Match!

Lipid-based nutrient supplements and all-cause mortality in children 6-24 months of age: a meta-analysis of randomized controlled trials.

Published on Nov 7, 2019in The American Journal of Clinical Nutrition6.568
· DOI :10.1093/ajcn/nqz262
Christine P. Stewart16
Estimated H-index: 16
(UC Davis: University of California, Davis),
Wessells Kr (UC Davis: University of California, Davis)+ 5 AuthorsKathryn G. Dewey72
Estimated H-index: 72
(UC Davis: University of California, Davis)
Abstract
BACKGROUND: Undernutrition is associated with an elevated risk of mortality among children in low- and middle-income countries. Small-quantity lipid-based nutrient supplements (LNS) have been evaluated as a method to prevent undernutrition and improve infant development, but the effects on mortality are unknown. OBJECTIVE: Our objective was to evaluate the effect of LNS on all-cause mortality among children 6-24 mo old. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials of LNS designed to prevent undernutrition, with or without other interventions. Literature was searched in May 2019 and trials were included if they enrolled children between 6 and 24 mo old and the period of supplementation lasted >/=6 mo. We extracted data from participant flow diagrams and contacted study investigators to request data. We conducted a meta-analysis to produce summary RR estimates. RESULTS: We identified 18 trials conducted in 11 countries that enrolled 41,280 children and reported 586 deaths. The risk of mortality was lower in the LNS arms than in the non-LNS comparison arms (RR: 0.73; 95% CI: 0.59, 0.89; 13 trials). Estimates were similar when trials with maternal LNS intervention arms were added or when alternative formulations of LNS were excluded. The results appeared stronger in trials in which LNS were compared with passive control arms. Excluding these contrasts and only comparing multicomponent arms with LNS groups and comparison groups that contained all the same components without LNS attenuated the effect estimate (RR: 0.82; 95% CI: 0.61, 1.10). CONCLUSIONS: LNS provided for the prevention of undernutrition may reduce the risk of mortality, but more trials with appropriate comparison groups allowing isolation of the effect of LNS alone are needed.This study was registered at www.crd.york.ac.uk/PROSPERO as CRD42019128718.
  • References (36)
  • Citations (2)
📖 Papers frequently viewed together
45 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References36
Newest
#1Julian P. T. Higgins (UoB: University of Bristol)H-Index: 99
#2Sally Green (UCL: University College London)H-Index: 50
The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.
7,644 Citations
#1Lieven Huybregts (IFPRI: International Food Policy Research Institute)H-Index: 22
#2Agnès Le Port (IFPRI: International Food Policy Research Institute)H-Index: 12
Last. Marie T. Ruel (IFPRI: International Food Policy Research Institute)H-Index: 53
view all 8 authors...
Background Community-based management of acute malnutrition (CMAM) has been widely adopted to treat childhood acute malnutrition (AM), but its effectiveness in program settings is often limited by implementation constraints, low screening coverage, and poor treatment uptake and adherence. This study addresses the problem of low screening coverage by testing the impact of distributing small-quantity lipid-based nutrient supplements (SQ-LNSs) at monthly screenings held by community health voluntee...
3 CitationsSource
#1Elodie Becquey (IFPRI: International Food Policy Research Institute)H-Index: 6
#2Lieven Huybregts (IFPRI: International Food Policy Research Institute)H-Index: 22
Last. Marie T. Ruel (IFPRI: International Food Policy Research Institute)H-Index: 53
view all 8 authors...
Background Community management of acute malnutrition (CMAM) is a highly efficacious approach for treating acute malnutrition (AM) in children who would otherwise be at significantly increased risk of mortality. In program settings, however, CMAM’s effectiveness is limited because of low screening coverage of AM, in part because of the lack of perceived benefits for caregivers. In Burkina Faso, monthly screening for AM of children 6 months of age. We used two study designs: (1) a repeated cross-...
2 CitationsSource
#1Barkat Ullah (UC Davis: University of California, Davis)H-Index: 7
#2Malay K. Mridha (BRACU: BRAC University)H-Index: 2
Last. Kathryn G. Dewey (UC Davis: University of California, Davis)H-Index: 11
view all 8 authors...
1 CitationsSource
#1Clemence Leyrat (Lond: University of London)H-Index: 7
#2Agnès Caille (University of Nantes)H-Index: 11
Last. Bruno Giraudeau (University of Nantes)H-Index: 45
view all 6 authors...
Background Cluster (CRTs) and individually randomized trials (IRTs) are often pooled together in meta-analyses (MAs) of randomized trials. However, the potential systematic differences in intervention effect estimates between these two trial types has never been investigated. Therefore, we conducted a meta-epidemiological study comparing intervention effect estimates between CRTs and IRTs. Methods All Cochrane MAs including at least one CRT and one IRT, published between 1 January 2010 and 31 De...
2 CitationsSource
#1K. Michael Hambidge (Anschutz Medical Campus)H-Index: 46
#2Jamie E Westcott (Anschutz Medical Campus)H-Index: 8
Last. Nancy F. Krebs (Anschutz Medical Campus)H-Index: 55
view all 21 authors...
7 CitationsSource
#1Andrew J. Prendergast (Johns Hopkins University)H-Index: 33
#2Bernard ChasekwaH-Index: 12
Last. Jean Hawes Humphrey (Johns Hopkins University)H-Index: 9
view all 16 authors...
Summary Background Children exposed to HIV have a high prevalence of stunting and anaemia. We aimed to test the effect of improved infant and young child feeding (IYCF) and improved water, sanitation, and hygiene (WASH) on child linear growth and haemoglobin concentrations. Methods We did a cluster randomised 2 × 2 factorial trial in two districts in rural Zimbabwe. Women were eligible for inclusion if they permanently lived in the trial clusters (ie, the catchment area of between one and four v...
2 CitationsSource
#1Seth Adu-Afarwuah (University of Ghana)H-Index: 11
#2Rebecca T Young (UC Davis: University of California, Davis)H-Index: 3
Last. Kathryn G. Dewey (UC Davis: University of California, Davis)H-Index: 11
view all 9 authors...
2 CitationsSource
#1Cornelius M. Smuts (NWU: North-West University)H-Index: 15
#2Tonderayi M. Matsungo (NWU: North-West University)H-Index: 4
Last. Mieke Faber (South African Medical Research Council)H-Index: 2
view all 13 authors...
5 CitationsSource
#1Jean Hawes Humphrey (Johns Hopkins University)H-Index: 9
#2Mduduzi N N MbuyaH-Index: 15
Last. Talent MakoniH-Index: 1
view all 610 authors...
Summary Background Child stunting reduces survival and impairs neurodevelopment. We tested the independent and combined effects of improved water, sanitation, and hygiene (WASH), and improved infant and young child feeding (IYCF) on stunting and anaemia in in Zimbabwe. Methods We did a cluster-randomised, community-based, 2 × 2 factorial trial in two rural districts in Zimbabwe. Clusters were defined as the catchment area of between one and four village health workers employed by the Zimbabwe Mi...
31 CitationsSource
Cited By2
Newest
#2Saijuddin ShaikhH-Index: 15
Last. Parul ChristianH-Index: 41
view all 8 authors...
Background: Four fortified complementary food supplements (CFSs) in a randomized controlled trial (RCT) were found to improve childhood linear growth in rural Bangladesh. We hypothesized children receiving these supplements would have improved micronutrient status. Methods: In the RCT, we assessed hemoglobin and serum ferritin, retinol, zinc, C-reactive protein (CRP), and α-1-acid glycoprotein (AGP) at endline (18 mo) in a subsample of children (n = 752). The impact of supplementation on mean co...
Source
Source
#1Saijuddin Shaikh (Johns Hopkins University)H-Index: 15
#2Rebecca K. Campbell (Johns Hopkins University)H-Index: 4
Last. Parul Christian (Johns Hopkins University)H-Index: 41
view all 10 authors...
BACKGROUND: Complementary food supplementation enhances linear growth and may affect body composition in children. OBJECTIVE: We aimed to determine the effect of complementary food supplements provided from the age of 6 to 18 mo on fat-free mass (FFM) and fat mass (FM) gain among children in rural Bangladesh. METHODS: In an unblinded, cluster-randomized, controlled trial we tested the effects of 4 complementary food supplements for 1 y [chickpea, rice lentil, Plumpy'doz, and wheat-soy-blend++ (W...
1 CitationsSource
#2Emily C KeatsH-Index: 2
view all 5 authors...
Micronutrient deficiencies continue to be widespread among children under-five in low- and middle-income countries (LMICs), despite the fact that several effective strategies now exist to prevent them. This kind of malnutrition can have several immediate and long-term consequences, including stunted growth, a higher risk of acquiring infections, and poor development outcomes, all of which may lead to a child not achieving his or her full potential. This review systematically synthesizes the avai...
Source