The objective was to test the hypothesis that a lipid-based nutritional supplement enriched with micronutrients (LNS+MN) would enhance linear growth in rural African young children compared to a paste without micronutrients (LNS).
Methods: Senegalese children (n=208) were enrolled at 6 months and assigned to one of the two arms (LNS+MN or LNS) of the double-blind randomized trial. Caregivers were asked to give a 20g daily dose of supplement (108kcal) to their child for a 12-month period. The primary outcome was length. Anthropometric status, haemoglobin concentration, iron markers, plasma zinc and morbidity outcomes were assessed at baseline and following 12 months of supplementation.
Results: The 2 groups did not differ significantly at baseline and the compliance was adequate. Anthropometric indicators were not different between the 2 groups after the 12-month intervention. The mean effect size for stunting was 0.28 [(95%CI=-0.40, 0.42), p=0.21]. The LNS+MN group had higher mean haemoglobin concentration [ES=0.98, (95%CI=0.01-1.62), p=0.002] and iron deficiency anaemia was significantly reduced in the LNS+MN group. Means plasma zinc concentration were not significantly different between groups after 12-month follow-up. Caregivers reported more episodes of diarrhoea in the LNS+MN group (p=0.02).
Conclusions: The LNS+MN had no positive effect on linear growth in Senegalese children aged 6 to 18 months compared to the same supplement without additional micronutrients. Further research on the effect of enriched LNS on growth and morbidity outcomes is needed to orient policy makers.
Despite progress, stunting or growth faltering globally affects at least 165 million children, and micronutrient deficiencies or “hidden hunger” remain a global challenge (1). Undernutrition may have damaging effects on child survival and development with adverse consequences in childhood and adult life (1, 2). Infants and young children have high nutrients’ needs to support their rapid growth and optimal development. These increased needs make them particularly vulnerable to micronutrient deficiencies or growth faltering early in life (3). While the causes of stunting are complex and interrelated, one of the determinants of growth faltering is inadequate complementary feeding practices from 6 to 24 months; when breastfeeding alone is no more sufficient to cover children’s nutritional requirements (4). Meeting young children’s needs, in quantity and quality, is particularly challenging in food insecure populations or when foods traditionally consumed are plant-based and poor in animal sources. In such settings, which are common in sub-Saharan Africa, it may be difficult to ensure that the feeding frequency, the energy density of complementary foods as well as their fatty acids and micronutrients (especially iron and zinc) composition are adequate (5, 6, 7).
Home (or “point-of-use”) fortification of complementary foods at household level with either multiple...