Effect of a 3-Month Modified, High-Quality Take-Home Ration on Linear Growth and Body Composition in Rural South Indian Infants Aged 6–9 Months: A Cluster-Randomized Controlled Trial
8 affiliations
- 1Centre for Doctoral Studies, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
- 2Division of Nutrition, St. John’s Research Institute, St. John’s National Academy of Health Sciences (a Unit of CBCI Society for Medical Education), Bangalore 560034, Karnataka, India
- 3Division of Epidemiology and Biostatistics, St. John’s Research Institute, St. John’s National Academy of Health Sciences (a Unit of CBCI Society for Medical Education), Bangalore 560034, Karnataka, India
- 4Department of Traditional Foods and Applied Nutrition, CSIR-Central Food Technological Research Institute, Mysuru 570020, Karnataka, India
- 5Department of Grain Science and Technology, CSIR-Central Food Technological Research Institute, Mysuru 570020, Karnataka, India
- 6Department of Food Engineering, CSIR-Central Food Technological Research Institute, Mysuru 570020, Karnataka, India
- 7Food Safety & Analytical Quality Control Laboratory, CSIR-Central Food Technological Research Institute, Mysuru 570020, Karnataka, India
- 8Department of Physiology, St. John’s Medical College, St. John’s National Academy of Health Sciences (a Unit of CBCI Society for Medical Education), Bangalore 560034, Karnataka, India
Abstract
Background/Objectives: Linear growth faltering remains a major public health concern in low- and middle-income countries, wherein sub-optimal complementary feeding and hygiene practices are key modifiable factors. Inadequate complementary feeding is addressed through government-issued Take-Home Ration (THR) for <3-year-old children. This THR is not consumed regularly and does not bridge deficits in protein quality and fat intake among South Indian rural children. The addition of milk and legumes into a reformulated THR would address these gaps, but its efficacy remains unknown. Methods: In this 3-month cluster-randomized controlled trial among rural infants (6–9 months old), the intervention group (12 village clusters; n = 67) received a modified milk-and legume-based THR along with standard government THR, while the control group (12 village clusters; n = 67) received standard government THR alone. Caregivers of both groups were educated on nutrition and hygiene practices. Anthropometry, body composition (BC), morbidity, diet, and compliance data were collected. The primary outcome (length-for-age z-score (LAZ)) and secondary outcomes were analyzed using cluster-adjusted linear mixed models (LMM) in an intention-to-treat analysis. Results: While LAZ did not differ significantly between groups (β = 0.063 LAZ/month, 95%CI: −0.019, 0.145; p = 0.130), adjusted LMM showed significant differences in length (0.213 cm/month, 95%CI: 0.025, 0.400, p = 0.027), weight (0.040 kg/month, 95%CI: 0.001, 0.079, p = 0.044) and head circumference (0.067 cm/month, 95%CI: 0.005, 0.128, p = 0.033). LAZ decreased in both groups, with a significantly lower decline in the intervention group (slope difference: β = 0.05, 95% CI: 0.006, 0.095, p = 0.027). BC did not differ significantly. Conclusions: Improving protein quality and fat content of the government-issued THR showed a favourable LAZ trajectory among infants from rural South India. (Clinical Trial Registry-India: CTRI/2020/06/025825).
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BibTeX
@article{kilpady2026effect,
title = {{Effect of a 3-Month Modified, High-Quality Take-Home Ration on Linear Growth and Body Composition in Rural South Indian Infants Aged 6–9 Months: A Cluster-Randomized Controlled Trial}},
author = {Chaitra A. Kilpady and Akshata A. Kamath and Aswathi Saji and Sridevi Annapurna Singh and Usha Dharmaraj and Chakkaravarthi Arugakeerthy and Vanajakshi Vasudeva and Nirupama Shivakumar and Anura V. Kurpad},
journal = {Nutrients},
year = {2026},
month = nov,
doi = {10.3390/nu18213654},
url = {https://www.mdpi.com/2072-6643/18/21/3654},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effect of a 3-Month Modified, High-Quality Take-Home Ration on Linear Growth and Body Composition in Rural South Indian Infants Aged 6–9 Months: A Cluster-Randomized Controlled Trial
AU - Chaitra A. Kilpady
AU - Akshata A. Kamath
AU - Aswathi Saji
AU - Sridevi Annapurna Singh
AU - Usha Dharmaraj
AU - Chakkaravarthi Arugakeerthy
AU - Vanajakshi Vasudeva
AU - Nirupama Shivakumar
AU - Anura V. Kurpad
PY - 2026
DA - 2026/11/03
JO - Nutrients
DO - 10.3390/nu18213654
UR - https://www.mdpi.com/2072-6643/18/21/3654
AB - Background/Objectives: Linear growth faltering remains a major public health concern in low- and middle-income countries, wherein sub-optimal complementary feeding and hygiene practices are key modifiable factors. Inadequate complementary feeding is addressed through government-issued Take-Home Ration (THR) for <3-year-old children. This THR is not consumed regularly and does not bridge deficits in protein quality and fat intake among South Indian rural children. The addition of milk and legumes into a reformulated THR would address these gaps, but its efficacy remains unknown. Methods: In this 3-month cluster-randomized controlled trial among rural infants (6–9 months old), the intervention group (12 village clusters; n = 67) received a modified milk-and legume-based THR along with standard government THR, while the control group (12 village clusters; n = 67) received standard government THR alone. Caregivers of both groups were educated on nutrition and hygiene practices. Anthropometry, body composition (BC), morbidity, diet, and compliance data were collected. The primary outcome (length-for-age z-score (LAZ)) and secondary outcomes were analyzed using cluster-adjusted linear mixed models (LMM) in an intention-to-treat analysis. Results: While LAZ did not differ significantly between groups (β = 0.063 LAZ/month, 95%CI: −0.019, 0.145; p = 0.130), adjusted LMM showed significant differences in length (0.213 cm/month, 95%CI: 0.025, 0.400, p = 0.027), weight (0.040 kg/month, 95%CI: 0.001, 0.079, p = 0.044) and head circumference (0.067 cm/month, 95%CI: 0.005, 0.128, p = 0.033). LAZ decreased in both groups, with a significantly lower decline in the intervention group (slope difference: β = 0.05, 95% CI: 0.006, 0.095, p = 0.027). BC did not differ significantly. Conclusions: Improving protein quality and fat content of the government-issued THR showed a favourable LAZ trajectory among infants from rural South India. (Clinical Trial Registry-India: CTRI/2020/06/025825).
SN - 2072-6643
ER -