Effect of lipid-based nutrient supplements on micronutrient status and hemoglobin among children with stunting: secondary analysis of a randomized controlled trial in Uganda

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt


  • Fulltext

    Forlagets udgivne version, 678 KB, PDF-dokument

Background: Micronutrient deficiencies and anemia are widespread among children with stunting. Objectives: We assessed the effects of lipid-based nutrient supplements (LNS) containing milk protein (MP) and/or whey permeate (WP) on micronutrient status and hemoglobin (Hb) among children with stunting. Methods: This was a secondary analysis of a randomized controlled trial. Children aged 12–59 mo with stunting were randomly assigned to LNS (100 g/d) with milk or soy protein and WP or maltodextrin for 12 wk, or no supplement. Hb, serum ferritin (S-FE), serum soluble transferrin receptor (S-TfR), plasma cobalamin (P-Cob), plasma methylmalonic acid (P-MMA), plasma folate (P-Fol), and serum retinol-binding protein (S-RBP) were measured at inclusion and at 12 wk. Data were analyzed using linear and logistic mixed-effects models. Results: Among 750 children, with mean age ± SD of 32 ± 11.7 mo, 45% (n = 338) were female and 98% (n = 736) completed follow-up. LNS, compared with no supplementation, resulted in 43% [95% confidence interval (CI): 28, 60] greater increase in S-FE corrected for inflammation (S-FEci), 2.4 (95% CI: 1.2, 3.5) mg/L greater decline in S-TfR, 138 (95% CI: 111, 164) pmol/L greater increase in P-Cob, 33% (95% CI: 27, 39) reduction in P-MMA, and 8.5 (95% CI: 6.6, 10.3) nmol/L greater increase in P-Fol. There was no effect of LNS on S-RBP. Lactation modified the effect of LNS on markers of cobalamin status, reflecting improved status among nonbreastfed and no effects among breastfed children. LNS increased Hb by 3.8 (95% CI: 1.7, 6.0) g/L and reduced the odds of anemia by 55% (odds ratio: 0.45, 95% CI: 0.29, 0.70). MP compared with soy protein increased S-FEci by 14% (95% CI: 3, 26). Conclusions: : LNS supplementation increases Hb and improves iron, cobalamin, and folate status, but not vitamin A status among children with stunting. LNS should be considered for children with stunting. This trial was registered at ISRCTN as 13093195.

BogserieAmerican Journal of Clinical Nutrition
Udgave nummer3
Sider (fra-til)829-837
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
HF and CM have received research grants from Arla Food for Health; HF, BG, and CM have received research grants from the Danish Dairy Research Foundation; CM and KFM also received funds from Arla Foods Amba; and finally, HF, CM, KFM, BG, SF, and AB have had research collaboration with Nutriset, a producer of LNS. Other authors declare no financial relationships with any organizations that might have had an interest in the submitted work in the previous 5 y and declare no other relationships or activities that could appear to have influenced the submitted work.

Funding Information:
The trial was funded by Arla Food for Health. Arla Food for Health is a public–private research partnership between the University of Copenhagen, Aarhus University, and the dairy company, Arla. Additional funds were obtained from the Danish Dairy Research Foundation, Augustinus Fonden, Læge Sofus Carl Emil Friis og Hustru Olga Doris Friis’ Legat, and A. P. Møller Fonden til Lægevidenskabens Fremme. The funders of the study had no role in study design, collection, analysis, and interpretation of data; or writing of the report. The supporting source had no restrictions regarding the submission of the report for publication.

Publisher Copyright:
© 2024 The Authors

ID: 384030016