-36 months. We used data from two interactive 24-h dietary recalls conducted 12 weeks after enrolment into each trial. Food intakes were compared between the regions using Chi-square and Student's t-test. There were 355 children that participated in the dietary recalls. The diets of children were of poor quality, but the children from Limera consumed more fish (54% vs. 35%, p = 0.009) and more bioavailable protein (26.0 +/- 10.3 g/day vs. 23.1 +/- 8.1 g/day, p = 0.018, respectively) than children in Masenjere. Food type and protein quality were not associated with any of the outcomes except an association between animal protein consumption and improvement in height-for-age z scores in children aged 12-36 months (p = 0.047). These findings support the notion that animal-source food (ASF) consumption in this vulnerable population promotes linear growth.