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Matern Child Nutr. 2015 Dec;11 Suppl 4:132-43. doi: 10.1111/mcn.12068.

Effect of complementary feeding with lipid-based nutrient supplements and corn-soy blend on the incidence of stunting and linear growth among 6- to 18-month-old infants and children in rural Malawi.

Author information

1
College of Medicine, University of Malawi, Blantyre, Malawi.
2
University of Tampere, School of Medicine, Tampere, Finland.
3
Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore.
4
University of California, Davis, California, USA.
5
Washington University School of Medicine, St. Louis, Missouri, USA.
6
Ministry for Social Affairs and Health, Tampere, Finland.
7
Department of Paediatrics, Tampere University Hospital, Tampere, Finland.

Abstract

Low nutritional value of complementary foods is associated with high incidence of childhood growth stunting in low-income countries. This study was done to test a hypothesis that dietary complementation with lipid-based nutrient supplements (LNS) promotes linear growth and reduces the incidence of severe stunting among at-risk infants. A total of 840 6-month-old healthy infants in rural Malawi were enrolled to a randomised assessor-blinded trial. The participants received 12-month supplementation with nothing, milk-LNS, soy-LNS, or corn-soy blend (CSB). Supplements provided micronutrients and approximately 280 kcal energy per day. Outcomes were incidence of severe and very severe stunting [length-for-age z-score, (LAZ) < -3.00 and <-3.50, respectively], and change in LAZ. The incidence of severe stunting was 11.8%, 8.2%, 9.1% and 15.5% (P = 0.098) and that of very severe stunting 7.4%, 2.9%, 8.0% and 6.4% (P = 0.138) in control, milk-LNS, soy-LNS and CSB groups, respectively. Between 9 and 12 months of age, the mean change in LAZ was -0.15, -0.02, -0.12 and -0.18 (P = 0.045) for control, milk-LNS, soy-LNS and CSB groups, respectively. There was no significant between-group difference in linear growth during other age-intervals. Although participants who received milk-LNS had the lowest incidence of severe and very severe stunting, the differences between the groups were smaller than expected. Thus, the results do not provide conclusive evidence on a causal association between the LNS supplementation and the lower incidence of stunting. Exploratory analyses suggest that provision of milk-LNS, but not soy-LNS promotes linear growth among at-risk infants mainly between 9 and 12 months of age.

KEYWORDS:

children; complementary feeding; infants; linear growth; lipid-based nutrient supplements; stunting

PMID:
23795976
DOI:
10.1111/mcn.12068
[Indexed for MEDLINE]
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