This observational cross-sectional study is investigating if young children in populations with higher prevalence of kwashiorkor malnutrition have lower dietary sulfur amino acid intake than populations with lower prevalence of kwashiorkor, controlling for multiple potential confounding factors. Intake is estimated through diet recalls during interviews with a child's caregiver, analysis of urine samples and analysis of food samples for their amino acid profiles.
Kwashiorkor is one of two categorizations of severe acute malnutrition, but its etiology remains unclear. Although kwashiorkor is found only where diets are low in quality protein, comparisons of total dietary protein of individual children with and without kwashiorkor has been inconclusive. This study aims to compare amino acid profiles of the diets, not just total protein. Evidence has shown that children with kwashiorkor consistently have very low circulating levels of sulfur amino acids (cysteine and methionine). Typical staple foods in regions with endemic kwashiorkor are generally poor in sulfur amino acids and the signs characterizing kwashiorkor can plausibly be explained by a shortage of sulfur amino acids. In eastern Democratic Republic of the Congo, certain populations have chronically higher prevalence of kwashiorkor than neighboring populations with similar livelihoods, religion, environment, language and ethnicity. This study will compare these two populations to understand what differences between them may explain the difference in prevalence.
Study Type
OBSERVATIONAL
Enrollment
360
no intervention
Restore Hope for Africa
Goma, North Kivu, Democratic Republic of the Congo
Dietary sulfur amino acid
mg of sulfur amino acid in the diet per kg of body weight
Time frame: one measure at one time point within three weeks of registration
dietary sulfur amino acid above or below WHO estimated average requirement (EAR)
the total sulfur amino acid in the diet will be calculated from a diet recall this will be a bivariate measure, "1" if the SAA in the diet is above or "0" if below the WHO/FAO requirement for sulfur amino acid intake of 17mg of sulfur amino acids per kg of body weight per day
Time frame: one measure at one time point within three weeks of registration
calories and protein in diet per kg of body weight
intake of calories (kcal/kg body weight), digestibility adjusted protein - sum of (grams of protein per food item x digestibility of food item) per kg of body weight quality adjusted protein = digestibility adjusted protein in the diet x proportion of requirement of the limiting amino acid
Time frame: one measure at one time point within three weeks of registration
urinary sulfate
sulfate excreted in the urine, normalized to creatinine
Time frame: one measure at one time point within three weeks of registration
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