title: Impact of lipid-based nutrient supplementation (LNS) on children's diet adequacy in Western Uganda.
abstract: Lipid-based nutrient supplements (LNS) can help treat undernutrition; however, the dietary adequacy of children supplemented with LNS, and household utilisation patterns are not well understood. We assessed diet adequacy and the quality of complementary foods by conducting a diet assessment of 128 Ugandan children, ages 6-59 months, who participated in a 10-week programme for children with moderate acute malnutrition (MAM, defined as weight-for-age z-score < -2). Caregivers were given a weekly ration of 650 kcal day(-1) (126 g day(-1) ) of a peanut/soy LNS. Two 24-h dietary recalls were administered per child. LNS was offered to 86% of targeted children at least once. Among non-breastfed children, over 90% met their estimated average requirement (EAR) cut-points for all examined nutrients. Over 90% of breastfed children met EAR cut-points for nutrient density for most nutrients, except for zinc where 11.7% met cut-points. A lower proportion of both breastfed and non-breastfed children met adjusted EARs for the specific nutritional needs of MAM. Fewer than 20% of breastfed children met EAR nutrient-density guidelines for MAM for zinc, vitamin C, vitamin A and folate. Underweight status, the presence of a father in the child's home, and higher programme attendance were all associated with greater odds of feeding LNS to targeted children. Children in this community-based supplemental feeding programme who received a locally produced LNS exhibited substantial micronutrient deficiencies given the special dietary needs of this population. These results can help inform programme strategies to improve LNS targeting, and highlight potential nutrient inadequacies for consumers of LNS in community-based settings.
authors.affiliation: Department of Kinesiology and Health Sciences, College of William and Mary, Williamsburg, Virginia, USA.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Ickes
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Adair
authors.affiliation: Department of Kinesiology and Health Sciences, College of William and Mary, Williamsburg, Virginia, USA.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Brahe
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Harsha
authors.initials: H
authors.lastname: Thirumurthy
authors.affiliation: Makerere University School of Public Health, Kampala, Uganda.
authors.forename: Baguma
authors.initials: B
authors.lastname: Charles
authors.affiliation: World Harvest Mission East Africa, Kijaabe, Kenya.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Myhre
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Bentley
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ammerman
mesh_terms: D001205:Ascorbic Acid / Q000008:administration & dosage / Q000032:analysis; D002675:Child, Preschool; D004041:Dietary Fats / Q000008:administration & dosage* / Q000032:analysis; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000032:analysis; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000737:chemistry*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000178:diet therapy*; D018977:Micronutrients / Q000008:administration & dosage / Q000032:analysis; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013851:Thinness / Q000178:diet therapy; D014454:Uganda; D014801:Vitamin A / Q000008:administration & dosage / Q000032:analysis; D015032:Zinc / Q000008:administration & dosage / Q000032:analysis
chemical_list: D004041:Dietary Fats; D018977:Micronutrients; D014801:Vitamin A; D005492:Folic Acid; D015032:Zinc; D001205:Ascorbic Acid
keywords: child malnutrition; diet adequacy; household allocation; lipid-based nutrient supplements; sharing