Nutrigenomics, PUFA, Iron and Cognition Amongst Under-two-year-old Indonesian Children
NCT ID: NCT01504633
Last Updated: 2014-02-26
Study Results
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Basic Information
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UNKNOWN
NA
240 participants
INTERVENTIONAL
2011-12-31
2014-12-31
Brief Summary
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Objectives: This study aims to assess gene-nutrient inter-relation in explaining the effect of LCPUFAs i.e. DHA and/or iron on cognitive functioning of children \<24mo in Indonesia. Specifically the study's objectives are: (1) to assess effect of LCPUFA (as DHA oil) and iron (as iron supplement) in altering gene expressions, and (2) to assess the mediating effect of genes involved in fatty acid and iron metabolism in improving serum LCPUFA, alpha-linolenic acids (ALA), DHA and cognitive function.
Study design and study population: The study is a double-blind randomized controlled trial with children aged less than 24 months (window of opportunity). The study area is in East Lombok district, in West Nusa Tenggara province, Indonesia where nutrient intake including iron and presumably LCPUFA, is not optimal.
Intervention: The study is an intervention study, consisting of four groups: DHA, iron, DHA+iron, and placebo (60 subjects/group = 240 subjects in total). Capsule containing 100mg/d DHA or its placebo and syrup containing 16mg/d iron will be given daily for 24 weeks. Before and after the intervention child cognition (as Bayley Mental Developmental Index or MDI score), serum PUFA level, iron status (haemoglobin, transferrin receptor, ferritin), inflammation status (CRP, AGP), gene expression profiles, and potential confounders of child cognition such as lengt-for-age, weight-for-length, and weight-for-age Z-scores, stimulation/home environment, maternal characteristics will be collected.
Study outcome: The primary study outcomes will be cognitive score (as Bayley Mental Developmental Index or MDI score) and gene expression profiles. Secondary study outcomes will be serum PUFA level, iron status (haemoglobin, TfR, ferritin).
Nature and extent of the burden and risks benefit and group relatedness:
Subjects, who will be included into the study will invest 14 hours. The consumption of iron is not associated with any increased risk of iron overload both for infectious (including malaria) and chronic diseases nor consumption of n-3 fatty acids EPA and DHA exceed the US Food and Drug Administrator (FDA) Generally Recognized as Save (GRAS) limit. Venous blood of 5 mL will be drawn at baseline and endline. During screening, children with severe anaemia (Hb\<70g/L) will be excluded from the study and referred to the local public health center for further treatment.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
FACTORIAL
QUADRUPLE
Study Groups
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DHA+EPA Group
DHA/EPA capsule (100mg DHA + 20mg) and placebo syrup per day
DHA/EPA and iron supplementation
24-week supplementation consisting of daily dosage of DHA/EPA or placebo capsule and iron/placebo syrup Capsule: DHA/EPA (100mg DHA + 20mg per day) or placebo Syrup: Fe syrup (16mg elemental iron per day) or placebo
Fe Group
Placebo capsule and Fe syrup (16mg elemental iron) per day
DHA/EPA and iron supplementation
24-week supplementation consisting of daily dosage of DHA/EPA or placebo capsule and iron/placebo syrup Capsule: DHA/EPA (100mg DHA + 20mg per day) or placebo Syrup: Fe syrup (16mg elemental iron per day) or placebo
DHA/EPA+Fe Group
DHA/EPA capsule (100mg DHA + 20mg) and Fe syrup (16mg elemental iron) per day
DHA/EPA and iron supplementation
24-week supplementation consisting of daily dosage of DHA/EPA or placebo capsule and iron/placebo syrup Capsule: DHA/EPA (100mg DHA + 20mg per day) or placebo Syrup: Fe syrup (16mg elemental iron per day) or placebo
Placebo Group
Placebo capsule and placebo syrup
DHA/EPA and iron supplementation
24-week supplementation consisting of daily dosage of DHA/EPA or placebo capsule and iron/placebo syrup Capsule: DHA/EPA (100mg DHA + 20mg per day) or placebo Syrup: Fe syrup (16mg elemental iron per day) or placebo
Interventions
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DHA/EPA and iron supplementation
24-week supplementation consisting of daily dosage of DHA/EPA or placebo capsule and iron/placebo syrup Capsule: DHA/EPA (100mg DHA + 20mg per day) or placebo Syrup: Fe syrup (16mg elemental iron per day) or placebo
Eligibility Criteria
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Inclusion Criteria
* Both father and mother of Sasak ethnicity
* Currently breastfed
Exclusion Criteria
* Congenital malformation and/or disorder that interfered with adequate functioning in daily life
* Hemoglobin value below 70 g/L
* Malaria
* Maternal depression
12 Months
16 Months
ALL
Yes
Sponsors
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Wageningen University
OTHER
Indonesia University
OTHER
Responsible Party
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Umi Fahmida
Principal Investigator
Principal Investigators
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Umi Fahmida, PhD
Role: PRINCIPAL_INVESTIGATOR
SEAMEO Regional Center for Food and Nutrition (RECFON) University of Indonesia
Locations
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SEAMEO Regional Center for Food and Nutrition (RECFON) University of Indonesia
Jakarta, DKI Jakarta, Indonesia
Countries
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References
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Arterburn LM, Hall EB, Oken H. Distribution, interconversion, and dose response of n-3 fatty acids in humans. Am J Clin Nutr. 2006 Jun;83(6 Suppl):1467S-1476S. doi: 10.1093/ajcn/83.6.1467S.
Bouwens M, van de Rest O, Dellschaft N, Bromhaar MG, de Groot LC, Geleijnse JM, Muller M, Afman LA. Fish-oil supplementation induces antiinflammatory gene expression profiles in human blood mononuclear cells. Am J Clin Nutr. 2009 Aug;90(2):415-24. doi: 10.3945/ajcn.2009.27680. Epub 2009 Jun 10.
Bouwens M, Grootte Bromhaar M, Jansen J, Muller M, Afman LA. Postprandial dietary lipid-specific effects on human peripheral blood mononuclear cell gene expression profiles. Am J Clin Nutr. 2010 Jan;91(1):208-17. doi: 10.3945/ajcn.2009.28586. Epub 2009 Nov 18.
Cunnane SC, McAdoo KR. Iron intake influences essential fatty acid and lipid composition of rat plasma and erythrocytes. J Nutr. 1987 Sep;117(9):1514-9. doi: 10.1093/jn/117.9.1514.
El-khayat H, Shaaban S, Emam EK, Elwakkad A. Cognitive functions in protein-energy malnutrition: in relation to long chain-polyunsaturated fatty acids. Pak J Biol Sci. 2007 Jun 1;10(11):1773-81. doi: 10.3923/pjbs.2007.1773.1781.
Idjradinata P, Pollitt E. Reversal of developmental delays in iron-deficient anaemic infants treated with iron. Lancet. 1993 Jan 2;341(8836):1-4. doi: 10.1016/0140-6736(93)92477-b.
Koletzko B, Demmelmair H, Schaeffer L, Illig T, Heinrich J. Genetically determined variation in polyunsaturated fatty acid metabolism may result in different dietary requirements. Nestle Nutr Workshop Ser Pediatr Program. 2008;62:35-44; discussion 44-9. doi: 10.1159/000146246.
Kwik-Uribe CL, Gietzen D, German JB, Golub MS, Keen CL. Chronic marginal iron intakes during early development in mice result in persistent changes in dopamine metabolism and myelin composition. J Nutr. 2000 Nov;130(11):2821-30. doi: 10.1093/jn/130.11.2821.
McCann JC, Ames BN. Is docosahexaenoic acid, an n-3 long-chain polyunsaturated fatty acid, required for development of normal brain function? An overview of evidence from cognitive and behavioral tests in humans and animals. Am J Clin Nutr. 2005 Aug;82(2):281-95. doi: 10.1093/ajcn.82.2.281.
McCann JC, Ames BN. An overview of evidence for a causal relation between iron deficiency during development and deficits in cognitive or behavioral function. Am J Clin Nutr. 2007 Apr;85(4):931-45. doi: 10.1093/ajcn/85.4.931.
Murray-Kolb LE, Beard JL. Iron deficiency and child and maternal health. Am J Clin Nutr. 2009 Mar;89(3):946S-950S. doi: 10.3945/ajcn.2008.26692D. Epub 2009 Jan 21.
Oloyede OB, Folayan AT, Odutuga AA. Effects of low-iron status and deficiency of essential fatty acids on some biochemical constituents of rat brain. Biochem Int. 1992 Aug;27(5):913-22.
Smuts CM, Tichelaar HY, van Jaarsveld PJ, Badenhorst CJ, Kruger M, Laubscher R, Mansvelt EP, Benade AJ. The effect of iron fortification on the fatty acid composition of plasma and erythrocyte membranes in primary school children with and without iron deficiency. Prostaglandins Leukot Essent Fatty Acids. 1995 Jan;52(1):59-67. doi: 10.1016/0952-3278(95)90098-5.
Stangl GI, Kirchgessner M. Different degrees of moderate iron deficiency modulate lipid metabolism of rats. Lipids. 1998 Sep;33(9):889-95. doi: 10.1007/s11745-998-0285-8.
Rajilic-Stojanovic M, Heilig HG, Molenaar D, Kajander K, Surakka A, Smidt H, de Vos WM. Development and application of the human intestinal tract chip, a phylogenetic microarray: analysis of universally conserved phylotypes in the abundant microbiota of young and elderly adults. Environ Microbiol. 2009 Jul;11(7):1736-51. doi: 10.1111/j.1462-2920.2009.01900.x. Epub 2009 Mar 11.
Shinta D; Asmarinah; Adhiyanto C, Htet MK, Fahmida U. The Association of TMPRSS6 Gene Polymorphism and Iron Intake with Iron Status among Under-Two-Year-Old Children in Lombok, Indonesia. Nutrients. 2019 Apr 19;11(4):878. doi: 10.3390/nu11040878.
Fahmida U, Htet MK, Adhiyanto C, Kolopaking R, Yudisti MA, Maududi A, Suryandari DA, Dillon D, Afman L, Muller M. Genetic variants of FADS gene cluster, plasma LC-PUFA levels and the association with cognitive function of under-two-year-old Sasaknese Indonesian children. Asia Pac J Clin Nutr. 2015;24(2):323-8. doi: 10.6133/apjcn.2015.24.2.17.
Related Links
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South East Asia Ministers of Education Organization, Regional Center for Food and Nutrition, University of Indonesia
Other Identifiers
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NUPICO-Indonesia
Identifier Type: -
Identifier Source: org_study_id
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