MAGNUS

Stunting, low height-for-age, is associated with delays in cognitive development and risk of chronic disease later in life.

Previous nutrition trials have focused on prevention of stunting by improving complementary diets of young children with corn-soy blend, which is used to prepare porridge, or small-quantity lipid-based nutrient supplements (SQ-LNS), an energy and nutrient dense paste based on peanuts.

However, there have not been any trials which provide supplements with larger amounts of milk or other high-quality proteins to already stunted children.

This may in part be due to previous concerns that stunted children will gain excess fat mass and so increase their risk of chronic disease.

We aim to assess the individual and combined effects of milk protein and whey permeate in large-quantity LNS (LNS-LQ) among stunted children on linear growth and other outcomes.

The study is a randomised, double-blind, two-by-two factorial trial, testing the effects of milk protein and whey permeate in LNS-LQ (100g/510-530 kcal).

An unsupplemented group is included to assess the overall effect of LNS. Children aged 12-59 months, with a height-for-age Z-score of less than -2 will be included from Jinja, Uganda (n=750).

The primary outcomes are change in knee-heel and total length/height over 12 weeks.

Secondary outcomes are child development, body composition, anthropometric indicators (mid-upper arm circumference, weight, head-circumference, weight-for-age, height-for-age and weight-for-height Z scores) and haemoglobin.

In addition, growth factors, markers of micronutrient status, systemic and intestinal inflammation and intestinal function, as well as the microbiota will be explored.

Our findings will contribute to an understanding of the role of specific milk ingredients in linear catch-up growth, and clarify to what extent milk ingredients will benefit important functional outcomes such as cognition.