title: A cluster-randomized trial determining the efficacy of caterpillar cereal as a locally available and sustainable complementary food to prevent stunting and anaemia.
abstract: OBJECTIVE
  We conducted a cluster-randomized controlled trial to assess the efficacy of a cereal made from caterpillars, a micronutrient-rich, locally available alternative animal-source food, on reducing stunting and anaemia in infants in the Democratic Republic of Congo.
  
  
  METHODS
  Six-month-old infants were cluster randomized to receive either caterpillar cereal daily until 18 months of age or the usual diet. At 18 months of age, anthropometric measurements and biological samples were collected.
  
  
  METHODS
  The rural Equateur Province in the Democratic Republic of Congo.
  
  
  METHODS
  One hundred and seventy-five infants followed from 6 to 18 months of age.
  
  
  RESULTS
  Stunting was common at 6 months (35%) and the prevalence increased until 18 months (69%). There was no difference in stunting prevalence at 18 months between the intervention and control groups (67% v. 71%, P = 0.69). Infants in the cereal group had higher Hb concentration than infants in the control group (10.7 v. 10.1 g/dl, P = 0.03) and fewer were anaemic (26 v. 50%, P = 0.006), although there was no difference in estimates of body Fe stores (6.7 v. 7.2 mg/kg body weight, P = 0.44).
  
  
  CONCLUSIONS
  Supplementation of complementary foods with caterpillar cereal did not reduce the prevalence of stunting at 18 months of age. However, infants who consumed caterpillar cereal had higher Hb concentration and fewer were anaemic, suggesting that caterpillar cereal might have some beneficial effect. The high prevalence of stunting at 6 months and the lack of response to this micronutrient-rich supplement suggest that factors other than dietary deficiencies also contribute to stunting.
authors: 1Department of Pediatrics,Division of Neonatal-Perinatal Medicine,School of Medicine,University of North Carolina at Chapel Hill,101 Manning Drive,CB#7596,Chapel Hill,NC 27599-7596,USA.
authors: Melissa
authors: M
authors: Bauserman
authors: 3Kinshasa School of Public Health,Kinshasa,Democratic Republic of Congo.
authors: Adrien
authors: A
authors: Lokangaka
authors: 3Kinshasa School of Public Health,Kinshasa,Democratic Republic of Congo.
authors: Justin
authors: J
authors: Gado
authors: 4RTI International,Research Triangle Park,NC,USA.
authors: Kelly
authors: K
authors: Close
authors: 4RTI International,Research Triangle Park,NC,USA.
authors: Dennis
authors: D
authors: Wallace
authors: 5Department of Pharmacy,University of Kinshasa,Kinshasa,Democratic Republic of Congo.
authors: Kule-Koto
authors: KK
authors: Kodondi
authors: 3Kinshasa School of Public Health,Kinshasa,Democratic Republic of Congo.
authors: Antoinette
authors: A
authors: Tshefu
authors: 1Department of Pediatrics,Division of Neonatal-Perinatal Medicine,School of Medicine,University of North Carolina at Chapel Hill,101 Manning Drive,CB#7596,Chapel Hill,NC 27599-7596,USA.
authors: Carl
authors: C
authors: Bose
mesh_terms: D000740:Anemia / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D000818:Animals; D003223:Congo / Q000453:epidemiology; D003677:Deficiency Diseases / Q000178:diet therapy* / Q000453:epidemiology; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology* / Q000517:prevention & control; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D007313:Insecta / Q000737:chemistry*; D008297:Male; D018977:Micronutrients / Q000172:deficiency / Q000627:therapeutic use*; D015995:Prevalence; D012424:Rural Population
chemical_list: D006454:Hemoglobins; D018977:Micronutrients
keywords: Anaemia; Complementary feeding; Stunting
references: J Nutr. 2002 Jun;132(6):1180-7
references: 12042431
references: Am J Clin Nutr. 1999 Sep;70(3):391-404
references: 10479202
references: J Nutr. 2006 Mar;136(3):656-63
references: 16484539
references: Blood. 2003 May 1;101(9):3359-64
references: 12521995
references: Lancet. 2008 Jan 19;371(9608):243-60
references: 18207566
references: Lancet. 2013 Aug 3;382(9890):427-451
references: 23746772
references: Am J Clin Nutr. 2012 May;95(5):1157-64
references: 22492382
references: Matern Child Nutr. 2008 Apr;4 Suppl 1:24-85
references: 18289157
references: Am J Clin Nutr. 2009 Jan;89(1):382-90
references: 19056572
references: J Nutr. 2004 Nov;134(11):3127-32
references: 15514286
references: J Nutr. 2007 Apr;137(4):1101-5
references: 17374687
references: Cochrane Database Syst Rev. 2005 Oct 19;(4):CD005039
references: 16235389
references: Am J Clin Nutr. 2010 Sep;92(3):546-55
references: 20610634
references: Lancet. 2008 Feb 2;371(9610):417-40
references: 18206226
references: Am J Clin Nutr. 2012 Oct;96(4):840-7
references: 22952176
references: Int J Vitam Nutr Res. 1987;57(3):333-4
references: 3679706
references: Acta Paediatr Suppl. 2006 Apr;450:76-85
references: 16817681
references: Anal Biochem. 1974 Sep;61(1):209-24
references: 4472196
references: Matern Child Nutr. 2015 Dec;11 Suppl 4:214-20
references: 23557509
references: Am J Clin Nutr. 2007 Aug;86(2):412-20
references: 17684213
references: PLoS One. 2010 Jun 17;5(6):e11165
references: 20567511
references: Lancet. 2013 Aug 3;382(9890):452-477
references: 23746776
references: Cochrane Database Syst Rev. 2012 Jun 13;(6):CD005039
references: 22696347
references: Lancet. 2008 Jan 26;371(9609):340-57
references: 18206223
references: Am J Clin Nutr. 2000 Mar;71(3):682-92
references: 10702160
references: CRC Crit Rev Clin Lab Sci. 1978;9(3):179-208
references: 401369
references: Am J Clin Nutr. 2013 May;97(5):911-8
references: 23553163
references: J Pediatr Gastroenterol Nutr. 2006 Mar;42(3):306-12
references: 16540800