title: A Food Transfer Program without a Formal Education Component Modifies Complementary Feeding Practices in Poor Rural Mexican Communities.
abstract: BACKGROUND
  Inadequate complementary feeding partially explains micronutrient deficiencies in the first 2 y of life. To prevent malnutrition, the Mexican government implemented the Programa de Apoyo Alimentario (PAL), which transferred either food baskets containing micronutrient-fortified milk and animal food products or cash to beneficiary families along with educational sessions.
  
  
  OBJECTIVE
  This study evaluated the impact of PAL on 2 indicators of complementary feeding: minimum dietary diversity and consumption of iron-rich or iron-fortified foods in children aged 6-23 mo.
  
  
  METHODS
  A secondary analysis of the original PAL evaluation design was conducted through a randomized community trial implemented with 3 intervention groups (food basket with education, food basket without education, and cash transfer with education) and a control. The impact of PAL after 14 mo of exposure was estimated in 2 cross-sectional groups of children aged 6-23 mo at baseline and at follow-up in a panel of 145 communities by using difference-in-difference models. Only children who lived in households and communities that were similar between treatment groups at baseline were included in the analysis. These children were identified by using a propensity score.
  
  
  RESULTS
  Of the 3 intervention groups, when compared with the control, only the food basket without education group component increased the consumption of iron-rich or iron-fortified foods by 31.2 percentage points (PP) (P < 0.01) and the prevalence of minimum dietary diversity by 21.6 PP (P < 0.01).
  
  
  CONCLUSIONS
  These findings suggest that in order to improve dietary quality in children, food baskets that include fortified complementary foods may be more effective than cash transfers. The fact that the 2 food basket groups differed in the observed impact does not allow for more convincing conclusions to be made about the education component of the program. This trial was registered at clinicaltrials.gov as NCT01304888.
authors.affiliation: Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: María J
authors.initials: MJ
authors.lastname: Ramírez-Luzuriaga
authors.affiliation: Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Mishel
authors.initials: M
authors.lastname: Unar-Munguía
authors.affiliation: Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Sonia
authors.initials: S
authors.lastname: Rodríguez-Ramírez
authors.affiliation: Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Rivera
authors.affiliation: Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico teresita.glezdecosio@ibero.mx.
authors.forename: Teresa
authors.initials: T
authors.lastname: González de Cosío
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D063105:Food Assistance; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D019266:Iron, Dietary / Q000008:administration & dosage*; D008297:Male; D008800:Mexico; D009752:Nutritional Status; D011203:Poverty; D012424:Rural Population
chemical_list: D019266:Iron, Dietary
keywords: Mexico; complementary feeding; dietary diversity; food transfers; iron intake