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    Lipid-based nutrient supplementation in the first 1000 d improves child growth in Bangladesh: a cluster-randomized effectiveness trial

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    Date
    2017-03-18
    Publisher
    © 2017 American Journal of Clinical Nutrition
    Author
    Dewey, Kathryn G
    Mridha, Malay K
    Matias, Susana L
    Arnold, Charles D
    Cummins, Joseph R
    Khan, Md Showkat Ali
    Maalouf-Manasseh, Zeina
    Siddiqui, Zakia
    Ullah, Md Barkat
    Vosti, Stephen A
    Metadata
    Show full item record
    URI
    http://hdl.handle.net/10361/8919
    Citation
    Dewey, K. G., Mridha, M. K., Matias, S. L., Arnold, C. D., Cummins, J. R., Khan, M. S. A., … Vosti, S. A. (2017). Lipid-based nutrient supplementation in the first 1000 d improves child growth in Bangladesh: a cluster- randomized effectiveness trial. American Journal of Clinical Nutrition, 105(4), 944–957. https://doi.org/10.3945/ajcn.116.147942
    Abstract
    Background: Stunting in linear growth occurs mainly during the first 1000 d, from conception through 24 mo of age. Despite the recognition of this critical period, there have been few evaluations of the growth impact of interventions that cover most of this window. Objective: We evaluated home fortification approaches for preventing maternal and child undernutrition within a community-based health program. We hypothesized that small-quantity lipid-based nutrient supplements (LNSs) provided to women during pregnancy and the first 6 mo postpartum, LNSs provided to their offspring from 6 to 24 mo of age, or both would result in greater child length-for-age z score (LAZ) at 24 mo than iron and folic acid (IFA) provided to women during pregnancy and postpartum plus micronutrient powder (MNP) or no supplementation for their offspring from 6 to 24 mo. Design: We conducted a cluster-randomized effectiveness trial with 4 arms: 1) women and children both received LNSs (LNS-LNS group), 2) women received IFA and children received LNSs (IFA-LNS group), 3) women received IFA and children received MNP (IFA-MNP group), and 4) women received IFA and children received no supplements (IFA-Control group). We enrolled 4011 women at #20 wk of gestation within 64 clusters, each comprising the supervision area of a community health worker. Analyses were primarily performed by using ANCOVA F tests and Tukey-Kramer–corrected pairwise comparisons. Results: At 24 mo, the LNS-LNS group had significantly higher LAZ (+0.13 compared with the IFA-MNP group) and head circumference (+0.15 z score compared with the IFA-Control group); these outcomes did not differ between the other groups. Stunting prevalence (LAZ ,22) was lower in the LNS-LNS group at 18 mo than in the IFA-MNP group (OR: 0.70; 95% CI: 0.53, 0.92), but the difference diminished by 24 mo (OR: 0.81; 95% CI: 0.63, 1.04). Conclusion: Home fortification with small-quantity LNSs, but not MNP, during the first 1000 d improved child linear growth and head size in rural Bangladesh. This trial was registered at clinicaltrials.gov as NCT01715038. Am J Clin Nutr doi: 10.3945/ajcn.116.147942.
    Keywords
    Growth faltering; Lipid-based nutrient supplements; Malnutrition; Micronutrient powder; Stunting
     
    Description
    This article was published in the American Journal of Clinical Nutrition [© 2017 American Journal of Clinical Nutrition ] and the definite version is available at : https://doi.org/10.3945/ajcn.116.147942. The Journal's website is at: http://ajcn.nutrition.org/content/early/2017/03/08/ajcn.116.147942.full.pdf
    Publisher Link
    http://ajcn.nutrition.org/content/early/2017/03/08/ajcn.116.147942.full.pdf
    DOI
    https://doi.org/10.3945/ajcn.116.147942
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    • Journal Articles (2017)

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