Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials
Background: Small-quantity lipid-based nutrient supplements (SQ-LNSs) have been shown to reduce the prevalence of child anemia and iron deficiency, but effects on other micronutrients are less well known. Identifying subgroups who benefit most from SQ-LNSs could support improved program design. Obje...
| Main Authors: | , , , , , , , |
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| Format: | Journal Article |
| Language: | Inglés |
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American Society for Nutrition
2021
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| Subjects: | |
| Online Access: | https://hdl.handle.net/10568/142329 |
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| author | Wessells, K. Ryan Arnold, Charles D. Stewart, Christine P. Prado, Elizabeth L. Abbeddou, Souheila Becquey, Elodie Huybregts, Lieven Leroy, Jef L. |
| author_browse | Abbeddou, Souheila Arnold, Charles D. Becquey, Elodie Huybregts, Lieven Leroy, Jef L. Prado, Elizabeth L. Stewart, Christine P. Wessells, K. Ryan |
| author_facet | Wessells, K. Ryan Arnold, Charles D. Stewart, Christine P. Prado, Elizabeth L. Abbeddou, Souheila Becquey, Elodie Huybregts, Lieven Leroy, Jef L. |
| author_sort | Wessells, K. Ryan |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background: Small-quantity lipid-based nutrient supplements (SQ-LNSs) have been shown to reduce the prevalence of child anemia and iron deficiency, but effects on other micronutrients are less well known. Identifying subgroups who benefit most from SQ-LNSs could support improved program design. Objectives: We aimed to identify study-level and individual-level modifiers of the effect of SQ-LNSs on child hemoglobin (Hb), anemia, and inflammation-adjusted micronutrient status outcomes. Methods: We conducted a 2-stage meta-analysis of individual participant data from 13 randomized controlled trials of SQ-LNSs provided to children 6–24 mo of age (n = 15,946). We generated study-specific and subgroup estimates of SQ-LNSs compared with control, and pooled the estimates using fixed-effects models. We used random-effects meta-regression to examine potential study-level effect modifiers. Results: SQ-LNS provision decreased the prevalence of anemia (Hb < 110 g/L) by 16% (relative reduction), iron deficiency (plasma ferritin < 12 µg/L) by 56%, and iron deficiency anemia (IDA; Hb < 110 g/L and plasma ferritin <12 µg/L) by 64%. We observed positive effects of SQ-LNSs on hematological and iron status outcomes within all subgroups of the study- and individual-level effect modifiers, but effects were larger in certain subgroups. For example, effects of SQ-LNSs on anemia and iron status were greater in trials that provided SQ-LNSs for >12 mo and provided 9 (as opposed to <9) mg Fe/d, and among later-born (than among first-born) children. There was no effect of SQ-LNSs on plasma zinc or retinol, but there was a 7% increase in plasma retinol-binding protein (RBP) and a 56% reduction in vitamin A deficiency (RBP < 0.70 µmol/L), with little evidence of effect modification by individual-level characteristics. Conclusions: SQ-LNSs can substantially reduce the prevalence of anemia, iron deficiency, and IDA among children across a range of individual, population, and study design characteristics. Policy-makers and program planners should consider SQ-LNSs within intervention packages to prevent anemia and iron deficiency. This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020156663. |
| format | Journal Article |
| id | CGSpace142329 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | American Society for Nutrition |
| publisherStr | American Society for Nutrition |
| record_format | dspace |
| spelling | CGSpace1423292025-10-28T10:12:08Z Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials Wessells, K. Ryan Arnold, Charles D. Stewart, Christine P. Prado, Elizabeth L. Abbeddou, Souheila Becquey, Elodie Huybregts, Lieven Leroy, Jef L. anaemia child nutrition micronutrient deficiency nutrition food supplementation trace elements children feeding iron fortification Background: Small-quantity lipid-based nutrient supplements (SQ-LNSs) have been shown to reduce the prevalence of child anemia and iron deficiency, but effects on other micronutrients are less well known. Identifying subgroups who benefit most from SQ-LNSs could support improved program design. Objectives: We aimed to identify study-level and individual-level modifiers of the effect of SQ-LNSs on child hemoglobin (Hb), anemia, and inflammation-adjusted micronutrient status outcomes. Methods: We conducted a 2-stage meta-analysis of individual participant data from 13 randomized controlled trials of SQ-LNSs provided to children 6–24 mo of age (n = 15,946). We generated study-specific and subgroup estimates of SQ-LNSs compared with control, and pooled the estimates using fixed-effects models. We used random-effects meta-regression to examine potential study-level effect modifiers. Results: SQ-LNS provision decreased the prevalence of anemia (Hb < 110 g/L) by 16% (relative reduction), iron deficiency (plasma ferritin < 12 µg/L) by 56%, and iron deficiency anemia (IDA; Hb < 110 g/L and plasma ferritin <12 µg/L) by 64%. We observed positive effects of SQ-LNSs on hematological and iron status outcomes within all subgroups of the study- and individual-level effect modifiers, but effects were larger in certain subgroups. For example, effects of SQ-LNSs on anemia and iron status were greater in trials that provided SQ-LNSs for >12 mo and provided 9 (as opposed to <9) mg Fe/d, and among later-born (than among first-born) children. There was no effect of SQ-LNSs on plasma zinc or retinol, but there was a 7% increase in plasma retinol-binding protein (RBP) and a 56% reduction in vitamin A deficiency (RBP < 0.70 µmol/L), with little evidence of effect modification by individual-level characteristics. Conclusions: SQ-LNSs can substantially reduce the prevalence of anemia, iron deficiency, and IDA among children across a range of individual, population, and study design characteristics. Policy-makers and program planners should consider SQ-LNSs within intervention packages to prevent anemia and iron deficiency. This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020156663. 2021-09-29 2024-05-22T12:10:19Z 2024-05-22T12:10:19Z Journal Article https://hdl.handle.net/10568/142329 en https://doi.org/10.1093/jn/nxab292 https://doi.org/10.1093/ajcn/nqab278 Open Access American Society for Nutrition Wessells, K. Ryan; Arnold, Charles D.; Stewart, Christine P.; Prado, Elizabeth L.; Abbeddou, Souheila; Becquey, Elodie; Huybregts, Lieven; Leroy, Jef L.; et al. 2021. Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition 114(Supplement 1): 68S-94S. https://doi.org/10.1093/ajcn/nqab276 |
| spellingShingle | anaemia child nutrition micronutrient deficiency nutrition food supplementation trace elements children feeding iron fortification Wessells, K. Ryan Arnold, Charles D. Stewart, Christine P. Prado, Elizabeth L. Abbeddou, Souheila Becquey, Elodie Huybregts, Lieven Leroy, Jef L. Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials |
| title | Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials |
| title_full | Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials |
| title_fullStr | Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials |
| title_full_unstemmed | Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials |
| title_short | Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials |
| title_sort | characteristics that modify the effect of small quantity lipid based nutrient supplementation on child anemia and micronutrient status an individual participant data meta analysis of randomized controlled trials |
| topic | anaemia child nutrition micronutrient deficiency nutrition food supplementation trace elements children feeding iron fortification |
| url | https://hdl.handle.net/10568/142329 |
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