Research: IANNOTTI and COLLEAGUES,

Listed in Issue 238

Abstract

IANNOTTI and COLLEAGUES,  (1)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) tested the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children in Haiti.

Background

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

Methodology

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

Results

Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modelling 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.

Conclusion

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

References

Iannotti LL(1), Dulience SJ, Green J, Joseph S, François J, Anténor ML, Lesorogol C, Mounce J, Nickerson NM. Linear growth increased in young children in an urban slum of Haiti: a randomized controlled trial of a lipid-based nutrient supplement. Am J Clin Nutr. 99(1):198-208. doi: 10.3945/ajcn.113.063883. Epub 2013 Nov 13. Jan 2014.

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