Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: effects on growth and motor development.
BACKGROUND
The low micronutrient content of complementary foods is associated with growth faltering in many populations. A potential low-cost solution is the home fortification of complementary foods with Sprinkles (SP) powder, crushable Nutritabs (NT) tablets, or energy-dense (108 kcal/d), fat-based Nutributter (NB).


OBJECTIVE
The objective was to test the hypothesis that multiple micronutrients added to home-prepared complementary foods would increase growth and that the effect would be greatest in the presence of added energy from fat.


METHODS
We randomly assigned 313 Ghanaian infants to receive SP, NT, or NB containing 6, 16, and 19 vitamins and minerals, respectively, daily from 6 to 12 mo of age. We assessed anthropometric status at 6, 9, and 12 mo; micronutrient status at 6 and 12 mo; motor development at 12 mo; and morbidity weekly. Infants (n = 96) not randomly selected for the intervention (nonintervention; NI) were assessed at 12 mo.


RESULTS
The groups did not differ significantly at baseline, except that the NB group had a higher proportion of boys and weighed slightly more. The dropout rate (15/313) was low. At 12 mo, after control for initial size, the NB group had a significantly greater weight-for-age z score (WAZ) (-0.49 +/- 0.54) and length-for-age z score (LAZ) (-0.20 +/- 0.54) than did the NT group (WAZ: -0.67 +/- 0.54; LAZ: -0.39 +/- 0.54) and the NT and SP groups combined (WAZ: -0.65 +/- 0.54; LAZ: -0.38 +/- 0.54); the difference with the NI group (WAZ: -0.74 +/- 1.1; LAZ: -0.40 +/- 1.0) was not significant. A lower percentage of the NI infants (25%) than of the intervention groups (SP: 39%; NT: 36%; NB: 49%) could walk independently by 12 mo.


CONCLUSIONS
All 3 supplements had positive effects on motor milestone acquisition by 12 mo compared with no intervention, but only NB affected growth.
Program in International Nutrition and Community Nutrition, University of California, Davis, CA 95616-8669, USA.
Seth
S
Adu-Afarwuah
Anna
A
Lartey
Kenneth H
KH
Brown
Stanley
S
Zlotkin
André
A
Briend
Kathryn G
KG
Dewey
D001724:Birth Weight; D001942:Breast Feeding; D019587:Dietary Supplements; D002149:Energy Intake; D005869:Ghana; D006128:Growth / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018977:Micronutrients / Q000494:pharmacology*; D008903:Minerals / Q000494:pharmacology; D009043:Motor Activity / Q000187:drug effects*; D014815:Vitamins / Q000494:pharmacology
D018977:Micronutrients; D008903:Minerals; D014815:Vitamins