Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: an individual participant data meta-analysis of randomized controlled trials-Reference-Cited by-同舟云学术

Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: an individual participant data meta-analysis of randomized controlled trials

Published:2021-09-29 Issue:Supplement_1 Volume:114 Page:15S-42S
ISSN:0002-9165
Container-title:The American Journal of Clinical Nutrition
language:en
Short-container-title:

Author:

Dewey Kathryn G¹^ORCID,Wessells K Ryan¹^ORCID,Arnold Charles D¹^ORCID,Prado Elizabeth L¹^ORCID,Abbeddou Souheila²^ORCID,Adu-Afarwuah Seth³^ORCID,Ali Hasmot⁴^ORCID,Arnold Benjamin F⁵^ORCID,Ashorn Per⁶⁷^ORCID,Ashorn Ulla⁶^ORCID,Ashraf Sania⁸^ORCID,Becquey Elodie⁹^ORCID,Bendabenda Jaden¹⁰^ORCID,Brown Kenneth H¹¹¹^ORCID,Christian Parul¹²,Colford John M¹³^ORCID,Dulience Sherlie J L¹⁴,Fernald Lia C H¹³^ORCID,Galasso Emanuela¹⁵^ORCID,Hallamaa Lotta⁶^ORCID,Hess Sonja Y¹^ORCID,Humphrey Jean H¹²¹⁶^ORCID,Huybregts Lieven⁹^ORCID,Iannotti Lora L¹⁴^ORCID,Jannat Kaniz¹⁷^ORCID,Lartey Anna³^ORCID,Le Port Agnes¹⁸^ORCID,Leroy Jef L⁹^ORCID,Luby Stephen P¹⁹^ORCID,Maleta Kenneth²⁰^ORCID,Matias Susana L²¹^ORCID,Mbuya Mduduzi N N¹⁶²²^ORCID,Mridha Malay K²³^ORCID,Nkhoma Minyanga²⁰^ORCID,Null Clair²⁴^ORCID,Paul Rina R²³^ORCID,Okronipa Harriet²⁵^ORCID,Ouédraogo Jean-Bosco²⁶^ORCID,Pickering Amy J²⁷^ORCID,Prendergast Andrew J¹⁶²⁸^ORCID,Ruel Marie⁹^ORCID,Shaikh Saijuddin⁴^ORCID,Weber Ann M²⁹^ORCID,Wolff Patricia³⁰,Zongrone Amanda³¹^ORCID,Stewart Christine P¹^ORCID

Affiliation:

1. Institute for Global Nutrition and Department of Nutrition, University of California, Davis, Davis, CA, USA

2. Public Health Nutrition, Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium

3. Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana

4. The JiVitA Project of Johns Hopkins University, Bangladesh, Paschimpara, Bangladesh

5. Francis I Proctor Foundation, University of California, San Francisco, San Francisco, CA, USA

6. Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland

7. Department of Paediatrics, Tampere University Hospital, Tampere, Finland

8. Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, PA, USA

9. Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA

10. Department of Nutrition and Food Safety, WHO, Geneva, Switzerland

11. Helen Keller International, New York, NY, USA

12. Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

13. School of Public Health, University of California, Berkeley, Berkeley, CA, USA

14. Brown School, Washington University in St. Louis, St Louis, MO, USA

15. Development Research Group, World Bank, Washington, DC, USA

16. Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe

17. School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia

18. Independent consultant, Dakar, Senegal

19. Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA

20. Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi

21. Department of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, CA, USA

22. Global Alliance for Improved Nutrition, Washington, DC, USA

23. Center for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, Dhaka, Bangladesh

24. Mathematica, Washington, DC, USA

25. Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA

26. Health Sciences Research Institute (IRSS), Bobo-Dioulasso, Burkina Faso

27. School of Engineering, Tufts University, Medford, MA, USA

28. Blizard Institute, Queen Mary University of London, London, United Kingdom

29. Division of Epidemiology, School of Community Health Sciences, University of Nevada, Reno, Reno, NV, USA

30. Meds & Foods for Kids, St. Louis, MO, USA

31. Independent consultant, Washington, DC, USA

Abstract

ABSTRACT Background Meta-analyses show that small-quantity lipid-based nutrient supplements (SQ-LNSs) reduce child stunting and wasting. Identification of subgroups who benefit most from SQ-LNSs may facilitate program design. Objectives We aimed to identify study-level and individual-level modifiers of the effect of SQ-LNSs on child growth outcomes. Methods We conducted a 2-stage meta-analysis of individual participant data from 14 randomized controlled trials of SQ-LNSs provided to children 6–24 mo of age (n = 37,066). We generated study-specific and subgroup estimates of SQ-LNS compared with control and pooled the estimates using fixed-effects models. We used random-effects meta-regression to examine study-level effect modifiers. In sensitivity analyses, we examined whether results differed depending on study arm inclusion criteria and types of comparisons. Results SQ-LNS provision decreased stunting (length-for-age z score < −2) by 12% (relative reduction), wasting [weight-for-length (WLZ) z score < −2] by 14%, low midupper arm circumference (MUAC) (<125 mm or MUAC-for-age z score < −2) by 18%, acute malnutrition (WLZ < −2 or MUAC < 125 mm) by 14%, underweight (weight-for-age z score < −2) by 13%, and small head size (head circumference-for-age z score < −2) by 9%. Effects of SQ-LNSs generally did not differ by study-level characteristics including region, stunting burden, malaria prevalence, sanitation, water quality, duration of supplementation, frequency of contact, or average compliance with SQ-LNS. Effects of SQ-LNSs on stunting, wasting, low MUAC, and small head size were greater among girls than among boys; effects on stunting, underweight, and low MUAC were greater among later-born (than among firstborn) children; and effects on wasting and acute malnutrition were greater among children in households with improved (as opposed to unimproved) sanitation. Conclusions The positive impact of SQ-LNSs on growth is apparent across a variety of study-level contexts. Policy-makers and program planners should consider including SQ-LNSs in packages of interventions to prevent both stunting and wasting. This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.

Funder

Bill and Melinda Gates Foundation

Publisher

Oxford University Press (OUP)

Subject

Nutrition and Dietetics,Medicine (miscellaneous)

Link

http://academic.oup.com/ajcn/article-pdf/114/Supplement_1/15S/41035007/nqab278.pdf

Reference91 articles.

1. Maternal and child undernutrition and overweight in low-income and middle-income countries;Black;Lancet,2013

2. Contextualising complementary feeding in a broader framework for stunting prevention;Stewart;Matern Child Nutr,2013

3. The stunting syndrome in developing countries;Prendergast;Paediatr Int Child Health,2014