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

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cg.authorship.typesCGIAR single centre
cg.authorship.typesCGIAR and developing country institute
cg.contributor.affiliationInternational Food Policy Research Institute
cg.contributor.crpAgriculture for Nutrition and Health
cg.contributor.donorBill & Melinda Gates Foundation
cg.contributor.donorUnited States Agency for International Development
cg.creator.identifierElodie Becquey: 0000-0002-8748-7637
cg.creator.identifierLieven Huybregts: 0000-0002-3068-2853
cg.creator.identifierJef L Leroy: 0000-0001-9371-3832
cg.creator.identifierMarie Ruel: 0000-0002-9506-348X
cg.identifier.doihttps://doi.org/10.1093/ajcn/nqab278
cg.identifier.projectIFPRI - Poverty, Health, and Nutrition Division
cg.identifier.publicationRankA plus
cg.isijournalISI Journal
cg.issn0002-9165
cg.issueSupplement 1
cg.journalAmerican Journal of Clinical Nutrition
cg.reviewStatusPeer Review
cg.volume114
dc.contributor.authorDewey, Kathryn G.
dc.contributor.authorWessells, K. Ryan
dc.contributor.authorArnold, Charles D.
dc.contributor.authorPrado, Elizabeth L.
dc.contributor.authorAbbeddou, Souheila
dc.contributor.authorBecquey, Elodie
dc.contributor.authorHuybregts, Lieven
dc.contributor.authorLeroy, Jef L.
dc.contributor.authorRuel, Marie T.
dc.date.accessioned2024-05-22T12:10:19Zen
dc.date.available2024-05-22T12:10:19Zen
dc.identifier.urihttps://hdl.handle.net/10568/142330
dc.titleCharacteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: An individual participant data meta-analysis of randomized controlled trialsen
dcterms.abstractBackground: 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.en
dcterms.accessRightsOpen Access
dcterms.bibliographicCitationDewey, Kathryn G.; Wessells, K. Ryan; Arnold, Charles D.; Prado, Elizabeth L.; Abbeddou, Souheila; Becquey, Elodie; Huybregts, Lieven; Leroy, Jef L.; Ruel, Marie T.; et al. 2021. 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. American Journal of Clinical Nutrition 114(Supplement 1): 15S-42S. https://doi.org/10.1093/ajcn/nqab278en
dcterms.extentpp. 15S-42S
dcterms.issued2021-09-29
dcterms.languageen
dcterms.licenseCC-BY-4.0
dcterms.publisherAmerican Society for Nutrition
dcterms.relationhttps://doi.org/10.1093/ajcn/nqab276en
dcterms.relationhttps://doi.org/10.1093/jn/nxab292en
dcterms.replaceshttps://ebrary.ifpri.org/digital/collection/p15738coll5/id/7950
dcterms.subjectlipidsen
dcterms.subjectchild nutritionen
dcterms.subjectstuntingen
dcterms.subjectmalnutritionen
dcterms.subjectnutritionen
dcterms.subjectfood supplementationen
dcterms.subjectwasting disease (nutritional disorder)en
dcterms.subjectfeedingen
dcterms.subjectfortificationen
dcterms.subjectwasting diseaseen
dcterms.subjectchild growthen
dcterms.typeJournal Article

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