Evaluating the impact of an oral nutrition supplement on biochemical profile, growth, and body composition in Indian children: an in-silico study

Abstract

Background: In-silico modeling provides a valuable approach for predicting the effects of nutritional interventions on child growth, particularly in settings where large-scale human trials are challenging. Validated, population-level predictive platforms optimize dosing and intervention strategies, facilitating the development of targeted nutritional approaches that enhance growth outcomes in children.

Objective: This study aims to assess the impact of an oral nutrition supplement (ONS) intervention on biochemical and growth parameters of Indian children using an in-silico intervention approach.

Methods: An energetics-based modeling framework was developed to simulate the growth trajectories of children aged 6-16 years, integrating national datasets for Indian children. The model, validated with published literature, was designed to predict the effects of nutritional interventions. This study evaluated the impact of two Horlicks Oral Nutrition Supplement (ONS) formulations with varying micronutrient dosages on key growth outcomes. Various intervention scenarios were simulated, including comparisons of ONS with water vs. milk, and interventions with different nutrient compositions, such as macronutrients alone or a combination of macro- and micronutrients. The primary outcomes of the study focused on both biochemical and physical growth changes. Key serum nutrient levels were analyzed, alongside anthropometric measures such as height, weight, and body composition indicators, including fat-free mass, fat mass, and bone mineral content, over simulated periods of 4, 8, and 12 months.

Results: The in-silico analysis predicted that two servings of Horlicks with milk significantly improved anthropometric and body composition parameters compared to both milk alone and other experimental groups. Biochemically, the Horlicks intervention led to notable increases in serum nutrient levels, which correlated with higher growth velocities and enhanced body composition relative to plain milk. The model underscored the critical role of combined macro- and micronutrient supplementation, with two servings yielding more pronounced effects than one.

Conclusion: This study provides important insights into the potential benefits of Horlicks interventions for enhancing child growth outcomes. It underscores the effectiveness of computational models in the preliminary assessment of nutrition interventions, providing foundation for targeted clinical studies to improve child health and development. However, it is important to note that the model benchmarking was conducted using data from the Indian population, and the findings may not be directly applicable to other ethnicities without further validation.

Keywords: biochemical profile; body composition; child growth; in silico study; oral nutrition supplement.

Figure 1

Child growth model representation. M/F, Male/Female; BF%, Body fat percentage; BW, Body weight; FM init, Initial fat mass; FFMinit, Initial fat-free mass; BMC init, Initial bone mineral content; CPF%, Carbohydrate, Protein, Fat percentage; RDA, Recommended Dietary Allowance; TEF, Thermic effect of Food; BMR, Basal Metabolic Rate.

Figure 2

Validating predictions of intervention-led anthropometric changes using published studies. The bar plots represent data from the sample studies, while the lines indicate predicted values. (A) Zinc supplementation; (B) Protein supplementation. Box: interquartile range; top, middle, and bottom edge of the box: Q1, Q2, Q3 respectively. Blue bars: Control; Brown bars: Intervention; Blue dotted line: Prediction for control; Orange solid line: Prediction for intervention.

Figure 3

Validation of anthropometric and body composition parameters against clinical data. (A) Predicted height; (B) Predicted weight; (C) Body fat percentage; (D) BMC (bone mineral content). Straight line: 45° line; Dotted line: Error percentage.

Figure 4

Percentage of RDA satisfied for key micronutrients by both the ONS formulations, given in addition to the basal diet. Box: interquartile range; top, middle, and bottom edge of the box: Q1, Q2, Q3, respectively. Blue: Group 4 (Plain milk); Brown: Group 5 (Horlicks-New); Orange: Group 7 (Horlicks).

Figure 5

Post-intervention changes in anthropometric parameters among Group 1 (Control), Group 2 (1 serve Horlicks-New), and Group 3 (2 serves Horlicks-New). (A) Percent change in height. (B) Percent change in weight. Gray: Group 1 (Control); Pink: Group 2 (1 serve Horlicks-New); Orange: Group 3 (2 serves Horlicks-New).

Figure 6

Gender-wise depiction of post-intervention change in height and weight among Group 4 (Plain milk) and Group 5 (Horlicks-New) children aged 6–9 years. (A) Height change in girls; (B) Height change in boys; (C) Weight change in girls; (D) Weight change in boys. Blue: Group 4 (Plain milk); Brown: Group 5 (Horlicks-New).

Figure 7

Gender-wise depiction of post-intervention change in height and weight among Group 4 (Plain milk) and Group 5 (Horlicks-New) children aged 10 to 16 years. (A) Height change in girls; (B) Height change in boys; (C) Weight change in girls; (D) Weight change in boys. Blue: Group 4 (Plain milk); Brown: Group 5 (Horlicks-New).

Figure 8

Post-intervention changes in anthropometric parameters among Group 4 (Plain milk) and Group 5 (Horlicks-New). (A) Percent change in height. (B) Percent change in weight. (C) Percent change in body mass index (BMI). Blue: Group 4 (Plain milk); Brown: Group 5 (Horlicks-New).

Figure 9

Post-intervention changes in body composition parameters among Group 4 (Plain milk) and Group 5 (Horlicks-New). (A) Percent change in FFM (fat-free mass). (B) Percent change in FM (fat mass). (C) Percent change in BMC (bone mineral content). Blue: Group 4 (Plain milk); Brown: Group 5 (Horlicks-New).

Figure 10

Post-intervention changes in anthropometric parameters among Group 5 (Horlicks-New) and Group 6 (Macronutrient-only). (A) Percent change in height. (B) Percent change in weight. Brown: Group 5 (Horlicks-New); Green: Group 6 (Macronutrient-only).