title: Longitudinal growth and health outcomes in nutritionally at-risk children who received long-term nutritional intervention.
abstract: BACKGROUND
  The benefits of short-term oral nutritional supplementation (ONS) in undernourished children are well-established. The benefits of long-term ONS in promoting longitudinal growth and health in children who are at risk of undernutrition have not been reported previously.
  
  
  METHODS
  In this 48-week prospective, single-arm, multicentre trial, 200 Filipino children aged 3-4 years with weight-for-height percentiles from 5th to 25th (WHO Child Growth Standards) were enrolled. Parents received dietary counselling at baseline, and at weeks 4 and 8. Two servings of ONS (450 mL) were consumed daily, providing 450 kcal, 13.5 g protein and micronutrients. Weight, height, dietary intake using 24-h dietary recalls, and physical activity and appetite using the visual analogue scales were assessed at baseline and weeks 4, 8, 16, 24, 32, 40 and 48. The number of sick days for acute illnesses was collected over the study period.
  
  
  RESULTS
  At baseline, mean age was 41.2 months with 50% being male. Weight-for-height percentiles showed the greatest increase in the first 4 weeks (12.1 and 12.8 percentiles, respectively, P < 0.0001) and remained significantly higher than baseline (P < 0.0001) but were relatively stable from week 4 onwards. Height-for-age percentiles increased steadily over time and became significantly higher than baseline from week 24 onwards (P < 0.0001). Appetite and physical activity scores at all post-baseline visits improved from baseline (P < 0.0001), and a reduction in the number of sick days from week 16 onwards was also observed (P < 0.0001). Higher parental education level, being male and higher baseline weight-for-height percentiles were significantly associated with higher ponderal and linear growth over time in repeated measures analysis of covariance.
  
  
  CONCLUSIONS
  Intervention consisting of initial dietary counselling and continued ONS helped sustain normal growth after a catch-up growth in nutritionally at-risk children.
authors: Abbott Nutrition Research & Development, Asia-Pacific Centre, Abbott Laboratories, Singapore, Singapore.
authors: D T T
authors: DT
authors: Huynh
authors: Asian Hospital and Medical Centre, Manila, Philippines.
authors: E
authors: E
authors: Estorninos
authors: Asian Hospital and Medical Centre, Manila, Philippines.
authors: R Z
authors: RZ
authors: Capeding
authors: Scientific and Medical Affairs, Abbott Nutrition, Abbott Laboratories, Columbus, OH, USA.
authors: J S
authors: JS
authors: Oliver
authors: Abbott Nutrition Research & Development, Asia-Pacific Centre, Abbott Laboratories, Singapore, Singapore.
authors: Y L
authors: YL
authors: Low
authors: Scientific and Medical Affairs, Abbott Nutrition, Abbott Laboratories, Columbus, OH, USA.
authors: F J
authors: FJ
authors: Rosales
mesh_terms: D001827:Body Height / Q000502:physiology*; D001835:Body Weight / Q000502:physiology*; D002657:Child Development / Q000502:physiology*; D015362:Child Nutrition Disorders / Q000178:diet therapy / Q000517:prevention & control*; D002675:Child, Preschool; D004032:Diet / Q000379:methods / Q000706:statistics & numerical data*; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D010679:Philippines; D011446:Prospective Studies
keywords: long-term supplementation; longitudinal growth; oral nutritional supplement; undernutrition