The purpose of this study is to evaluate the effects of experimental growing up milk (EXPL) as compared to traditional children's fortified milk (CTRL) fed for 6 months on bone mass index.
A randomized, double-blind controlled clinical trial was chosen to study the effects of toddler milk containing L. reuteri and GOS (4g/L) and a low sn-1, -3 fat blend when compared to a control formula. There is an additional unblinded habitual intake reference group (REF) for "real-world" comparison (including 58% non-dairy drinkers according to observational data).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
TRIPLE
Enrollment
273
Fortified cow's milk
Milk with synbiotics and fat blend
Habitual diet
Asian Foundation for Tropical Medicine, Inc.
City of Muntinlupa, Philippines
Speed of sound (SOS)
Speed of sound (SOS) using a quantitative ultrasound methods measured by Pediatric Sunlight 9000 device
Time frame: Day 1, Day 90, Day 180
GI tolerance and stooling patterns
Stool patterns including stool frequency will be recorded retrospectively via 24-hour GI Symptom and Behavior Recall
Time frame: Day 1
GI tolerance and stooling patterns
Stool patterns including stool consistency will be recorded retrospectively via 24-hour GI Symptom and Behavior Recall
Time frame: Day 1
GI tolerance and stooling patterns
Stool patterns including stool frequency will be recorded using 3-day GI Symptom and Behavior diary
Time frame: Day 90, Day 180
GI tolerance and stooling patterns
Stool patterns including stool consistency will be recorded using 3-day GI Symptom and Behavior diary
Time frame: Day 90, Day 180
GI tolerance and stooling patterns
Parent perceptions of GI symptoms using parent-reported questionnaire Toddler Gut Comfort Questionnaire (GCQ) using VAS from 1-Never to 6-Always with higher scores indicating increasing GI burden.
Time frame: Day 1, Day 90, Day 180
GI tolerance and stooling patterns
Parent perceptions of GI-related behaviors using parent-reported questionnaire Toddler Gut Comfort Questionnaire (GCQ) using VAS from 1-Never to 6-Always with higher scores indicating increasing GI burden.
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Time frame: Day 1, Day 90, Day 180
Stool analyses
Excretion of fecal calcium fatty acid soaps
Time frame: Day 1, Day 180
Stool analyses
Measurement of stool calcium content
Time frame: Day 1, Day 180
Serum vitamin D
Measured by serum 25\[OH\]D concentration requiring 1mL of whole blood sample.
Time frame: Day 1, Day 180
Urine and Blood bone turnover markers
Bone accretion markers in urinary \[C-terminal cross-linked telopeptides of type I collagen (CTX)
Time frame: Day 1, Day 180 (EXPL and CTRL groups only)
Urine and Blood bone turnover markers
serum procollagen type I N-terminal propeptide (PINP)
Time frame: Day 1, Day 180 (EXPL and CTRL groups only
Gut microbiota
Gut microbiota analyzed for microbiome composition and diversity using next generation shotgun metagenomics sequencing, requiring 3g of stool sample.
Time frame: Day 1, Day 180
Stool analyses
Determination of fecal short chain fatty acids (SCFAs)
Time frame: Day 1, Day 180
Stool analyses
Fecal pH and metabolism.
Time frame: Day 1, Day 180
Stool analyses
Fecal markers of gut health
Time frame: Day 1, Day 180
Physical strength
Hand grip test (Jamar hand dynamometer) tailored for toddlers will be used as previously described Bohannon et al Pediatric Physical Therapy 2017.
Time frame: Day 1, Day 180
Vitamin B
serum vitamin B concentration requiring 2 mL of whole blood sample.
Time frame: Day 1, Day 180
Dietary intake patterns
Intake patterns are assessed using parent-reported questionnaire Child Eating Behavior Questionnaire including variety of food groups consumed as well as behaviors rated from Never to Always.
Time frame: Day 1, Day 180
Child quality of life using validated ITQOL SF-47 questionnaire
assessed using the parent-reported questionnaires
Time frame: Day 1, Day 180
Outdoor Playtime
Assessed using parent-reported questionnaire on Outdoor Playtime recording number of hours child spent outside.
Time frame: Day 1 and Day 180
Child temperament
Children's Behavior Questionnaire (very short form), consisting of 36 questions and 3 scales on child temperament domains Surgency, Negative Affect and Effort Control with each question ranging 1-extremely untrue to 7- extremely true of parent observing various behaviors.
Time frame: Day 1, Day 180