title: Effects of an intervention on infant growth and development: evidence for different mechanisms at work.
abstract: Millions of children in low-income and middle-income countries falter in linear growth and neurobehavioral development early in life. This faltering may be caused by risk factors that are associated with both growth and development, such as insufficient dietary intake and infection in infancy. Alternatively, these risk factors may be indicative of an environment that constrains both linear growth and development through different mechanisms. In a cluster-randomized trial in Burkina Faso, we previously found that provision of lipid-based nutrient supplements plus malaria and diarrhoea treatment from age 9 to 18 months resulted in positive effects of ~0.3 standard deviation on length-for-age z-score (LAZ) and of ~0.3 standard deviation on motor, language and personal-social development scores at age 18 months. In this paper, we examined whether the effect of the intervention on developmental scores was mediated by the effect on LAZ, or, alternatively, whether the intervention had independent effects on growth and development. For motor, language, and personal-social z-scores, the effect of the intervention decreased from 0.32 to 0.21, from 0.33 to 0.27 and from 0.35 to 0.29, respectively, when controlling for change in LAZ from 9 to 18 months. All effects remained significant. These results indicate that the intervention had independent positive effects on linear growth and development, suggesting that these effects occurred through different mechanisms. © 2016 John Wiley & Sons Ltd.
authors.affiliation: Department of Nutrition, University of California Davis, Davis, CA, USA.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Prado
authors.affiliation: Department of Nutrition, University of California Davis, Davis, CA, USA.
authors.forename: Souheila
authors.initials: S
authors.lastname: Abbeddou
authors.affiliation: Departments of Individual, Family, and Community Education and Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Yakes Jimenez
authors.affiliation: Department of Nutrition, University of California Davis, Davis, CA, USA.|Institut de Recherche en Sciences de la Santé/DRO, Bobo-Dioulasso, Burkina Faso.
authors.forename: Jérôme W
authors.initials: JW
authors.lastname: Somé
authors.affiliation: Department of Nutrition, University of California Davis, Davis, CA, USA.
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Dewey
authors.affiliation: Department of Nutrition, University of California Davis, Davis, CA, USA.|Bill & Melinda Gates Foundation, Seattle, WA, USA.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Brown
authors.affiliation: Department of Nutrition, University of California Davis, Davis, CA, USA.
authors.forename: Sonja Y
authors.initials: SY
authors.lastname: Hess
mesh_terms: D001827:Body Height; D002050:Burkina Faso; D002657:Child Development; D002675:Child, Preschool; D016000:Cluster Analysis; D003967:Diarrhea / Q000628:therapy; D004032:Diet; D019587:Dietary Supplements; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008288:Malaria / Q000628:therapy; D018977:Micronutrients / Q000008:administration & dosage*; D012307:Risk Factors
chemical_list: D018977:Micronutrients
keywords: growth faltering; infant development; infant growth; infant interventions; low-resource settings; neurobehavioral development