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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
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 identi...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560311/ https://www.ncbi.nlm.nih.gov/pubmed/34590116 http://dx.doi.org/10.1093/ajcn/nqab277 |
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author | Prado, Elizabeth L Arnold, Charles D Wessells, K Ryan Stewart, Christine P Abbeddou, Souheila Adu-Afarwuah, Seth Arnold, Benjamin F Ashorn, Ulla Ashorn, Per Becquey, Elodie Brown, Kenneth H Chandna, Jaya Christian, Parul Dentz, Holly N Dulience, Sherlie J L Fernald, Lia C H Galasso, Emanuela Hallamaa, Lotta Hess, Sonja Y Huybregts, Lieven Iannotti, Lora L Jimenez, Elizabeth Y Kohl, Patricia Lartey, Anna Le Port, Agnes Luby, Stephen P Maleta, Kenneth Matchado, Andrew Matias, Susana L Mridha, Malay K Ntozini, Robert Null, Clair Ocansey, Maku E Parvez, Sarker M Phuka, John Pickering, Amy J Prendergast, Andrew J Shamim, Abu A Siddiqui, Zakia Tofail, Fahmida Weber, Ann M Wu, Lee S F Dewey, Kathryn G |
author_facet | Prado, Elizabeth L Arnold, Charles D Wessells, K Ryan Stewart, Christine P Abbeddou, Souheila Adu-Afarwuah, Seth Arnold, Benjamin F Ashorn, Ulla Ashorn, Per Becquey, Elodie Brown, Kenneth H Chandna, Jaya Christian, Parul Dentz, Holly N Dulience, Sherlie J L Fernald, Lia C H Galasso, Emanuela Hallamaa, Lotta Hess, Sonja Y Huybregts, Lieven Iannotti, Lora L Jimenez, Elizabeth Y Kohl, Patricia Lartey, Anna Le Port, Agnes Luby, Stephen P Maleta, Kenneth Matchado, Andrew Matias, Susana L Mridha, Malay K Ntozini, Robert Null, Clair Ocansey, Maku E Parvez, Sarker M Phuka, John Pickering, Amy J Prendergast, Andrew J Shamim, Abu A Siddiqui, Zakia Tofail, Fahmida Weber, Ann M Wu, Lee S F Dewey, Kathryn G |
author_sort | Prado, Elizabeth L |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8560311 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-85603112021-11-03 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 Prado, Elizabeth L Arnold, Charles D Wessells, K Ryan Stewart, Christine P Abbeddou, Souheila Adu-Afarwuah, Seth Arnold, Benjamin F Ashorn, Ulla Ashorn, Per Becquey, Elodie Brown, Kenneth H Chandna, Jaya Christian, Parul Dentz, Holly N Dulience, Sherlie J L Fernald, Lia C H Galasso, Emanuela Hallamaa, Lotta Hess, Sonja Y Huybregts, Lieven Iannotti, Lora L Jimenez, Elizabeth Y Kohl, Patricia Lartey, Anna Le Port, Agnes Luby, Stephen P Maleta, Kenneth Matchado, Andrew Matias, Susana L Mridha, Malay K Ntozini, Robert Null, Clair Ocansey, Maku E Parvez, Sarker M Phuka, John Pickering, Amy J Prendergast, Andrew J Shamim, Abu A Siddiqui, Zakia Tofail, Fahmida Weber, Ann M Wu, Lee S F Dewey, Kathryn G Am J Clin Nutr Supplement Article 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. Oxford University Press 2021-09-29 /pmc/articles/PMC8560311/ /pubmed/34590116 http://dx.doi.org/10.1093/ajcn/nqab277 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Supplement Article Prado, Elizabeth L Arnold, Charles D Wessells, K Ryan Stewart, Christine P Abbeddou, Souheila Adu-Afarwuah, Seth Arnold, Benjamin F Ashorn, Ulla Ashorn, Per Becquey, Elodie Brown, Kenneth H Chandna, Jaya Christian, Parul Dentz, Holly N Dulience, Sherlie J L Fernald, Lia C H Galasso, Emanuela Hallamaa, Lotta Hess, Sonja Y Huybregts, Lieven Iannotti, Lora L Jimenez, Elizabeth Y Kohl, Patricia Lartey, Anna Le Port, Agnes Luby, Stephen P Maleta, Kenneth Matchado, Andrew Matias, Susana L Mridha, Malay K Ntozini, Robert Null, Clair Ocansey, Maku E Parvez, Sarker M Phuka, John Pickering, Amy J Prendergast, Andrew J Shamim, Abu A Siddiqui, Zakia Tofail, Fahmida Weber, Ann M Wu, Lee S F Dewey, Kathryn G 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Supplement Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560311/ https://www.ncbi.nlm.nih.gov/pubmed/34590116 http://dx.doi.org/10.1093/ajcn/nqab277 |
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