This study will be comprised of 2 phases. Phase 1 study is a comparative cross-sectional study which will be conducted among children aged 12-24 months living in agricultural area. A total of 172 healthy children consisted of 86 stunted children (Length for age z-score \<-2 Standard deviation) and 86 non-stunted children (Length for age z-score ≥0.5 Standard Deviation) will be recruited. Dietary intake, urine and dried blood spot from finger prick will be collected to assess amino acid intake, intestinal permeability and essential blood amino acid respectively. Qualitative study i.e. focus group discussion (FGD) and market survey will also be implemented. According to the result of phase 1 study, 2 types of food-based approaches will be developed, namely Complementary food recommendations (CFR) and Food multi-mix formula
Phase 1 study will recruit a total of 172 healthy children who are matched by sex and age. Aside of being stunted, children must have normal weight for length z-score (not wasted or overweight). Data collection will be performed as follows: 1. Dietary intake of the children will be collected by 9 days Estimated Food Record by visiting the respondents house 2. Urine will be collected once to measure intestinal permeability profile using Lactulose Mannitol ratio indicator. 3. Dried blood spot from finger prick will be collected to essential blood amino acid. To collect information on locally available and culturally accepted protein rich food sources, series of focus group discussion (FGD) and market survey will also be implemented. Food-based approaches will be developed according to the information attained from phase 1 study. Problem nutrients that are identified from dietary assessment will be fulfilled through optimization of locally available food by using linear programming approach. Problem nutrients that are not able to be fulfilled by CFR will be use as a basis to develop a Food multi-mix (FMM) formula. Data of intestinal permeability profile will be used to add other locally available food in FMM that are potential to improve intestinal permeability.
Study Type
OBSERVATIONAL
Enrollment
172
Amino acid intake
Amino acid intake will be assessed by estimated food record
Time frame: January - February 2020
Blood amino acid
Essential blood amino acid will be measured from finger prick dried blood spot and will be analyzed using LC-MS/MS
Time frame: January - April 2020
Intestinal Permeability
Intestinal permeability will be measured from urine and will be analyzed using HPLC
Time frame: January-April 2020
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