title: Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6-18 months living in the rural region of Intibucá, Honduras.
abstract: BACKGROUND
  Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children.
  
  
  METHODS
  A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months' blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data.
  
  
  RESULTS
  At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence.
  
  
  CONCLUSIONS
  These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Siega-Riz
authors.forename: Yaniré
authors.initials: Y
authors.lastname: Estrada Del Campo
authors.forename: Alan
authors.initials: A
authors.lastname: Kinlaw
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Reinhart
authors.forename: Lindsay H
authors.initials: LH
authors.lastname: Allen
authors.forename: Setareh
authors.initials: S
authors.lastname: Shahab-Ferdows
authors.forename: Jeff
authors.initials: J
authors.lastname: Heck
authors.forename: Chirayath M
authors.initials: CM
authors.lastname: Suchindran
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Bentley
mesh_terms: D002657:Child Development; D016000:Cluster Analysis; D004041:Dietary Fats / Q000008:administration & dosage*; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000097:blood; D005500:Follow-Up Studies; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007501:Iron / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D044342:Malnutrition / Q000517:prevention & control*; D018977:Micronutrients / Q000008:administration & dosage* / Q000172:deficiency; D009752:Nutritional Status; D012256:Riboflavin / Q000097:blood; D012424:Rural Population; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000097:blood; D035862:Vulnerable Populations; D015032:Zinc / Q000097:blood
chemical_list: D004041:Dietary Fats; D008055:Lipids; D018977:Micronutrients; D005492:Folic Acid; D007501:Iron; D015032:Zinc; D014805:Vitamin B 12; D012256:Riboflavin
keywords: Honduras; child undernutrition; lipid-based nutrient supplements; micronutrients; prevention; randomised controlled trial