title: Intervention study shows suboptimal growth among children receiving a food supplement for five months in a slum in Bangladesh.
abstract: OBJECTIVE
  This study assessed weight and height changes among underweight children who received a locally produced, cereal-based, ready-to-use supplementary food.
  
  
  METHODS
  We recruited 500 underweight Bangladeshi children aged 6-23 months from a Dhaka slum and individually matched them by sex and neighbourhood with 480 well-nourished controls. The intervention group received the daily food supplement for five months, and both groups received daily micronutrient supplements. Their weight, height, mid-upper-arm circumference and head circumference were measured monthly.
  
  
  RESULTS
  The children's mean daily weight gain decreased from 1.27 to 0.66 grams per kilogram per day (g/kg/day) in the intervention group and 0.77 to 0.49 g/kg/day in the controls after adjusting for age differences between the two groups from baseline to five months of follow-up. The mean monthly height gain decreased from 1.13 to 1.03 millimetres per metre per month in the intervention children and 1.26 to 1.01 in the controls. The weight gain was highest in the intervention children who were most wasted at baseline and the controls who were least stunted.
  
  
  CONCLUSIONS
  The children showed suboptimal growth despite food supplements, highlighting the need for ongoing research to develop inexpensive, locally sourced food supplements to improve the nutrition of underweight children in Bangladesh.
authors.affiliation: Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh.
authors.forename: Nuzhat
authors.initials: N
authors.lastname: Choudhury
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Sabri
authors.initials: S
authors.lastname: Bromage
authors.affiliation: Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh.
authors.forename: Md Ashraful
authors.initials: MA
authors.lastname: Alam
authors.affiliation: Disease Prevention and Control Division, University of Queensland School of Public Health, Herston, QLD, Australia.
authors.forename: A M
authors.initials: AM
authors.lastname: Shamsir Ahmed
authors.affiliation: Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh.
authors.forename: M
authors.initials: M
authors.lastname: Munirul Islam
authors.affiliation: Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh.
authors.forename: M
authors.initials: M
authors.lastname: Iqbal Hossain
authors.affiliation: Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Mahfuz
authors.affiliation: Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Mondal
authors.affiliation: Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh.
authors.forename: Rashidul
authors.initials: R
authors.lastname: Haque
authors.affiliation: Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh. tahmeed@icddrb.org.
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
mesh_terms: D001459:Bangladesh; D002657:Child Development; D005260:Female; D005502:Food; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D011204:Poverty Areas; D013851:Thinness / Q000178:diet therapy*
keywords: Bangladesh; children; growth; malnutrition; ready-to-use supplementary food