Dietary Diversity of Young Children During CoVID-19 Outbreak: A Longitudinal Study

Study Overview
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Brief Summary
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The 2019-2020 coronavirus pandemic has had far-reaching consequences beyond the spread of the disease. Quarantine measures during a public health pandemic can be particularly detrimental to urban poor families and affect the dietary diversity and food security. This can disproportionately affect young children aged 6 and below, and severely impact those <2 years. Sudden unemployment may result in an unexpected reduction in income that will place pressure on daily budgets for food. Children of families may not have access to foods of adequate diversity that will enable them to meet their macro and micronutrient requirements for growth and development, especially during the Movement Control Order (MCO). The study plans to monitor and evaluate dietary diversity in young children's food intake after the MCO and use the collected information to direct targeted food aid to address observed macro- and micronutrient deficiencies among the urban vulnerable group.

Detailed Description
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Children are the future to our society. The first thousand days of life, starting from conception till one's second birthday is a critical period of cognitive and physical development. It is the most sensitive period where brain development is most receptive to positive nutrition. Any form of malnutrition, especially during this golden time frame, can lead to irreversible effects to growth, health, education and future career attainment to our potential leaders, which in turn can be a barrier to human development. The CoVID outbreak is a unique period in recent human history where drastic public health measures such as MCO for an extended period of time has to be implemented nation-wide. These measures have untold severe consequences on the food security of the vulnerable urban group, in particular the young children whose brains require diverse micronutrients to support the rapid growth. These micronutrients can only be obtained from a daily diet that is equally diverse, especially from fresh vegetables and fruits which will be short in supplies. These perishable food items are not usually included in food aids, thus the child may have to subsist on staple-rich diet which are energy-dense but nutrient-poor. These dietary practices are associated with negative health outcomes. Thus by monitoring dietary diversity of the children, we hope to better inform food aid organisations to consider the inclusion of healthier food options to prevent micronutrient deficiencies.

Official Title
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Dietary Diversity of Young Children During CoVID-19 Outbreak: A Longitudinal Study

Conditions
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Dietary Diversity

Intervention / Treatment
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* Other: Dietary counselling on Food Groups according to IYC Feeding practices, WHO


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All well-children aged between 6 months and 6 years Exclusion Criteria: Children with chronic illnesses

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 6 Years

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Child Health Clinic (CHC)<br>Children attending CHC for routine vaccinations and follow-up in a tertiary center Parents will be counselled on food groups based on Infant and Young Children feeding practices. Monthly telephone calls to collect data on dietary diversity - 4 telephone calls in total. Anthropometric measurements and Blood investigations for hemoglobin and iron status at the start and end of study - optional | Other: Dietary counselling on Food Groups according to IYC Feeding practices, WHO<br>* Monitoring of Dietary diversity and growth<br>* Other names: Anthropometric measurements and Blood investigations for hemoglobin and iron status (optional);|
| Community Children<br>Children of urban poor families living in low-cost flats around Kuala Lumpur. Parents will be counselled on food groups based on Infant and Young Children feeding practices. Monthly telephone calls to collect data on dietary diversity - 4 telephone calls in total. Anthropometric measurements and Blood investigations for hemoglobin and iron status at the start and end of study - optional | Other: Dietary counselling on Food Groups according to IYC Feeding practices, WHO<br>* Monitoring of Dietary diversity and growth<br>* Other names: Anthropometric measurements and Blood investigations for hemoglobin and iron status (optional);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Minimal Dietary Diversity (MDD) of more than 5 food groups in 24 hours | Number of food groups in 24 hours | 24 hours | 
| Height | Height increase in centimetres | 4 months | 
| Weight | Weight increase in kilogram | 4 months | 
| Meal frequencies in past 24 hours | Number of meal frequencies | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood hemoglobin in children at the start of study and 4 months later | Change in gram/L | 4 months | 
| Serum ferritin in children at the start of study and 4 months later | Change in microgram/L | 4 months | 
| Consumption of sugar and processed foods | Number of types | 1 month | 
| Food Aids received | Types of food groups | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dietary diversity, micro-nutrient adequacy, young children, urban settings