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
Background: 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...
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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/10568/142330 |
| _version_ | 1855533152808730624 |
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| author | Dewey, Kathryn G. Wessells, K. Ryan Arnold, Charles D. Prado, Elizabeth L. Abbeddou, Souheila Becquey, Elodie Huybregts, Lieven Leroy, Jef L. Ruel, Marie T. |
| author_browse | Abbeddou, Souheila Arnold, Charles D. Becquey, Elodie Dewey, Kathryn G. Huybregts, Lieven Leroy, Jef L. Prado, Elizabeth L. Ruel, Marie T. Wessells, K. Ryan |
| author_facet | Dewey, Kathryn G. Wessells, K. Ryan Arnold, Charles D. Prado, Elizabeth L. Abbeddou, Souheila Becquey, Elodie Huybregts, Lieven Leroy, Jef L. Ruel, Marie T. |
| author_sort | Dewey, Kathryn G. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background: 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. |
| format | Journal Article |
| id | CGSpace142330 |
| 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 | CGSpace1423302025-02-24T06:47:39Z 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 Dewey, Kathryn G. Wessells, K. Ryan Arnold, Charles D. Prado, Elizabeth L. Abbeddou, Souheila Becquey, Elodie Huybregts, Lieven Leroy, Jef L. Ruel, Marie T. lipids child nutrition stunting malnutrition nutrition food supplementation wasting disease (nutritional disorder) feeding fortification wasting disease child growth Background: 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. 2021-09-29 2024-05-22T12:10:19Z 2024-05-22T12:10:19Z Journal Article https://hdl.handle.net/10568/142330 en https://doi.org/10.1093/ajcn/nqab276 https://doi.org/10.1093/jn/nxab292 Open Access American Society for Nutrition Dewey, 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/nqab278 |
| spellingShingle | lipids child nutrition stunting malnutrition nutrition food supplementation wasting disease (nutritional disorder) feeding fortification wasting disease child growth Dewey, Kathryn G. Wessells, K. Ryan Arnold, Charles D. Prado, Elizabeth L. Abbeddou, Souheila Becquey, Elodie Huybregts, Lieven Leroy, Jef L. Ruel, Marie T. 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 |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | lipids child nutrition stunting malnutrition nutrition food supplementation wasting disease (nutritional disorder) feeding fortification wasting disease child growth |
| url | https://hdl.handle.net/10568/142330 |
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