TY - JOUR
T1 - Chicken liver and eggshell crackers as a safe and affordable animal source food for overcoming micronutrient deficits during pregnancy and lactation in Indonesia
T2 - A double-blind, randomised placebo-controlled trial (SISTIK Growth Study)
AU - Diana, Aly
AU - Rahmannia, Sofa
AU - Suhadi, Yenni Zuhairini
AU - Luftimas, Dimas Erlangga
AU - Rizqi, Haidar
AU - Purnamasari, Afini Dwi
AU - Jihadillah, Ayunda
AU - Ansari, Mohammad Brachim
AU - Haq, Dearly Ayu Zahrotun
AU - Pratiwi, Aisyah Nur
AU - Scott, Samuel
AU - Hampel, Daniela
AU - Allen, Lindsay H.
AU - Haszard, Jillian J.
AU - Houghton, Lisa A.
AU - Gibson, Rosalind S.
AU - Fahmida, Umi
N1 - Funding Information:
Special thanks to Prof. Anna Alisjahbana, Frontiers for Health (F2H), the people of the communities, and our team of dedicated research assistants, cadres, midwives, and primary health centres' staff.
Publisher Copyright:
© 2022 Diana A et al.
PY - 2022
Y1 - 2022
N2 - Background: Indonesia ranks fifth in terms of the number of stunted children and there has been little change in the stunting prevalence in the last decade. In earlier observational studies conducted in 2014-2015, we identified several key underlying problems with the potential to impact stunting in Sumedang district, West Java, Indonesia. Deficits in intakes of growth-limiting micronutrients were observed, most notably calcium, iron, zinc, and vitamin A, emphasizing the need for a food-based intervention to overcome these micronutrient deficits in the diets of mothers and their infants. Methods: A double-blind placebo-controlled cluster randomised trial comparing the effect of daily consumption of 75 grams of locally produced micronutrient-enriched crackers (MEC) (intervention group) compared to placebo crackers (control group) by mothers at two-time intervals: (i) from the 8-14 weeks of pregnancy to delivery (i.e., 28-34 weeks of consumption of MEC) on birth length, and (ii) from the 8-14 weeks of pregnancy to 5 months post-partum on attained linear growth and linear growth velocity of breast-fed infants. A total of 324 pregnant women from 28 clusters (villages) located in 3 sub-districts in Sumedang district, West Java, Indonesia, will be randomly assigned to either intervention (n=14 villages) or control (n=14 villages). Discussion: This will be the first study in Indonesia to use crackers based on powdered eggshells and chicken liver, in a form which is acceptable, safe, and has a long shelf life. If daily consumption of MEC for 6 months during pregnancy can enhance birth length, or their continued daily consumption for 5 months postpartum improves both attained and incremental linear growth at 5 months of age, then scaling-up in Indonesia may be considered.
AB - Background: Indonesia ranks fifth in terms of the number of stunted children and there has been little change in the stunting prevalence in the last decade. In earlier observational studies conducted in 2014-2015, we identified several key underlying problems with the potential to impact stunting in Sumedang district, West Java, Indonesia. Deficits in intakes of growth-limiting micronutrients were observed, most notably calcium, iron, zinc, and vitamin A, emphasizing the need for a food-based intervention to overcome these micronutrient deficits in the diets of mothers and their infants. Methods: A double-blind placebo-controlled cluster randomised trial comparing the effect of daily consumption of 75 grams of locally produced micronutrient-enriched crackers (MEC) (intervention group) compared to placebo crackers (control group) by mothers at two-time intervals: (i) from the 8-14 weeks of pregnancy to delivery (i.e., 28-34 weeks of consumption of MEC) on birth length, and (ii) from the 8-14 weeks of pregnancy to 5 months post-partum on attained linear growth and linear growth velocity of breast-fed infants. A total of 324 pregnant women from 28 clusters (villages) located in 3 sub-districts in Sumedang district, West Java, Indonesia, will be randomly assigned to either intervention (n=14 villages) or control (n=14 villages). Discussion: This will be the first study in Indonesia to use crackers based on powdered eggshells and chicken liver, in a form which is acceptable, safe, and has a long shelf life. If daily consumption of MEC for 6 months during pregnancy can enhance birth length, or their continued daily consumption for 5 months postpartum improves both attained and incremental linear growth at 5 months of age, then scaling-up in Indonesia may be considered.
KW - Food based intervention
KW - Indonesia
KW - Lactation
KW - Linear growth
KW - Micronutrient deficiencies
KW - Pregnancy
KW - Stunting
UR - http://www.scopus.com/inward/record.url?scp=85134839880&partnerID=8YFLogxK
U2 - 10.12688/wellcomeopenres.17879.1
DO - 10.12688/wellcomeopenres.17879.1
M3 - Article
C2 - 35865219
AN - SCOPUS:85134839880
SN - 2398-502X
VL - 7
JO - Wellcome Open Research
JF - Wellcome Open Research
M1 - 167
ER -