A developmental view of the effects of an energy and micronutrient supplement in undernourished children in Indonesia.
OBJECTIVE
This paper presents the results of a structural equation model testing whether the longitudinal data of the Pangalengan subjects fit the theoretical model regarding the intellectual delay of undernourished children.


METHODS
Two cohorts of children were randomly assigned to three treatments: E = 1171 kJ + 12 mg iron; M = 12 mg iron + 209 kJ; S = 104 kJ. Supplementation was given for 6 months.


METHODS
The sites were six tea plantations in Indonesia.


METHODS
A 12-month-old (n = 53) and an 18-month-old (n = 83) cohort were recruited from day-care-centers. Inclusion criteria were: no chronic disease; length-for-age = < 1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization.


METHODS
Twenty-four-hour dietary intakes were assessed using the weighted individual inventory technique. Body weight and length were obtained using standard procedures; motor development was assessed with the Bayley Scale and with a custom made scale for motor development leading to bipedal locomotion. Four-hour observations were made of the child's interactions with the environment. Carrying a child in the arms and exploratory behavior were used as indicators of caregiving and exploration. All measurements were obtained every 2 months.


RESULTS
The original model did not fit the data. The model was then modified with the inclusion of two new pathways: from activity and from motor development to mental development. Following these adjustments the model fit the data for each cohort and for both cohorts combined.
Pollitt
E
E
Department of Pediatrics and Program in International Nutrition, University of California, Davis 95616-8538, USA.
Jahari
A
A
Walka
H
H
D000886:Anthropometry; D001921:Brain / Q000254:growth & development; D002657:Child Development; D003071:Cognition; D015331:Cohort Studies; D015930:Diet Records; D019587:Dietary Supplements; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006801:Humans; D007214:Indonesia; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008124:Locomotion; D008137:Longitudinal Studies; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000494:pharmacology; D008954:Models, Biological; D009748:Nutrition Disorders / Q000178:diet therapy / Q000503:physiopathology*
D018977:Micronutrients