Impact of School Milk Program on Nutritional Status of Primary School Children
Condition: Milk Intervention on Body Composition and School Attendance
Study type: Interventional

Summary: 
      Malnutrition is very common in Pakistan, especially in children of under developed areas due
      to lack of resources and access to nutritious food. It can disturb the normal physical and
      mental development as well as functioning in children which can put economic burden on
      country level.

      Therefore, school meal programs can play an important role in providing school children with
      healthy and nutritious food which can improve their nutritional status as well as overall
      health.
    

Detailed description: 
      The proposed intervention study was conducted in the primary school going children of age
      4-16 years old in two districts of Punjab namely Attock and Sheikhpura with collaboration of
      University of Veterinary and Animal Sciences, Lahore, University of Education, Lahore and
      Friesland Campina (Engro Foods Pvt. Ltd.), Pakistan. The participants of study was students
      studying in classes nursery to 5, out of study population of 90 Schools of different tehsils
      of two districts (Attock city and Sheikupura city), Punjab-Pakistan that are being run by the
      administration of University of Education, Lahore.

      The study participants for research are 8.9 % of 7799 total population involved in school
      milk program children i.e. total 693 (380 Attock city and 313 Sheikhupura). A total of 18
      schools (9 from each district) was selected as a sample of the study population, since there
      were three groups (A-Group to receive Full Cream Milk; B-Group to receive Flavored Milk;
      C-Group is control) and three schools in each districts form each group. In addition, the
      selected schools have been selected in each district in a way in both selected districts to
      have a uniform population of around 160±5.

      At initiation of the study, baseline data was collected from the study participants. Data
      regarding socio-demographic factors, 24-hrs dietary recall, anthropometric, school
      attendance, body composition, dietary deficiency signs and symptoms was collected from study
      population i.e. 693 students. After baseline findings, for dietary intervention, the sample
      population based on schools was divided into 3 clusters/group including control, Ultra High
      Temperature (UHT) and flavored milk as intervention groups (i.e., UHT and flavored milk
      groups, were given milk (180 mL/participants/day; on alternate days basis and/or daily basis
      as the case may be owing to Covid situation) for 3 months. The data was collected from study
      participants at different intervals initiation (baseline) and termination (3 months),
      whereas, data after 2 months of termination will be collected to estimate washout period
      differences of the intervention on the study parameters. After the completion of study, the
      control group will also receive milk for same duration on humanitarian basis.

      Inclusion Criteria: Children having no symptoms of Lactose Intolerance Exclusion Criteria:
      Children having symptoms of Lactose Intolerance

      Informed Consent and other considerations:

      All the protocols of study were explained to study participants/teachers and informed consent
      was obtained prior to enrollment in the study. The data was considered as relevant and
      reliable, if 70% of the sample (compared to start of the study) completes the study with
      minimum of 80% of allocated milk consumption. If any student(s) wants to quit during the
      course of the study, he/she do it on his/her will and was not forced to complete the study.

      Data Analysis:

      Descriptive analysis was carried out by using SPSS version 25 (SPSS for windows version 25;
      SPSS Inc., Chicago, IL, USA), Microsoft excel and World Health Organization Anthroplus
      (Software) was used to calculate height for age and BMI for age z scores. The data was
      analyzed by using independent sample t-test, paired sample t-test and one-way ANOVA,
      statistical significance was at p > 0.05.
    

Intervention name(s): UHT Milk; Flavored Milk
Intervention type(s): Combination Product; Combination Product
Intervention description(s): In this group of participants, UHT milk, 180 mL was provided and results were compared with control and flavored milk group; In this group of participants, flavored milk, 180 mL was provided and results were compared with control and UHT group
Allocation: Non-Randomized
Intervention model: Factorial Assignment
Intervention model description: There were three groups in study. Group A is the one which received UHT Milk, Group B received Flavored Milk and Group C was a control group.
Masking: None (Open Label)
Primary purpose: Other