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Am J Clin Nutr. 2014 Jan;99(1):198-208. doi: 10.3945/ajcn.113.063883. Epub 2013 Nov 13.

Linear growth increased in young children in an urban slum of Haiti: a randomized controlled trial of a lipid-based nutrient supplement.

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Institute for Public Health, George Warren Brown School of Social Work, Washington University, St Louis, MO (LLI, SJLD, JG, SJ, JF, M-LA, CL, and JM); the Notre Dame de la Sagesse Nursing School, Cap-Haïtien, Haiti (SJLD and SJ); Konbit Sante, Portland, ME (NMN); and Konbit Sante, Cap-Haïtien, Haiti (NMN).



Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children.


We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children.


Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally.


Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm.


A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at as NCT01552512.

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