Affiliation:
1. icddr,b, Dhaka, Bangladesh
2. Faculty of Medicine and Life Sciences, University of Tampere, Finland
3. University of Virginia, Charlottesville, VA, USA
Abstract
ABSTRACT
Background
Childhood stunting is the most prevalent public health nutrition problem in low- and middle-income countries.
Objective
This study aimed to determine whether daily supplementation in 12–18-mo-old undernourished Bangladeshi children with egg, cow milk, and multiple micronutrients improves linear growth.
Methods
In the Bangladesh Environmental Enteric Dysfunction (BEED) study, a community-based intervention study, 12–18-mo-old children with length-for-age z score (LAZ) <1 were supplemented daily with an egg and 150 mL of milk for 90 feeding days, and 1 sachet of multiple micronutrient powder was provided daily for 60 feeding days. The change in LAZ over this period was compared with that in children of the same age and same baseline LAZ who were enrolled in the recently completed Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health (MAL-ED) Dhaka birth cohort study conducted in the same community where no nutrition intervention was provided. Difference-in-difference (DID) analysis was done and the effect size was adjusted for other possible covariates using a generalized estimating equation in a regression model.
Results
A total of 472 children with LAZ <1 completed the intervention and data were available for 174 children in the comparison group. Compared with the comparison group, adjusted DID analysis revealed a change in LAZ in the intervention group of +0.23 (95% CI: 0.18, 0.29; P < 0.05). In a subgroup analysis, the changes were +0.27 (95% CI: 0.18, 0.35; P < 0.05) in stunted (LAZ <2) children and +0.19 (95% CI: 0.12, 0.27; P < 0.05) in children at risk of stunting (LAZ −1 to −2). No allergic reactions or other adverse events related to milk and egg consumption were observed.
Conclusions
Daily directly observed milk, egg, and multiple micronutrient supplementation may improve linear growth of stunted children. A randomized controlled trial with longer duration of supplementation coupled with an additional intervention aimed at reducing pathogen burden is warranted to confirm these results. This trial was registered at clinicaltrials.gov as NCT02812615.
Funder
Bill and Melinda Gates Foundation
Publisher
Oxford University Press (OUP)
Subject
Nutrition and Dietetics,Medicine (miscellaneous)
Cited by
20 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献