Complementary food supplements fill energy and protein gaps among children with dietary inadequacy in a complementary feeding trial in rural Bangladesh.

Autor:	Pasqualino MM; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America. Electronic address: mpasqua2@jhmi.edu., Campbell RK; Division of Epidemiology and Biostatistics, University of Illinois Chicago, Chicago, IL, USA., Hurley KM; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America., Wu LS; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America., Shamim AA; Center for Noncommunicable Diseases and Nutrition, BRAC James P Grant of School of Public Health, BRAC University, Mohakhali, Dhaka 1213; The JiVitA Project, Gaibandha, Bangladesh., Shaikh S; The JiVitA Project, Gaibandha, Bangladesh., de Pee S; World Food Programme, Rome, Italy., Christian P; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
Jazyk:	angličtina
Zdroj:	The Journal of nutrition [J Nutr] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.
DOI:	10.1016/j.tjnut.2024.12.001
Abstrakt:	Background: Few studies have evaluated the dietary impact of complementary food supplements (CFSs) designed to deliver macro- and micronutrients to children at risk for undernutrition. In a randomized controlled trial in rural Bangladesh, we previously reported that CFSs increased children's micronutrient adequacy. Objective: To longitudinally characterize energy and macronutrient intakes and inadequacies and evaluate the extent to which CFSs fill intake gaps. Methods: Children were enrolled at 6 months and received one of four CFSs plus caregiver nutrition counseling or counseling alone for one year. A semi-quantitative diet questionnaire was administered at 6, 9, 12, 15, 18, and 24 months. Energy and macronutrient intakes were estimated by age and arm; protein adequacy was adjusted for protein quality and infection. We estimated the proportion meeting intake requirements set by FAO and the Institute of Medicine and compared group-wise differences using log binomial regression models with generalized estimating equations. We used multivariate analysis of variance models to evaluate if CFSs substituted home foods. Results: Across groups, most children did not meet energy or protein requirements at enrollment (74.6-81.3% and 77.4-79.2%, respectively). Estimated energy and macronutrient intakes from home foods increased from 6 to 24 months. Energy inadequacy was lower in the supplemented groups compared to the control at all ages (e.g., 10.5-13.8% versus 31.4% at 18 months). In the control group, protein inadequacy dropped from 78.4% at 6 months to 8.3% at 9 months to 2.8% by 18 months; adjusted protein estimates were 25.1% at 9 months and 7.0% at 18 months. Protein inadequacy was highest in the control group at all timepoints. CFSs did not substitute home foods. Conclusions: CFSs can significantly bridge energy and protein intake gaps. With earlier trial findings that CFSs filled micronutrient gaps and improved growth, these findings strengthen evidence supporting using CFSs for improved health outcomes. Clinical Trial Registry: NCT01562379, https://clinicaltrials.gov/ct2/show/NCT01562379. Competing Interests: Declaration of Competing Interest ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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