Effect of lipid-based nutrient supplements on micronutrient status and hemoglobin among children with stunting: secondary analysis of a randomized controlled trial in Uganda.
Am J Clin Nutr
; 119(3): 829-837, 2024 03.
Article
em En
| MEDLINE
| ID: mdl-38278366
ABSTRACT
BACKGROUND:
Micronutrient deficiencies and anemia are widespread among children with stunting.OBJECTIVES:
We assessed the effects of lipid-based nutrient supplements (LNS) containing milk protein (MP) and/or whey permeate (WP) on micronutrient status and hemoglobin (Hb) among children with stunting.METHODS:
This was a secondary analysis of a randomized controlled trial. Children aged 12-59 mo with stunting were randomly assigned to LNS (100 g/d) with milk or soy protein and WP or maltodextrin for 12 wk, or no supplement. Hb, serum ferritin (S-FE), serum soluble transferrin receptor (S-TfR), plasma cobalamin (P-Cob), plasma methylmalonic acid (P-MMA), plasma folate (P-Fol), and serum retinol-binding protein (S-RBP) were measured at inclusion and at 12 wk. Data were analyzed using linear and logistic mixed-effects models.RESULTS:
Among 750 children, with mean age ± SD of 32 ± 11.7 mo, 45% (n = 338) were female and 98% (n = 736) completed follow-up. LNS, compared with no supplementation, resulted in 43% [95% confidence interval (CI) 28, 60] greater increase in S-FE corrected for inflammation (S-FEci), 2.4 (95% CI 1.2, 3.5) mg/L greater decline in S-TfR, 138 (95% CI 111, 164) pmol/L greater increase in P-Cob, 33% (95% CI 27, 39) reduction in P-MMA, and 8.5 (95% CI 6.6, 10.3) nmol/L greater increase in P-Fol. There was no effect of LNS on S-RBP. Lactation modified the effect of LNS on markers of cobalamin status, reflecting improved status among nonbreastfed and no effects among breastfed children. LNS increased Hb by 3.8 (95% CI 1.7, 6.0) g/L and reduced the odds of anemia by 55% (odds ratio 0.45, 95% CI 0.29, 0.70). MP compared with soy protein increased S-FEci by 14% (95% CI 3, 26).CONCLUSIONS:
LNS supplementation increases Hb and improves iron, cobalamin, and folate status, but not vitamin A status among children with stunting. LNS should be considered for children with stunting. This trial was registered at ISRCTN as 13093195.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Oligoelementos
/
Anemia
Tipo de estudo:
Clinical_trials
Limite:
Child
/
Female
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Humans
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Infant
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Male
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article