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Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study
OBJECTIVE: To assess the effectiveness of dietary counselling and complementary food supplements on anaemia and stunting prevalence in children aged 6–23 months. DESIGN: A controlled intervention study with measurements of height and haemoglobin levels, and cross-sectional surveys in August 2012 (ba...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093399/ https://www.ncbi.nlm.nih.gov/pubmed/27799239 http://dx.doi.org/10.1136/bmjopen-2016-011234 |
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author | Zhang, Yanfeng Wu, Qiong Wang, Wei van Velthoven, Michelle Helena Chang, Suying Han, Huijun Xing, Min Chen, Li Scherpbier, Robert W. |
author_facet | Zhang, Yanfeng Wu, Qiong Wang, Wei van Velthoven, Michelle Helena Chang, Suying Han, Huijun Xing, Min Chen, Li Scherpbier, Robert W. |
author_sort | Zhang, Yanfeng |
collection | PubMed |
description | OBJECTIVE: To assess the effectiveness of dietary counselling and complementary food supplements on anaemia and stunting prevalence in children aged 6–23 months. DESIGN: A controlled intervention study with measurements of height and haemoglobin levels, and cross-sectional surveys in August 2012 (baseline), 2013 (mid-term) and 2014 (end-line). SETTING: One intervention county and one control county in rural Qinghai Province, China. INTERVENTION: Complementary food supplements (containing protein, fat, carbohydrate, vitamin A, B(1), B(2), B(12), D(3), folic acid, iron, zinc and calcium) and complementary feeding counselling were given in the intervention county. PARTICIPANTS: Caregivers and their children aged 6–23 months. PRIMARY AND SECONDARY OUTCOME MEASURES: Effect of the interventions on the prevalence of anaemia (haemoglobin <110 g/L) and stunting (z-score of height-for-age <−2.0) (controlled for differences between the counties), and on infant feeding practices. RESULTS: The surveys were conducted on 1804, 2187 and 2186 children aged 6–23 months in the intervention county in August 2012, 2013 and 2014, respectively, and 804, 680 and 790 children in the control county, respectively. Between the baseline and end-line surveys, anaemia prevalence decreased more in the intervention county than in the control county (71.1% to 47.8% vs 86.3% to 75.3%, respectively; p<0.0001). There was no difference in the decrease in stunting prevalence between the counties (9.7% to 7.1% vs 17.0% to 15.0%; p=0.7954). The proportions of children given iron-rich or iron-fortified food, introduced to (semi-) solid food at 6–8 months, and given food with minimum dietary diversity increased from 43.2% to 88.8% (p<0.0001), 81.4% to 96% (p=0.0470) and 53.0% to 59.8% (p<0.0001), respectively in the intervention county. CONCLUSIONS: We found much higher anaemia prevalence in poor rural areas of Qinghai Province compared with the national data. Community-based complementary food supplements combined with dietary counselling can improve feeding practices and reduce anaemia prevalence. Future studies should use longer follow-up to assess the effects on stunting. STRENGTHS AND LIMITATIONS: We included a large number of participants and assessed a combined complementary food supplements and dietary counselling intervention in a poor rural area in China with high anaemia prevalence. Although the study took place in only one intervention county and one control county, we conducted an analysis that controlled for differences between the two counties. Also, although we made significant efforts to train village doctors, their education was not systematically assessed after training and thus their delivery of the interventions may have been variable. TRIAL REGISTRATION NUMBER: ChiCTRPRC12002444; Pre-results. |
format | Online Article Text |
id | pubmed-5093399 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-50933992016-11-14 Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study Zhang, Yanfeng Wu, Qiong Wang, Wei van Velthoven, Michelle Helena Chang, Suying Han, Huijun Xing, Min Chen, Li Scherpbier, Robert W. BMJ Open Public Health OBJECTIVE: To assess the effectiveness of dietary counselling and complementary food supplements on anaemia and stunting prevalence in children aged 6–23 months. DESIGN: A controlled intervention study with measurements of height and haemoglobin levels, and cross-sectional surveys in August 2012 (baseline), 2013 (mid-term) and 2014 (end-line). SETTING: One intervention county and one control county in rural Qinghai Province, China. INTERVENTION: Complementary food supplements (containing protein, fat, carbohydrate, vitamin A, B(1), B(2), B(12), D(3), folic acid, iron, zinc and calcium) and complementary feeding counselling were given in the intervention county. PARTICIPANTS: Caregivers and their children aged 6–23 months. PRIMARY AND SECONDARY OUTCOME MEASURES: Effect of the interventions on the prevalence of anaemia (haemoglobin <110 g/L) and stunting (z-score of height-for-age <−2.0) (controlled for differences between the counties), and on infant feeding practices. RESULTS: The surveys were conducted on 1804, 2187 and 2186 children aged 6–23 months in the intervention county in August 2012, 2013 and 2014, respectively, and 804, 680 and 790 children in the control county, respectively. Between the baseline and end-line surveys, anaemia prevalence decreased more in the intervention county than in the control county (71.1% to 47.8% vs 86.3% to 75.3%, respectively; p<0.0001). There was no difference in the decrease in stunting prevalence between the counties (9.7% to 7.1% vs 17.0% to 15.0%; p=0.7954). The proportions of children given iron-rich or iron-fortified food, introduced to (semi-) solid food at 6–8 months, and given food with minimum dietary diversity increased from 43.2% to 88.8% (p<0.0001), 81.4% to 96% (p=0.0470) and 53.0% to 59.8% (p<0.0001), respectively in the intervention county. CONCLUSIONS: We found much higher anaemia prevalence in poor rural areas of Qinghai Province compared with the national data. Community-based complementary food supplements combined with dietary counselling can improve feeding practices and reduce anaemia prevalence. Future studies should use longer follow-up to assess the effects on stunting. STRENGTHS AND LIMITATIONS: We included a large number of participants and assessed a combined complementary food supplements and dietary counselling intervention in a poor rural area in China with high anaemia prevalence. Although the study took place in only one intervention county and one control county, we conducted an analysis that controlled for differences between the two counties. Also, although we made significant efforts to train village doctors, their education was not systematically assessed after training and thus their delivery of the interventions may have been variable. TRIAL REGISTRATION NUMBER: ChiCTRPRC12002444; Pre-results. BMJ Publishing Group 2016-10-31 /pmc/articles/PMC5093399/ /pubmed/27799239 http://dx.doi.org/10.1136/bmjopen-2016-011234 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Public Health Zhang, Yanfeng Wu, Qiong Wang, Wei van Velthoven, Michelle Helena Chang, Suying Han, Huijun Xing, Min Chen, Li Scherpbier, Robert W. Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study |
title | Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study |
title_full | Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study |
title_fullStr | Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study |
title_full_unstemmed | Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study |
title_short | Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study |
title_sort | effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of qinghai province, china: a controlled interventional study |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093399/ https://www.ncbi.nlm.nih.gov/pubmed/27799239 http://dx.doi.org/10.1136/bmjopen-2016-011234 |
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