Clinical trial NCT04447209: Dietary Diversity of Young Children During CoVID-19 Outbreak: A Longitudinal Study
Official title: Dietary Diversity of Young Children During CoVID-19 Outbreak: A Longitudinal Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Dietary Diversity
Keywords: Dietary diversity
micro-nutrient adequacy
young children
urban settings
consumption of sugar sweetened foods and beverages
Lead sponsor: University of Malaya
Sponsor class: OTHER
First posted: 2020-06-25
Enrollment: 350
Sex: ALL
Minimum age (years): 6
Maximum age (years): 6
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: 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: 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.

Eligibility criteria: Inclusion Criteria:

* All well-children aged between 6 months and 6 years

Exclusion Criteria:

* Children with chronic illnesses

Primary outcomes:
measure: Minimal Dietary Diversity (MDD) of more than 5 food groups in 24 hours
timeFrame: At study completion, an average of 9 months.
measure: Consumption of fruits and vegetables, pre and post-intervention
timeFrame: At study completion, an average of 9 months.
measure: Consumption of sugar-sweetened foods and beverages, pre and post-intervention
timeFrame: At study completion, an average of 9 months.
measure: Height and Weight z-scores, pre and post-intervention
timeFrame: At study completion, an average of 9 months.
Secondary outcomes:
measure: Blood hemoglobin in children at the start of study and 4 months later
timeFrame: At study completion, an average of 9 months.
measure: Serum ferritin in children at the start of study and 4 months later
timeFrame: At study completion, an average of 9 months.
Other outcomes:
Locations:
city: Kuala Lumpur
country: Malaysia
facility: University of Malaya Medical Center
state: Wilayah Persekutuan Kuala Lumpur
Study officials:
affiliation: University of Malaya Medical Center
name: Mohammad Y Jalaludin, MBBS MPaeds
role: STUDY_DIRECTOR
References:
citation: World Health Organization. Indicators for assessing infant and young child feeding practices Part 1: Definitions. Geneva: WHO; 2008
citation: Working Group on Infant and Young Child Feeding Indicators. Developing and validating simple indicators of dietary quality of infants and young children in developing countries: Additional analysis of 10 data sets. Report submitted to: the Food and Nutrition Technical Assistance (FANTA) Project/Academy for Educational Development (AED), July 2007
citation: Kennedy GL, Pedro MR, Seghieri C, Nantel G, Brouwer I. Dietary diversity score is a useful indicator of micronutrient intake in non-breast-feeding Filipino children. J Nutr. 2007 Feb;137(2):472-7. doi: 10.1093/jn/137.2.472.
citation: Cusick SE, Georgieff MK. The Role of Nutrition in Brain Development: The Golden Opportunity of the "First 1000 Days". J Pediatr. 2016 Aug;175:16-21. doi: 10.1016/j.jpeds.2016.05.013. Epub 2016 Jun 3. No abstract available.
citation: Steyn NP, Nel JH, Nantel G, Kennedy G, Labadarios D. Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy? Public Health Nutr. 2006 Aug;9(5):644-50. doi: 10.1079/phn2005912.
citation: World Health Organization, Geneva. 2017; Global Nutritional Monitoring Framework: Operational guidance for tracking progress in meeting targets for 2025