Effectiveness of community-based complementary food supplement (Yingyangbao) distribution in children aged 6-23 months in poor areas in China.
BACKGROUND
Poor growth and micronutrient deficiency mainly attack older infants and young children. Some countries have adopted clinically effective measures to combat malnutrition, but the compliance and improvement in efficacy of intervention vehicles in national programs require evaluation.


METHODS
Baseline and follow-up cross-sectional surveys were conducted before and after a nutrition intervention program in 3 national poverty counties in China. Soybean-based complementary food supplements called Yingyangbao (YYB) in Chinese and training materials on child feeding were distributed to households with children aged 6-23 months for 18 months. Representative children were selected by probability proportional to size sampling methods to assess compliance of YYB and the intervention efficacy. A questionnaire was designed to collect data on basic characteristics of children, breastfeeding, 24-hour dietary intake, and consumption and appetite of YYB. Anthropometrics and hemoglobin were measured in the field, and anemia prevalence was evaluated. Venous blood was drawn from children aged 12-35 months to evaluate micronutrient status. Logistic regression was used to identify the risk factors for children's anemia.


RESULTS
Of the children involved in the follow-up survey (n = 693), the P50 (P25, P75) intake of YYB was 6.7 (3.5, 7.0) sachets weekly, and 54.7% of the children liked the taste of YYB. Compared with the baseline situation (n = 823), the proportion of children fed a diverse diet and foods rich in iron or vitamin A increased (P < 0.01) in the follow-up study. The prevalence of stunting and underweight decreased (P < 0.05), the prevalence of anemia decreased from 28.0% to 19.9% (P < 0.01), and the prevalence of vitamin B12 deficiency decreased from 26.8% to 15.4% (P < 0.01). For children aged 12-23 months, those who liked YYB and consumed 6 or more sachets of YYB weekly were at lower risk for anemia (OR = 0.34, 95% CI 0.13-0.90, P < 0.05), but the risk of stunting was associated with a non-diverse diet (OR = 1.48, 95% CI 1.06-2.07, P < 0.05).


CONCLUSIONS
The quality of diet and nutritional status of children aged 6-23 months are significantly improved by the intervention of YYB and nutrition education, and good compliance to YYB contributes to a low risk for anemia.


BACKGROUND
Chinese Clinical Trial Registry ChiCTR-OOC-16008846.
Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Jie
J
Wang
Section of Health and Nutrition and Water, Environment and Sanitation, United Nations Children's Fund, Beijing, China.
Suying
S
Chang
Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Liyun
L
Zhao
Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Wentao
W
Yu
Department of Nutrition on Aging, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Jian
J
Zhang
Department of Nutrition on Aging, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Qingqing
Q
Man
Department of Science and Technology, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Li
L
He
Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Yifan
Y
Duan
Department of Population Research, China Population and Development Research Center, Beijing, China.
Hui
H
Wang
Section of Health and Nutrition and Water, Environment and Sanitation, United Nations Children's Fund, Beijing, China.
Robert
R
Scherpbier
Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Shi-An
SA
Yin
D000740:Anemia / Q000097:blood / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control; D015415:Biomarkers / Q000097:blood; D001942:Breast Feeding; D002681:China; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D004435:Eating; D004505:Education, Nonprofessional; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000097:blood / Q000178:diet therapy* / Q000453:epidemiology / Q000517:prevention & control*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000097:blood / Q000178:diet therapy* / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D018977:Micronutrients / Q000097:blood / Q000172:deficiency; D016487:Parenting; D010349:Patient Compliance; D011204:Poverty Areas; D012307:Risk Factors; D045730:Soy Foods
D015415:Biomarkers; D006454:Hemoglobins; D018977:Micronutrients