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dc.contributor.authorSmuts, Cornelius M.
dc.contributor.authorMatsungo, Tonderayi M.
dc.contributor.authorMalan, Linda
dc.contributor.authorKruger, Herculina S.
dc.contributor.authorRothman, Marinel
dc.contributor.authorCovic, Namukolo
dc.contributor.authorJoosten, Karen
dc.contributor.authorLombard, Carl J.
dc.contributor.authorFaber, Mieke
dc.date.accessioned2019-03-06T14:14:36Z
dc.date.available2019-03-06T14:14:36Z
dc.date.issued2019
dc.identifier.citationSmuts, C.M. et al. 2019. Effect of small-quantity lipid-based nutrient supplements on growth, psychomotor development, iron status, and morbidity among 6- to 12-mo-old infants in South Africa: a randomized controlled trial. American journal of clinical nutrition, 109(1):55-68. [https://doi.org/10.1093/ajcn/nqy282]en_US
dc.identifier.issn0002-9165
dc.identifier.issn1938-3207 (Online)
dc.identifier.urihttp://hdl.handle.net/10394/31912
dc.identifier.urihttps://academic.oup.com/ajcn/article-pdf/109/1/55/27693656/nqy282.pdf
dc.identifier.urihttps://doi.org/10.1093/ajcn/nqy282
dc.description.abstractBackground Evidence on the effect of small-quantity lipid-based nutrient supplements (SQ-LNSs) on early child growth and development is mixed. Objective This study assessed the effect of daily consumption of 2 different SQ-LNS formulations on linear growth (primary outcome), psychomotor development, iron status (secondary outcomes), and morbidity in infants from age 6 to 12 mo within the context of a maize-based complementary diet. Methods Infants (n = 750) were randomly assigned to receive SQ-LNS, SQ-LNS-plus, or no supplement. Both SQ-LNS products contained micronutrients and essential fatty acids. SQ-LNS-plus contained, in addition, docosahexaenoic acid, arachidonic acid (important for brain and eye development), lysine (limiting amino acid in maize), phytase (enhances iron absorption), and other nutrients. Infants’ weight and length were measured bimonthly. At age 6 and 12 mo, psychomotor development using the Kilifi Developmental Inventory and South African Parent Rating Scale and hemoglobin, plasma ferritin, C-reactive protein, and α1-acid glycoprotein were assessed. WHO Motor Milestone outcomes, adherence, and morbidity were monitored weekly through home visits. Primary analysis was by intention-to-treat, comparing each SQ-LNS group with the control. Results SQ-LNS-plus had a positive effect on length-for-age zscore at age 8 mo (mean difference: 0.11; 95% CI: 0.01, 0.22; P = 0.032) and 10 mo (0.16; 95% CI: 0.04, 0.27; P = 0.008) but not at 12 mo (0.09; 95% CI: −0.02, 0.21; P = 0.115), locomotor development score (2.05; 95% CI: 0.72, 3.38; P = 0.003), and Parent Rating Score (1.10; 95% CI: 0.14, 2.07; P = 0.025), but no effect for weight-for-age zscore. Both SQ-LNS (P = 0.027) and SQ-LNS-plus (P = 0.005) improved hemoglobin concentration and reduced the risk of anemia, iron deficiency, and iron-deficiency anemia. Both SQ-LNS products reduced longitudinal prevalence of fever, coughing, and wheezing but increased incidence and longitudinal prevalence of diarrhea, vomiting, and rash/sores. Conclusions Point-of-use fortification with SQ-LNS-plus showed an early transient effect on linear growth and improved locomotor development. Both SQ-LNS products had positive impacts on anemia and iron status. This trial was registered at clinicaltrials.gov as NCT01845610en_US
dc.language.isoenen_US
dc.publisherOxford Univ Pressen_US
dc.subjectInfants and young childrenen_US
dc.subjectStuntingen_US
dc.subjectLipid-based nutrient supplementsen_US
dc.subjectIron-deficiency anemiaen_US
dc.subjectPsychomotor developmenten_US
dc.subjectMorbidityen_US
dc.subjectPoint-of-use fortificationen_US
dc.subjectSouth Africaen_US
dc.titleEffect of small-quantity lipid-based nutrient supplements on growth, psychomotor development, iron status, and morbidity among 6- to 12-mo-old infants in South Africa: a randomized controlled trialen_US
dc.typeArticleen_US
dc.contributor.researchID20924445 - Smuts, Cornelius Mattheus
dc.contributor.researchID10091130 - Malan, Linda
dc.contributor.researchID10061568 - Kruger, Herculina Salome
dc.contributor.researchID12912654 - Covic, Namukolo Margaret
dc.contributor.researchID12978361 - Rothman, Marinel
dc.contributor.researchID24420875 - Matsungo, Tonderayi Mathew
dc.contributor.researchID21744866 - Joosten, Karen I.
dc.contributor.researchID31457355 - Lombard, Carl J.


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