A Clinical Trial to Study the Impact of a Nutritional Beverage on Tests of Memory in Healthy Preschool Age Children

Study Overview
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Brief Summary
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The effect of supplementation using both protein and multiple micronutrients in preschool age children on cognitive performance and growth is unknown. The study will compare the effect of combination of protein and multiple micronutrients on indicators of cognitive performance and growth in preschool age children. Cognitive performance and anthropometric assessments will be measured at baseline and at 6 months.

Official Title
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A Double Blind Randomised Controlled Trial in Pre-school Age Children to Evaluate the Impact of a Nutritional Beverage Powder on Cognitive Performance Measures

Conditions
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Cognition

Intervention / Treatment
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* Other: Test beverage powder (High Proteins and added micronutrients)
* Other: Control beverage powder (Low protein and no added micronutrients)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Consent: Demonstrates understanding of the study and willingness to participate as evidenced by subject's parents or legally authorised representative's voluntary written informed consent and has received a signed and dated copy of the informed consent form. Compliance : Understands and is willing, able and likely to comply with all study procedures and restrictions General Health : Good general and mental health with, in the opinion of the investigator Child with BMI for age between <+1 standard deviation (SD) to > -2SD Exclusion Criteria: Children in Care (CiC): A child who has been placed under the control or protection of an agency, organisation, institution or entity by the courts, the government or a government body, acting in accordance with powers conferred on them by law or regulation. Allergy/Intolerance: Known or suspected intolerance or hypersensitivity to the study materials (lactose, wheat gluten, soy protein) or any of their stated ingredients. Child with severe anaemia (Haemoglobin < 7 g/dl) as determined by the non invasive spectrophotometry results. Participation in another clinical study or receipt of an investigational drug within 30 days of the screening visit. Participation in any nutritional study or didactic nutrition education in the last 6 months of the screening visit 5. Current or relevant history of any serious, severe or unstable physical or psychiatric illness or any medical disorder that would make the subject unlikely to fully complete the study or any condition that presents undue risk from the study product or procedures in the opinion of the investigator. 6. Recent history (3 months) of serious infections, injuries and/ or surgeries. 7. Children consuming iron, calcium and/or other nutritional supplements and/ or health food drinks on a regular basis (more than 3 times a week, in the recommended dosage) in the last 1 month prior to screening visit. 8. Use of any prescription medications during the study period for more than or equal to two weeks.

Ages Eligible for Study
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Minimum Age: 36 Months
Maximum Age: 65 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Test beverage powder<br>30 grams of cereal beverage powder with protein and added micronutrients will be made up to 100 mL drink using luke warm water. Subjects will be administered two doses of the drink (100 mL each) everyday | Other: Test beverage powder (High Proteins and added micronutrients)<br>* High protein and added Micronutrients at recommended dietary allowance levels<br>|
| Active Comparator: Control beverage powder<br>30 grams of cereal beverage powder with low protein and no added micronutrients will be made up to 100 mL using luke warm water. Subjects will be administered two doses of the drink (100 mL each) everyday | Other: Control beverage powder (Low protein and no added micronutrients)<br>* Low protein and no added micronutrients<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change From Baseline in Short Term Memory at 6 Months | Short term memory was measured using word order and number recall sub tests of Kaufman Assessment Battery for Children (KABC).In Number Recall, child was asked to repeat series of number in same sequence after making sure that child is paying attention.A score of 0 and 1 given for incorrect and correct response respectively. In Word Order,qualified site staff said series of words and child then pointed pictures of those words in same sequence.Later items (object cards with pictures) included an interference task in which child named colors after hearing the word. Each subtest score was the total of item scores, ranging from 0-31 for word order and 0-22 for number recall. The two subtest scores were standardized for each subject and visit (Z score), and short term memory was calculated as the average of the two standardized values where higher scores reflect better short term memory. | Baseline and 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change From Baseline in Weight at 6 Months | Weight was measured (single measurement) in standard clothing on weighing scale to the nearest 0.1kilograms(kg). | Baseline and 6 months | 
| Change From Baseline in Height at 6 Months | Height was measured (single measurement) using a portable stadio-meter, with the participant standing bare-foot, to the nearest 0.1centimeters (cm). | Baseline and 6 months | 
| Change From Baseline in Body Mass Index (BMI) at 6 Months | BMI for was obtained using the World Health Organization Anthroplus software version 1.0.2. | Baseline and 6 months | 
| Change From Baseline in Triceps Skin Fold (TSF) at 6 Months | The TSF was measured in the midline of the posterior aspect of the arm, over the triceps muscle, at a level midway between the lateral projection of the acromion process of the scapula and the inferior margin of the olecranon process of the ulna. The right elbow is flexed at 90°and the midpoint between the acromion and the olecranon process is located and marked at the lateral side of the arm. The skinfold was then measured with the arm hanging loosely while standing. The triceps skinfold was picked up with the left thumb and index finger approximately 1cm proximal to the marked level and the tips calipers were applied to the skin-fold at the marked level. The triceps measurement was done (three measurements) using Holtain calipers to the nearest 0.2 millimeters (mm) and the average value was recorded. | Baseline and 6 months | 
| Change From Baseline in Mid Upper Arm Circumference (MUAC) at 6 Months | The MUAC (single measurement) was measured midway between the acromion and the olecranon process, while the participant stands with the elbow flexed at 90. The circumference was measured with a fiber glass tape to the nearest 0.1 cm on the right hand. | Baseline and 6 months | 
| Change From Baseline in Arm Muscle Area (AMA) and Arm Fat Area (AFA) at 6 Months | Using the MUAC measurement and TSF measurement, the arm muscle AMA and AFA were calculated i.e. AMA (cm2) = (MUAC-(π*TSF))2/4 π and AFA (cm2) = (MUAC2/4π) - AMA | Baseline and 6 months | 
| Number of Ill Days at 6 Months | Number of ill days due to cold, cough and/or associated fever were recorded. The mean number of ill days due was analyzed at 6 months using Analysis of Variance (ANOVA). | Baseline upto 6 months | 
| Change From Baseline in Problem Solving at 6 Months | Test measured visual construction ability, understanding of spatial relationships and problem solving abilities. The child arranged flat shapes of various sizes and colors (items) to match a model or picture as instructed by the qualified staff. For items 1 to 2 (score 2 for success on first trial and 1 on second trial); items 3 to 10 (Score 1 for success and 0 for failure on first trial). The test continued till 3 consecutive scores of 0. The Raw score was the total of item score. Score range 0-29. Higher scores reflect better short term memory | Baseline and 6 months |