MAGNUS

Milk affecting growth, cognition and the gut in child stunting

The study aims to assess the effects of nutritional supplementation with milk components – milk protein and whey permeate – on growth and development of stunted children. In addition, the role of the gut in stunting and modification of the effects of supplementation is assessed.

Medical examination

 

  • During the 12-week study, children that did not receive any supplement became more stunted and had an unhealthy change in body composition. We found that their height-for-age z-score declined, and relative to their height, these children accumulated fat mass and lost fat-free mass.
  • In contrast, the children that received any of the 4 lipid-based nutrient supplements increased in height-for-age z-score and fat-free mass, however not fat mass. There was no difference in catch-up growth between children below and above 2 years.
  • In the main analyses of the randomized 2x2 factorial trial, we showed that there were no additional effects of adding milk protein or whey permeate to lipid-based nutrient supplements on linear growth or body composition.
  • We conclude that since children on a growth faltering trajectory gain fat at the expense of fat-free mass if they are left untreated, programs using lipid-based nutrient supplements to treat stunting should be considered.

 

 

  1. Lewis, J. I., Friis, H., Mupere, E., Wells, J. C. & Grenov, B. Calibration of Bioelectrical Impedance Analysis Against Deuterium Dilution for Body Composition Assessment in Stunted Ugandan Children. The Journal of Nutrition 153, 426–434 (2023).

  2. Mbabazi, J., Pesu, H., Mutumba, R., Filteau, S., Lewis, J. I., Wells, J. C., Olsen, M. F., Briend, A., Michaelsen, K. F., Mølgaard, C., Ritz, C., Nabukeera-Barungi, N., Mupere, E., Friis, H. & Grenov, B. Effect of milk protein and whey permeate in large quantity lipid-based nutrient supplement on linear growth and body composition among stunted children: A randomized 2 × 2 factorial trial in Uganda. PLoS Med 20, e1004227 (2023).

  3. Mbabazi, J., Pesu, H., Mutumba, R., McCray, G., Michaelsen, K. F., Ritz, C., Filteau, S., Briend, A., Mupere, E., Grenov, B., Friis, H. & Olsen, M. F. Effect of Milk Protein and Whey Permeate in Large-Quantity Lipid-Based Nutrient Supplement on Early Child Development among Children with Stunting: A Randomized 2 × 2 Factorial Trial in Uganda. Nutrients 15, 2659 (2023)

  4. Mbabazi, J., Pesu, H., Mutumba, R., Bromley, K., Ritz, C., Filteau, S., Briend, A., Mupere, E., Grenov, B., Friis, H. & Olsen, M. F. Correlates of early child development among children with stunting: A cross-sectional study in Uganda. Matern Child Nutr e13619 (2024). doi:1111/mcn.13619

  5. Mutumba, R., Mbabazi, J., Pesu, H., Greibe, E., Olsen, M. F., Briend, A., Mølgaard, C., Ritz, C., Mupere, E., Filteau, S., Friis, H. & Grenov, B. Micronutrient Status and Other Correlates of Hemoglobin among Children with Stunting: A Cross-Sectional Study in Uganda. Nutrients 15, 3785 (2023).

  6. Mutumba, R., Pesu, H., Mbabazi, J., Greibe, E., Olsen, M. F., Briend, A., Mølgaard, C., Ritz, C., Nabukeera-Barungi, N., Mupere, E., Filteau, S., Friis, H. & Grenov, B. Correlates of Iron, Cobalamin, Folate, and Vitamin A Status among Stunted Children: A Cross-Sectional Study in Uganda. Nutrients 15, 3429 (2023).

  7. Mutumba, R., Pesu, H., Mbabazi, J., Greibe, E., Nexo, E., Olsen, M. F., Briend, A., Mølgaard, C., Michaelsen, K. F., Ritz, C., Filteau, S., Mupere, E., Friis, H. & Grenov, B. Effect of lipid-based nutrient supplements on micronutrient status and hemoglobin among children with stunting: secondary analysis of a randomized controlled trial in Uganda. The American Journal of Clinical Nutrition 119, 829–837 (2024).

  8. Pesu, H., Mbabazi, J., Mutumba, R., Savolainen, O., Olsen, M. F., Mølgaard, C., Michaelsen, K. F., Ritz, C., Filteau, S., Briend, A., Mupere, E., Friis, H. & Grenov, B. Correlates of Plasma Citrulline, a Potential Marker of Enterocyte Mass, among Children with Stunting: A Cross-Sectional Study in Uganda. The Journal of Nutrition 154, 765–776 (2024).

  9. Pesu, H., Mutumba, R., Mbabazi, J., Olsen, M. F., Mølgaard, C., Michaelsen, K. F., Ritz, C., Filteau, S., Briend, A., Mupere, E., Friis, H. & Grenov, B. The Role of Milk Protein and Whey Permeate in Lipid-based Nutrient Supplements on the Growth and Development of Stunted Children in Uganda: A Randomized Trial Protocol (MAGNUS). Curr Dev Nutr 5, nzab067 (2021).

 

 

 

 

 

 

 

 

 

Involved in the project

Internal

Name Title Phone E-mail
Benedikte Grenov Associate Professor +4520456654 E-mail
Christian Mølgaard Professor +4535332516 E-mail
Henrik Friis Professor +4535333860 E-mail
Mette Frahm Olsen Associate Professor +4528340979 E-mail
Name Title Institution
André Briend Affiliate Professor Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark

External

Name Title Institution
Hannah Pesu Jespersen PhD-student Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
Ezekiel Mupere MD, PhD, Head, Ug Principal Investigator Department of Paediatrics and Child Health, Makerere University & CFU, Uganda
Joseph Mbabazi MSc, PhD-student Department of Paediatrics and Child Health, Makerere University & CFU, Uganda
Rolland Mutumba MD, PhD-student Department of Paediatrics and Child Health, Makerere University & CFU, Uganda
Suzanne Filteau MSc, PhD, Prof. London School of Hygiene and Tropical Medicine, UK
Jonathan Wells MSc, PhD, Prof, Institute of Child Health, University College London, UK

Funded by

  • AFH Arla Food for Health
  • The Danish Dairy Research Foundation
  • Nutriset
  • Various Danish foundations:
    • Læge Sofus Carl Emil Friis og Hustru Olga Doris Friis Legat
    • Augustinus Fonden
    • P. Møller Fonden til Lægevidenskabens Fremme

Period: 2019 - 2022.

Contact

Benedikte Grenov
Associate Professor