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Protein type for children U2 and Pregnant and Lactating women- Specific guidance?

This question was posted the Infant and young child feeding interventions forum area and has 6 replies. You can also reply via email – be sure to leave the subject unchanged.

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Charulatha Banerjee

Terre des hommes Foundation

Normal user

21 Sep 2015, 09:59

Are there any specific guidelines on what should be the protein sources and distribution between animal and plant protein for adequate nutrition in children U2 and for PLW?
In communities where animal protein is expensive or for communities with vegetarian diets can an increased intake of legumes and nuts compensate for the lack of animal protein?

Any references and opinions from this expert forum will be much appreciated.

Many thanks

Mark Myatt

Consultant Epideomiologist

Frequent user

21 Sep 2015, 13:12

I am not an expert but I can venture an opinion ... from an "assessment" perspective.

Animal sources protein contain all of the essential amino acids and might be called "complete protein sources". Plant sources of protein are often not complete protein sources. Some are ... Soya, for example, is a complete protein source. A diet with a mix of vegetable sources of protein is likely to be protein complete.

If you are concerned about protein completeness then you can collect data on food intake (a small sample will probably be OK if diets do not vary much ... you will probably only want to look at the least wealthy group) and use food tables to assess protein completeness. You might also look at zinc and iron as diets containing animal protein are likely to also contain sufficient quantities of zinc and iron compared to mainly vegetarien diets. A simpler approach would be to use the food groups from the DDS component of an IYCF score. I think you might want to use more food groups than the seven traditionally used in IYCF indicator sets. Remember to include "wild foods" such as insects, snails, grubs, &c. as these can be important "coping" foods.

What you find from your assessment of diet can inform interventions ... you might (e.g.) decide that a targeted or universal LNS distribution or SFP.

Remember that we expect U2 kids to be breastfed (a source of animal protein). You will want to also look at the diets or PLWs (ad your question suggests).

I think we do need a true expert opinion here as much written on vegetarian diets is ideological.

Charulatha Banerjee

Terre des hommes Foundation

Normal user

5 Oct 2015, 11:22

Thank you very much Dr Myatt for your response. I am also looking for articles on the subject and will share with this forum if I find something useful.

Felicity Savage

Chair, World Alliance for Breastfeeding Action

Technical expert

5 Oct 2015, 12:00

I was very glad to see at the end of a comment the reference to breastmilk - which is of course the most ideal protein for children, and can help to balance any incomplete vegetable sources. Other animal milks are also a useful source of protein, though not as good a match for the human infant as breast milk. One of the main reasons for eating meat in fact is not the protein content, but the iron and zinc content, and the protein can be fairly easily substituted with a mix of legumes and cereals and other vegetables.
Readers may be interested to look out for Edition 3 of "Nutrition for Developing Countries" currently being printed with Oxford University press, and publication expected within a month.

Charulatha Banerjee

Terre des hommes Foundation

Normal user

6 Oct 2015, 05:02

Dear Dr Felicity,

Thank you for your response and bringing attention to the book- I located a pre order option and look forward to reading it.

One clarification- The basic understanding of First class proteins being Animal protein especially meat vs Second class protein being from legumes and pulses or other vegetable sources - is this still valid? Or has more recent research told us otherwise?

For poor populations where no cultural barriers exist to consumption of animal meat the main barriers are cost. But costs of pulses and legumes are also on the rise and additionally do not "satisfy" a population which associates meat with the best nutrition. I look forward to any comments you might have from your extensive experience on this.

Many thanks

André BRIEND

Frequent user

6 Oct 2015, 06:57

Dear Charulatha

The assessment of protein quality is discussed in a recent FAO WHO report available at:

http://www.fao.org/ag/humannutrition/35978-02317b979a686a57aa4593304ffc17f06.pdf

To answer specifically to your question, animal proteins are usually of better quality than plant proteins, but you can balance and improve the profile of plant proteins by mixing up different sources (cereals + legumes).

Animal source foods seem superior, however, to plant based foods to promote children growth. See for instance:

Dagnelie PC, van Staveren WA. Macrobiotic nutrition and child health: results of a population-based, mixed-longitudinal cohort study in The Netherlands. Am J Clin Nutr. 1994 May;59(5 Suppl):1187S-1196S.

It is not clear whether this effect is related to a better quality of proteins. Another possible explanation is that nutrients needed for growth (in particular Zn and phosphorus) are better absorbed in animal source foods which don’t have antinutrients preventing their absorption.

Charulatha Banerjee

Terre des hommes Foundation

Normal user

6 Oct 2015, 07:28

Thank you very much for the links and your very clear response Dr Briend. Much appreciated. Cheers

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