TY - JOUR

T1 - Effect of milk protein and whey permeate in large-quantity lipid-based nutrient supplement on early child development among children with stunting: A randomized 2 × 2 factorial trial in Uganda

AU - Mbabazi, Joseph

AU - Pesu, Hannah

AU - Mutumba, Rolland

AU - McCray, Gareth

AU - Michaelsen, Kim F.

AU - Ritz, Christian

AU - Filteau, Suzanne

AU - Briend, André

AU - Mupere, Ezekiel

AU - Grenov, Benedikte

AU - Friis, Henrik

AU - Olsen, Mette Frahm

N1 - CURIS 2023 NEXS 150

PY - 2023

Y1 - 2023

N2 - Stunting affects 22% children globally, putting them at risk of adverse outcomes including delayed development. We investigated the effect of milk protein (MP) vs. soy and whey permeate (WP) vs. maltodextrin in large-quantity, lipid-based nutrient supplement (LNS), and LNS itself vs. no supplementation, on child development and head circumference among stunted children aged 1-5 years. We conducted a randomized, double-blind, community-based 2 × 2 factorial trial in Uganda (ISRCTN1309319). We randomized 600 children to one of four LNS formulations (~535 kcal/d), with or without MP (n = 299 vs. n = 301) or WP (n = 301 vs. n = 299), for 12 weeks or to no supplementation (n = 150). Child development was assessed using the Malawi Development Assessment Tool. Data were analyzed using linear mixed-effects models. Children had a median [interquartile range] age of 30 [23; 41] months and mean ± standard deviation height-for-age z-score of -3.02 ± 0.74. There were no interactions between MP and WP for any of the outcomes. There was no effect of either MP or WP on any developmental domain. Although LNS itself had no impact on development, it resulted in 0.07 (95%CI: 0.004; 0.14) cm higher head circumference. Neither dairy in LNS, nor LNS in itself, had an effect on development among already stunted children.

AB - Stunting affects 22% children globally, putting them at risk of adverse outcomes including delayed development. We investigated the effect of milk protein (MP) vs. soy and whey permeate (WP) vs. maltodextrin in large-quantity, lipid-based nutrient supplement (LNS), and LNS itself vs. no supplementation, on child development and head circumference among stunted children aged 1-5 years. We conducted a randomized, double-blind, community-based 2 × 2 factorial trial in Uganda (ISRCTN1309319). We randomized 600 children to one of four LNS formulations (~535 kcal/d), with or without MP (n = 299 vs. n = 301) or WP (n = 301 vs. n = 299), for 12 weeks or to no supplementation (n = 150). Child development was assessed using the Malawi Development Assessment Tool. Data were analyzed using linear mixed-effects models. Children had a median [interquartile range] age of 30 [23; 41] months and mean ± standard deviation height-for-age z-score of -3.02 ± 0.74. There were no interactions between MP and WP for any of the outcomes. There was no effect of either MP or WP on any developmental domain. Although LNS itself had no impact on development, it resulted in 0.07 (95%CI: 0.004; 0.14) cm higher head circumference. Neither dairy in LNS, nor LNS in itself, had an effect on development among already stunted children.

KW - Stunting

KW - Child

KW - Infant

KW - Early child development

KW - Whey permeate

KW - Milk Protein

KW - Uganda

KW - Micronutrients

KW - Dietary Supplements

KW - Growth disorders / prevention & control

KW - Nutrient supplements

KW - Lipid-based nutrient supplements

KW - LNS

U2 - 10.3390/nu15122659

DO - 10.3390/nu15122659

M3 - Journal article

C2 - 37375563

VL - 15

JO - Nutrients

JF - Nutrients

SN - 2072-6643

IS - 12

M1 - 2659

ER -