Abstract
Limited evidence is available on the associations of high-quality protein and energy intake, serum transthyretin (TTR), serum amino acids and serum insulin-like growth factor-1 (IGF-1) with linear growth of young children. Data collected during the baseline of a randomized control trial involving rural Ethiopian children aged 6–35 months (n = 873) were analyzed to evaluate the associations among height/length-for-age z-scores, dietary intakes, and these biomarkers (i.e., serum level of TTR, IGF-1, tryptophan and lysine, and inflammation). The prevalence of stunting was higher for children >23 months (38%) than ≤23 months (25%). The prevalence of inflammation was 35% and of intestinal parasites 48%. Three-quarters of the children were energy deficient, and stunted children had lower daily energy intake that non-stunted children (p < 0.05). Intakes of tryptophan, protein, and energy, and serum levels of tryptophan and IGF-1 were positively correlated with the linear growth of children. Controlling for inflammation, intestinal parasites, and sociodemographic characteristics, daily tryptophan (b = 0.01, p = 0.001), protein (b = 0.01, p = 0.01) and energy (b = 0.0003, p = 0.04) intakes and serum TTR (b = 2.58, p = 0.04) and IGF-1 (b = 0.01, p = 0.003) were positively associated with linear growth of children. Linear growth failure in Ethiopian children is likely associated with low quality protein intake and inadequate energy intake. Nutrition programs that emphasize improved protein quantity and quality and energy intake may enhance the linear growth of young children and need to be further investigated in longitudinal and interventional studies.
Highlights
IntroductionAn estimated 151 million children were affected by linear growth failure in 2017 [1]
An estimated 151 million children were affected by linear growth failure in 2017 [1].Linear growth failure in early childhood as a manifestation of chronic undernutrition is a major public health problem in developing countries [2]
The analyses of serum transthyretin, serum insulin-like growth factor-1 (IGF-1), AGP, and C-reactive protein (CRP) were conducted at the Ethiopian
Summary
An estimated 151 million children were affected by linear growth failure in 2017 [1]. The role of protein-energy and high-quality protein intake on linear growth of children has so far been poorly studied in developing countries [6,7]. When children have inadequate intake of protein and essential amino acids, their serum transthyretin (TTR), serum amino acids (AAs), as well as serum IGF-1 level maybe low, which may, in turn, reduce the growth of children This relationship has not been studied in developing countries with higher levels of inflammation. This study is the first to investigate the associations among the intakes of protein, energy, and the essential amino acids tryptophan and lysine; serum levels of TTR, lysine, Nutrients 2017, 9, x FOR PEER REVIEW tryptophan, and IGF-1; and linear growth of Ethiopian children. Materials and Methods children [12]
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