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

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

Authors
Prado, E. L. Arnold, C. D. Wessells, K. R. Stewart, C. P. Abbeddou, S. Adu-Afarwuah, S. Arnold, B. F. Ashorn, U. Ashorn, P. Becquey, E. Brown, K. H. Chandna, J. Christian, P. Dentz, H. N. Dulience, S. J. L. Fernald, L. C. H. Galasso, E. Hallamaa, L. Hess, S. Y. Huybregts, L. Iannotti, L. L. Jimenez, E. Y. Kohl, P. Lartey, A. Le Port, A. Luby, S. P. Maleta, K. Matchado, A. Matias, S. L. Mridha, M. K. Ntozini, R. Null, C. Ocansey, M. E. Parvez, S. M. Phuka, J. Pickering, A. J. Prendergast, A. J. Shamim, A. A. Siddiqui, Z. Tofail, F. Weber, A. M. Wu, L. S. F. Dewey, K. G.
Year
2021
Journal
American Journal of Clinical Nutrition
Volume
29
Pages
29
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.

Oversett med Google Translate
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Type of intervention

Early Intervention

Topic

Development and Life Coping Skills

Cognition

Motor development

Language

Intervention

Alternative Treatment

Nutritional Supplements and Nutrition

Age group

Infants and Toddlers (0-2 years)

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