title: Effects of animal source food and micronutrient fortification in complementary food products on body composition, iron status, and linear growth: a randomized trial in Cambodia.
abstract: BACKGROUND
  Poor nutritional quality of complementary foods often limits growth. Animal source foods, such as milk or meat, are often unaffordable. Local affordable alternatives are needed.
  
  
  OBJECTIVE
  We evaluate the efficacy of 2 newly developed, rice-based complementary food products: WinFood (WF) with small fish and edible spiders and WinFood-Lite (WF-L) fortified with small fish, against 2 existing fortified corn-soy blend products, CSB+ (purely plant based) and CSB++ (8% dried skimmed milk).
  
  
  METHODS
  In total, 419 infants aged 6 mo were enrolled in this randomized, single-blinded study for 9 mo, designed primarily to assess increments in fat-free mass by a deuterium dilution technique and change in plasma ferritin and soluble transferrin receptor. Secondary endpoints were changes in anthropometric variables, including knee-heel length. Data were analyzed by the intention-to-treat approach.
  
  
  RESULTS
  There was no difference in fat-free mass increment in WF or WF-L compared with CSB+ [WF: +0.04 kg (95% CI: -0.20, 0.28 kg); WF-L: +0.14 kg (95% CI: -0.10, 0.38 kg)] or CSB++ [WF: -0.03 kg (95% CI: -0.27, 0.21 kg); WF-L: +0.07 kg (95% CI: -0.18, 0.31 kg)] and no effect on iron status. The 1.7-mm (95% CI: -0.1, 3.5 mm) greater increase in knee-heel length in WF-L than in CSB+ was not significant.
  
  
  CONCLUSIONS
  No difference was found between the locally produced products (WF and WF-L) and the CSBs. Micronutrient fortification may be necessary, and small fish may be an affordable alternative to milk to improve complementary foods. The dietary role of edible spiders needs to be further explored. This trial was registered at controlled-trials.com as ISRCTN19918531.
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Jutta K H
authors.initials: JK
authors.lastname: Skau
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Bunthang
authors.initials: B
authors.lastname: Touch
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Chamnan
authors.initials: C
authors.lastname: Chhoun
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Mary
authors.initials: M
authors.lastname: Chea
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Uma S
authors.initials: US
authors.lastname: Unni
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Jan
authors.initials: J
authors.lastname: Makurat
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Suzanne
authors.initials: S
authors.lastname: Filteau
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Frank T
authors.initials: FT
authors.lastname: Wieringa
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Marjoleine A
authors.initials: MA
authors.lastname: Dijkhuizen
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Christian
authors.initials: C
authors.lastname: Ritz
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Wells
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Jacques
authors.initials: J
authors.lastname: Berger
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Henrik
authors.initials: H
authors.lastname: Friis
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Kim F
authors.initials: KF
authors.lastname: Michaelsen
authors.affiliation: From the Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark (JKHS, MD, CR, HF, KFM, and NR); Inland Fisheries Research and Development Institute, Phnom Penh, Cambodia (BT); Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (CC); National Nutrition Programme, Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia (MC); Institute of Nutritional Sciences, Justus Liebig University, Giessen, Germany (JM); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (SF); Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JW); St. John's Research Institute, Bangalore, India (USU); and Institut de Recherche pour le Développement (IRD), Montpellier, France (FW and JB).
authors.forename: Nanna
authors.initials: N
authors.lastname: Roos
mesh_terms: D001823:Body Composition; D001827:Body Height; D001835:Body Weight; D002160:Cambodia; D004032:Diet; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000032:analysis*; D007227:Infant Nutritional Physiological Phenomena; D019266:Iron, Dietary / Q000097:blood*; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D009753:Nutritive Value; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D019266:Iron, Dietary; D018977:Micronutrients
keywords: animal source foods; body composition; complementary food; fortification; iron status