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Open AccessArticle

Associations among High-Quality Protein and Energy Intake, Serum Transthyretin, Serum Amino Acids and Linear Growth of Children in Ethiopia

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Division of Human Nutrition, Wageningen University, 6700 AA Wageningen, The Netherlands
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Ethiopian Public Health Institute, Gulele Sub City, P.O. Box 1242, Addis Ababa, Ethiopia
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Human Nutrition Unit, Jimma University, P.O. Box 378, Jimma, Ethiopia
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Department of Nutrition Science and Public Health Graduate Program, Purdue University, West Lafayette, IN 47907, USA
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Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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International Maize and Wheat Improvement Centre (CIMMYT), P.O. Box 5689, Addis Ababa, Ethiopia
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International Maize and Wheat Improvement Centre (CIMMYT), P.O. Box 1041-00621, Nairobi, Kenya
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Author to whom correspondence should be addressed.
Nutrients 2018, 10(11), 1776; https://doi.org/10.3390/nu10111776
Received: 31 August 2018 / Revised: 5 November 2018 / Accepted: 9 November 2018 / Published: 16 November 2018
(This article belongs to the Special Issue Complementary Feeding in Infants)
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. View Full-Text
Keywords: protein intake; protein quality; energy intake; serum transthyretin; serum IGF-1; inflammation; linear growth; Ethiopia protein intake; protein quality; energy intake; serum transthyretin; serum IGF-1; inflammation; linear growth; Ethiopia
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Tessema, M.; Gunaratna, N.S.; Brouwer, I.D.; Donato, K.; Cohen, J.L.; McConnell, M.; Belachew, T.; Belayneh, D.; De Groote, H. Associations among High-Quality Protein and Energy Intake, Serum Transthyretin, Serum Amino Acids and Linear Growth of Children in Ethiopia. Nutrients 2018, 10, 1776.

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