TY - JOUR
T1 - Complementary feeding interventions have a small but significant impact on linear and ponderal growth of children in low- and middle-income countries
T2 - A systematic review and meta-analysis
AU - Panjwani, Anita
AU - Heidkamp, Rebecca
N1 - Funding Information:
Published in a supplement to The Journal of Nutrition. This article is part of a project to update the nutrition modeling components of the Lives Saved Tool (LiST), which is supported by a grant from the Children®s Investment Fund Foundation (CIFF). LiST is developed and maintained by the Institute for International Programs at Johns Hopkins Bloomberg School of Public Health, with support from the Bill & Melinda Gates Foundation. The Supplement Coordinator for the supplement publication is Adrienne Clermont. Supplement Coordinator disclosures: Adrienne Clermont is a member of the project team at Johns Hopkins Bloomberg School of Public Health that is implementing the CIFF-funded project that this supplement is a part of. As a result, part of her salary is paid through the grant from CIFF. The article contents are the responsibility of the authors and do not necessarily represent the official views of institutions or sponsors involved. Publication costs for this supplement were defrayed in part by the payment of page charges. This publication must therefore be hereby marked "advertisement" in accordance with 18 USC section 1734 solely to indicate this fact. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or the publisher, Editor, or Editorial Board of The Journal of Nutrition. Supported by the Children®s Investment Fund Foundation. Also supported by a Harry D Kruse Publication Award in Human Nutrition. Author disclosures: AP and RH, no conflicts of interest. Supplemental Tables 1 and 2, Supplemental Methods, and Supplemental Figures 1–5 are available from the ‘‘Online Supporting Material’’ link in the online posting of the article and from the same link in the online table of contents at http://jn. nutrition.org. Address correspondence to RH (e-mail: rheidka1@jhu.edu). Abbreviations used: CBA, controlled before-and-after study; CHERG, Child Health Epidemiology Reference Group; LAZ, length-for-age z score; LiST, Lives Saved Tool; LMIC, low-and middle-income country; MD, mean difference; NCHS, National Center for Health Statistics; SMD, standardized mean difference; WLZ, weight-for-length z score.
Publisher Copyright:
© 2017 American Society for Nutrition.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background: World Health Assembly member states have committed to ambitious global targets for reductions in stunting and wasting by 2025. Improving complementary diets of children aged 6-23 mo is a recommended approach for reducing stunting in children < 5 y old. Less is known about the potential of these interventions to prevent wasting. Objective: The aim of this article was to review and synthesize the current literature for the impact of complementary feeding interventions on linear [length-for-age z score (LAZ)] and ponderal [weight-for-length z score (WLZ)] growth of children aged 6-23 mo, with the specific goal of updating intervention-outcome linkages in the Lives Saved Tool (LiST). Methods: We started our review with studies included in the previous LiST review and searched for articles published since January 2012. We identified longitudinal trials that compared children aged 6-23 mo who received 1 of 2 types of complementary feeding interventions (nutrition education or counseling alone or complementary food supplementation with or without nutrition education or counseling) with a no-intervention control. We assessed study quality and generated pooled estimates of LAZ and WLZ change, as well as length and weight gain, for each category of intervention. Results: Interventions that provided nutrition education or counseling had a small but significant impact on linear growth in food-secure populations [LAZ standardized mean difference (SMD): 0.11; 95% CI: 0.01, 0.22] but not on ponderal growth. Complementary food supplementation interventions with or without nutrition education also had a small, significant effect in food-insecure settings on both LAZ (SMD: 0.08; 95% CI: 0.04, 0.13) and WLZ (SMD: 0.05; 95% CI: 0.01, 0.08). Conclusions: Nutrition education and complementary feeding interventions both had a small but significant impact on linear growth, and complementary feeding interventions also had an impact on ponderal growth of children aged 6-23 mo in low- and middle-income countries. The updated LiST model will support nutrition program planning and evaluation efforts by allowing users to model changes in intervention coverage on both stunting and wasting.
AB - Background: World Health Assembly member states have committed to ambitious global targets for reductions in stunting and wasting by 2025. Improving complementary diets of children aged 6-23 mo is a recommended approach for reducing stunting in children < 5 y old. Less is known about the potential of these interventions to prevent wasting. Objective: The aim of this article was to review and synthesize the current literature for the impact of complementary feeding interventions on linear [length-for-age z score (LAZ)] and ponderal [weight-for-length z score (WLZ)] growth of children aged 6-23 mo, with the specific goal of updating intervention-outcome linkages in the Lives Saved Tool (LiST). Methods: We started our review with studies included in the previous LiST review and searched for articles published since January 2012. We identified longitudinal trials that compared children aged 6-23 mo who received 1 of 2 types of complementary feeding interventions (nutrition education or counseling alone or complementary food supplementation with or without nutrition education or counseling) with a no-intervention control. We assessed study quality and generated pooled estimates of LAZ and WLZ change, as well as length and weight gain, for each category of intervention. Results: Interventions that provided nutrition education or counseling had a small but significant impact on linear growth in food-secure populations [LAZ standardized mean difference (SMD): 0.11; 95% CI: 0.01, 0.22] but not on ponderal growth. Complementary food supplementation interventions with or without nutrition education also had a small, significant effect in food-insecure settings on both LAZ (SMD: 0.08; 95% CI: 0.04, 0.13) and WLZ (SMD: 0.05; 95% CI: 0.01, 0.08). Conclusions: Nutrition education and complementary feeding interventions both had a small but significant impact on linear growth, and complementary feeding interventions also had an impact on ponderal growth of children aged 6-23 mo in low- and middle-income countries. The updated LiST model will support nutrition program planning and evaluation efforts by allowing users to model changes in intervention coverage on both stunting and wasting.
KW - Complementary feeding
KW - Food security
KW - Lives Saved Tool
KW - Stunting
KW - Wasting
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U2 - 10.3945/jn.116.243857
DO - 10.3945/jn.116.243857
M3 - Article
C2 - 28904113
AN - SCOPUS:85032719136
SN - 0022-3166
VL - 147
SP - 2169S-2178S
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 11
ER -