title: Effect of 12-month intervention with lipid-based nutrient supplement on the physical activity of Malawian toddlers: a randomised, controlled trial.
abstract: Physical activity is beneficial for children's well-being. The effect of dietary supplementation on children's physical activity in food-insecure areas remains little studied. We examined the effects of a lipid-based nutrient supplement (LNS) on children's objectively measured physical activity in a randomised, controlled, outcome-assessor-blinded trial. Mothers of the children received one capsule daily of Fe-folic acid (IFA), one capsule containing eighteen micronutrients (MMN) or one 20 g sachet of LNS (containing twenty-two MMN, protein, carbohydrates, essential fatty acids and 494 kJ (118 kcal)) during pregnancy and for 6 months thereafter. Children in the IFA and MMN groups received no supplementation, and these groups were collapsed into a single control group; children in the LNS group received 20 g LNS from 6 to 18 months. We measured physical activity with accelerometers over 1 week at 18 months. The main outcome was mean vector magnitude counts/15 s. Of the 728 children at the beginning of child intervention at 6 months, 570 (78 %) provided sufficient data for analysis. The mean accelerometer counts for the 190 children in the LNS group and for the 380 children in the control group were 303 (sd 59) and 301 (sd 56), respectively (P for difference=0·65). LNS, given to mothers during pregnancy and 6 months postpartum and to their infants from 6 to 18 months of age, did not increase physical activity among 18-month-old children.
authors.affiliation: 1Department of Public Health,University of Turku and Turku University Hospital,20014 Turku,Finland.
authors.forename: A
authors.initials: A
authors.lastname: Pulakka
authors.affiliation: 2Centre for Quantitative Medicine,Duke-National University of Singapore Medical School,Singapore 169857,Singapore.
authors.forename: Y B
authors.initials: YB
authors.lastname: Cheung
authors.affiliation: 4School of Public Health and Family Medicine,University of Malawi College of Medicine,Mahatma Gandhi Road,Blantyre,Malawi.
authors.forename: K
authors.initials: K
authors.lastname: Maleta
authors.affiliation: 5Department of Nutrition,University of California, Davis,Davis,CA 95616-5270,USA.
authors.forename: K G
authors.initials: KG
authors.lastname: Dewey
authors.affiliation: 6Department of Human Nutrition and Health,Lilongwe University of Agriculture and Natural Resources,PO Box 219, Lilongwe,Malawi.
authors.forename: C
authors.initials: C
authors.lastname: Kumwenda
authors.affiliation: 4School of Public Health and Family Medicine,University of Malawi College of Medicine,Mahatma Gandhi Road,Blantyre,Malawi.
authors.forename: J
authors.initials: J
authors.lastname: Bendabenda
authors.affiliation: 7Tampere Center for Child Health Research,University of Tampere and Tampere University Hospital,30014 Tampere,Finland.
authors.forename: U
authors.initials: U
authors.lastname: Ashorn
authors.affiliation: 7Tampere Center for Child Health Research,University of Tampere and Tampere University Hospital,30014 Tampere,Finland.
authors.forename: P
authors.initials: P
authors.lastname: Ashorn
mesh_terms: D061725:Accelerometry; D000328:Adult; D019587:Dietary Supplements; D015444:Exercise; D005228:Fatty Acids, Essential / Q000494:pharmacology*; D005260:Female; D005492:Folic Acid / Q000494:pharmacology*; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D007501:Iron / Q000494:pharmacology*; D008295:Malawi; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D018977:Micronutrients / Q000494:pharmacology*; D011247:Pregnancy; D055815:Young Adult
chemical_list: D005228:Fatty Acids, Essential; D018977:Micronutrients; D005492:Folic Acid; D007501:Iron
keywords:  IFA Fe-folic acid;  LNS lipid-based nutrient supplements;  MMN micronutrients;  MVPA moderate-to-vigorous physical activity;  VM vector magnitude;  iLiNS International Lipid-Based Nutrient Supplements Study Group; Accelerometer; Lipid-based nutrient supplements; Physical activity; Sub-Saharan Africa; Undernutrition