Development of Appetite Measuring Tool and Appetite Status of Stunted Children
Condition: Nutritional Stunting
MeSH terms: Growth Disorders
Study type: Interventional

Summary: 
      This study will provide a tool for researchers to measure important outcomes in relation to
      trial of intervention to reduce or prevent stunting.

      Hypothesis: We assume that appetite score will be associated with improvement in growth and
      development parameters of children given the nutrition and psychosocial stimulation
      intervention

      Objectives:

      To explore maternal perception regarding childhood stunting To develop and validate an
      appetite measuring tool To assess the appetite status of young children To examine the
      relationship between appetite score, growth and development, potential biomarkers of
      appetite, child food intake and intestinal inflammation of the children.

      Methods: In the first phase, a qualitative study will be conducted to explore maternal
      perception regarding childhood stunting and to develop a tool- the "Early Childhood Appetite
      and Satiety Tool"(ECAST) using mixed method approach (qualitative and quantitative). In the
      second phase, a community-based trial will be conducted with 50 stunted children of aged
      12-18 months, living in urban slums of Dhaka, and 50 age-sex matched control children
      (non-stunted).
    

Detailed description: 
      The stunted children will receive an intervention package which includes food supplementation
      (FS) with one egg and 150 ml of whole milk supplementing the usual home diet, 6 days a week
      for 3 months; psychosocial stimulation (PS) for 6 months, and routine clinical care monthly
      for 6 months. The control children will receive routine clinical care but no FS and PS.
      Routine clinical care includes micronutrients powder, de-worming, health and nutrition
      education and immunization. All children will be assessed for appetite score (ECAST score)
      and anthropometry-at baseline then monthly for 6 months; food intake at baseline then monthly
      for 3 months, and cognitive development using Bayley Scales of Infant and Toddler
      Development, third version (Bayley-III) on enrolment and at 3 and 6 months of enrolment.
      Blood samples will be collected to examine gut hormones, complete blood count and haemoglobin
      percentage.

      Stool samples will be collected for routine examination and stool biomarkers. Urine sample
      will be collected for screening urinary tract infection. All the specimens will be collected
      at baseline and at 3 and 6 months of enrollment.

      Outcome measures/variables:

      The primary outcome:

      Assessment of appetite score of stunted children aged 12-18 months compared to non-stunted
      children.

      The secondary outcomes are:

      -Association of appetite score with growth and development with potential biomarkers of
      appetite with child food intake and intestinal inflammation of the children.
    

Intervention name(s): Food supplementation
Intervention type(s): Dietary Supplement
Intervention description(s): Arm 1 will be given food supplementation (FS), psychosocial stimulation (PS) and routine clinical care will be given and arm will be provided only with routine clinical care.
The control children will receive routine clinical care but no FS or PS.
Other intervention name(s): Routine clinical care, psychosocial stimulation
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Appetite, Stunting, Satiety, Children