Linear growth increased in young children in an urban slum of Haiti: a randomized controlled trial of a lipid-based nutrient supplement.
BACKGROUND
Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children.


OBJECTIVE
We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children.


METHODS
Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally.


RESULTS
Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm.


CONCLUSIONS
A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.
Institute for Public Health, George Warren Brown School of Social Work, Washington University, St Louis, MO (LLI, SJLD, JG, SJ, JF, M-LA, CL, and JM); the Notre Dame de la Sagesse Nursing School, Cap-Haïtien, Haiti (SJLD and SJ); Konbit Sante, Portland, ME (NMN); and Konbit Sante, Cap-Haïtien, Haiti (NMN).
Lora L
LL
Iannotti
Sherlie Jean Louis
SJ
Dulience
Jamie
J
Green
Saminetha
S
Joseph
Judith
J
François
Marie-Lucie
ML
Anténor
Carolyn
C
Lesorogol
Jacqueline
J
Mounce
Nathan M
NM
Nickerson
D001835:Body Weight; D002657:Child Development; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control; D019587:Dietary Supplements; D002149:Energy Intake; D005500:Follow-Up Studies; D006205:Haiti; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D019266:Iron, Dietary / Q000008:administration & dosage*; D008137:Longitudinal Studies; D009017:Morbidity; D011204:Poverty Areas; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000517:prevention & control; D012959:Socioeconomic Factors; D014505:Urban Population; D014801:Vitamin A / Q000008:administration & dosage*; D014805:Vitamin B 12 / Q000008:administration & dosage*; D015032:Zinc / Q000008:administration & dosage*
D019266:Iron, Dietary; D014801:Vitamin A; D015032:Zinc; D014805:Vitamin B 12