Small-quantity lipid-based nutrient supplements for children age 6-24 months: a systematic review and individual participant data meta-analysis of effects on developmental outcomes and effect modifiers.
Am J Clin Nutr
; 114(Suppl 1): 43S-67S, 2021 11 02.
Article
em En
| MEDLINE
| ID: mdl-34590116
ABSTRACT
BACKGROUND:
Small-quantity (SQ) lipid-based nutrient supplements (LNSs) provide many nutrients needed for brain development.OBJECTIVES:
We aimed to generate pooled estimates of the effect of SQ-LNSs on developmental outcomes (language, social-emotional, motor, and executive function), and to identify study-level and individual-level modifiers of these effects.METHODS:
We conducted a 2-stage meta-analysis of individual participant data from 14 intervention against control group comparisons in 13 randomized trials of SQ-LNSs provided to children age 6-24 mo (total n = 30,024).RESULTS:
In 11-13 intervention against control group comparisons (n = 23,588-24,561), SQ-LNSs increased mean language (mean difference 0.07 SD; 95% CI 0.04, 0.10 SD), social-emotional (0.08; 0.05, 0.11 SD), and motor scores (0.08; 95% CI 0.05, 0.11 SD) and reduced the prevalence of children in the lowest decile of these scores by 16% (prevalence ratio 0.84; 95% CI 0.76, 0.92), 19% (0.81; 95% CI 0.74, 0.89), and 16% (0.84; 95% CI 0.76, 0.92), respectively. SQ-LNSs also increased the prevalence of children walking without support at 12 mo by 9% (1.09; 95% CI 1.05, 1.14). Effects of SQ-LNSs on language, social-emotional, and motor outcomes were larger among study populations with a higher stunting burden (≥35%) (mean difference 0.11-0.13 SD; 8-9 comparisons). At the individual level, greater effects of SQ-LNSs were found on language among children who were acutely malnourished (mean difference 0.31) at baseline; on language (0.12), motor (0.11), and executive function (0.06) among children in households with lower socioeconomic status; and on motor development among later-born children (0.11), children of older mothers (0.10), and children of mothers with lower education (0.11).CONCLUSIONS:
Child SQ-LNSs can be expected to result in modest developmental gains, which would be analogous to 1-1.5 IQ points on an IQ test, particularly in populations with a high child stunting burden. Certain groups of children who experience higher-risk environments have greater potential to benefit from SQ-LNSs in developmental outcomes.This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020159971.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Desenvolvimento Infantil
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Suplementos Nutricionais
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Fenômenos Fisiológicos da Nutrição do Lactente
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Lipídeos
Tipo de estudo:
Clinical_trials
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Limite:
Child, preschool
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Female
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Humans
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Infant
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Male
País/Região como assunto:
Africa
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Asia
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Caribe
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Haiti
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article