title: The Impact of Nutritional Interventions beyond the First 2 Years of Life on Linear Growth: A Systematic Review and Meta-Analysis.
abstract: A large body of evidence suggests that the first 1000 d from conception is a critical window in which interventions to address malnutrition will be most effective, but little is known about the impact on linear growth of nutritional interventions in children ≥2 y of age. The aim of this analysis was to evaluate the effectiveness of several nutrition-based interventions, specifically iron, zinc, calcium, iodine, vitamin A, multiple (≥2) micronutrients, protein, and food, at improving growth in children ≥2 y of age. A systematic search of MEDLINE and EMBASE retrieved 7794 articles. A total of 69 studies met prespecified inclusion criteria. Baseline height-for-agezscore, age, nutrient dose, and study duration were examined as potential sources of heterogeneity. Zinc (mean effect size: 0.15; 95% CI: 0.06, 0.24), vitamin A (0.05; 95% CI: 0.01, 0.09), multiple micronutrients (0.26; 95% CI: 0.13, 0.39), and protein (0.68; 95% CI: 0.30, 1.05) had significant positive effects on linear growth, with baseline height-for-agezscore as a significant inverse predictor of the effect size. Iron, calcium, iodine, and food-based interventions had no significant effect on growth. Age at baseline, study duration, and dose were not related to effect size for any nutrient examined. These findings suggest that zinc, vitamin A, multiple micronutrients, and protein interventions delivered after 24 mo of age can have a positive effect on linear growth, especially in populations that have experienced growth failure.
authors.affiliation: Nutrition and Health Sciences, Laney Graduate School, and.
authors.forename: Joseph L
authors.identifier: http://orcid.org/0000-0001-6839-1173
authors.initials: JL
authors.lastname: Roberts
authors.affiliation: Nutrition and Health Sciences, Laney Graduate School, and aryeh.stein@emory.edu.|Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Aryeh D
authors.identifier: http://orcid.org/0000-0003-1138-6458
authors.initials: AD
authors.lastname: Stein
mesh_terms: D002675:Child, Preschool; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage*; D019587:Dietary Supplements; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D018977:Micronutrients / Q000008:administration & dosage*; D015596:Nutrition Assessment; D009752:Nutritional Status; D016032:Randomized Controlled Trials as Topic
chemical_list: D004044:Dietary Proteins; D018977:Micronutrients
keywords: 1000 days; calcium; iron; multiple micronutrient; protein; stunting; vitamin A; zinc