We commend Semba et al. (2016) for examining child stunting in
the context of protein and amino acids, which, beyond supplying essential
nitrogen for protein synthesis, are involved in regulation of linear
growth, an issue that has not been addressed sufficiently. The authors
reported significant associations between low levels of serum amino
acids and stunting in a cross-sectional study of young children in rural
Malawi. As the authors note, studies of micronutrient and lipid supplements
have failed to demonstrate improved linear growth in malnourished
children. Furthermore, the ten most effective interventions
recommended for scale up at the global level are likely to reduce
stunting by only ~20% even at a coverage level of 90% (Bhutta et al.,
2013). Thus, we are writing to comment on the findings of Semba et
al., highlight relevant past and current research and advocate for further
collaborative effort forward in the area of protein quality and childhood
stunting.