There is one clinical trial.
Protein is one type of nutrients known as the cause of stunting in developing countries since the mid-1970s (1) but then less attention on protein intake with the assumption that protein intake is sufficient. Compilation of published and non-published dietary intake research among Indonesian children aged 3-12 years (2), 0-18 years old (3) and 1-3 years old (3) found that protein intake among Indonesian children was sufficient (4). This finding is also confirmed by some other studies in 6 low-income countries and lead to the conclusion that growth restriction is not due to protein deficiency (5). Since then, micronutrient received main attention for the past 4 decades (1) to improve the health and survival of young children in developing countries. Issues on the need to re-examined protein recently emerge after the paper of Semba (1,6) regarding the low circulating amino acid among stunted children. It was hypothesized that the correlation between the low level of circulating amino acid with linear growth was through the mechanism of rapamycin complex C1 (mTORC1) and general control nonderepressible 2 (GCN2) pathway that contributes in the synthesis of sphingolipids and glycerophospholipids (6). However, the mechanism on how amino acid link to linear growth remains unclear. Fortification among Asian children revealed that only milk as food vehicles reported a significant effect on linear growth (2). It is likely that the effect on linear growth is influenced not only on micronutrient content of the fortified foods but also on protein and amino acid profiles of milk as the food vehicle.
The analysis will be performed using Nutrisurvey 2017 with Indonesian food composition table.. VDR Gene Polymorphism of SNP rs4516035 and rs11568820.
Description: Height of the subject will be measured using Shorrboard. Height measurement will be taken twice, the difference between 1st and 2nd measurements should be not more than 0.7 cm. The data analyzed using WHO AnthroPlus to obtain height for age z-score (HAZ) of the subject.Measure: Increasing of children height who receive intervention from baseline Time: 3 days in end-line of study
Description: Dietary of energy intake, macronutrients, calcium and other micronutrients related to growth will be assessed using 24-hour recall with multiple-pass interviewing technique. The analysis will be performed using Nutrisurvey 2017 with Indonesian food composition table.Measure: nutrient intakes Time: 3 days in baseline and end-line
Description: The SNP Genotyping assay analyzed using Real Time PCR and StepOne V2.3 Software. A total of 40 cycles will performed. The cycling steps of the analysis are Hold (95oC, 20s), Denaturation (95oC, 3s), Annealing Extension (60oC, 20s). The total running time was about one and a half hours for 40 cycles.Measure: VDR Gene Polymorphism of SNP rs4516035 and rs11568820 Time: in middle of study (2 months after baseline)
Description: The expression of 5' TOP genes as biomarker of downstream mTORC1 pathway will be analyzed using RT-qPCR and StepOne V2.3 Software. mRNA quantified by SYBR Green reaction. A total of 40 cycles will performed. The cycling steps of the analysis are UDG activation (50oC, 2min), Dual-Lock DNA polymerase (95oC, 2min), Denaturation (95oC, 3s), Annealing Extension (60oC, 30s). The total running time was about half an hour for 40 cycles.Measure: gene expression of mTORC1 pathway Time: 3 days in end-line of study