Anita Panjwani1, Rebecca Heidkamp2. 1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD rheidka1@jhu.edu.
Abstract
Background: World Health Assembly member states have committed to ambitious global targets for reductions in stunting and wasting by 2025. Improving complementary diets of children aged 6-23 mo is a recommended approach for reducing stunting in children <5 y old. Less is known about the potential of these interventions to prevent wasting.Objective: The aim of this article was to review and synthesize the current literature for the impact of complementary feeding interventions on linear [length-for-age z score (LAZ)] and ponderal [weight-for-length z score (WLZ)] growth of children aged 6-23 mo, with the specific goal of updating intervention-outcome linkages in the Lives Saved Tool (LiST). Methods: We started our review with studies included in the previous LiST review and searched for articles published since January 2012. We identified longitudinal trials that compared children aged 6-23 mo who received 1 of 2 types of complementary feeding interventions (nutrition education or counseling alone or complementary food supplementation with or without nutrition education or counseling) with a no-intervention control. We assessed study quality and generated pooled estimates of LAZ and WLZ change, as well as length and weight gain, for each category of intervention. Results: Interventions that provided nutrition education or counseling had a small but significant impact on linear growth in food-secure populations [LAZ standardized mean difference (SMD): 0.11; 95% CI: 0.01, 0.22] but not on ponderal growth. Complementary food supplementation interventions with or without nutrition education also had a small, significant effect in food-insecure settings on both LAZ (SMD: 0.08; 95% CI: 0.04, 0.13) and WLZ (SMD: 0.05; 95% CI: 0.01, 0.08).Conclusions: Nutrition education and complementary feeding interventions both had a small but significant impact on linear growth, and complementary feeding interventions also had an impact on ponderal growth of children aged 6-23 mo in low- and middle-income countries. The updated LiST model will support nutrition program planning and evaluation efforts by allowing users to model changes in intervention coverage on both stunting and wasting.
Background: World Health Assembly member states have committed to ambitious global targets for reductions in stunting and wasting by 2025. Improving complementary diets of children aged 6-23 mo is a recommended approach for reducing stunting in children <5 y old. Less is known about the potential of these interventions to prevent wasting.Objective: The aim of this article was to review and synthesize the current literature for the impact of complementary feeding interventions on linear [length-for-age z score (LAZ)] and ponderal [weight-for-length z score (WLZ)] growth of children aged 6-23 mo, with the specific goal of updating intervention-outcome linkages in the Lives Saved Tool (LiST). Methods: We started our review with studies included in the previous LiST review and searched for articles published since January 2012. We identified longitudinal trials that compared children aged 6-23 mo who received 1 of 2 types of complementary feeding interventions (nutrition education or counseling alone or complementary food supplementation with or without nutrition education or counseling) with a no-intervention control. We assessed study quality and generated pooled estimates of LAZ and WLZ change, as well as length and weight gain, for each category of intervention. Results: Interventions that provided nutrition education or counseling had a small but significant impact on linear growth in food-secure populations [LAZ standardized mean difference (SMD): 0.11; 95% CI: 0.01, 0.22] but not on ponderal growth. Complementary food supplementation interventions with or without nutrition education also had a small, significant effect in food-insecure settings on both LAZ (SMD: 0.08; 95% CI: 0.04, 0.13) and WLZ (SMD: 0.05; 95% CI: 0.01, 0.08).Conclusions: Nutrition education and complementary feeding interventions both had a small but significant impact on linear growth, and complementary feeding interventions also had an impact on ponderal growth of children aged 6-23 mo in low- and middle-income countries. The updated LiST model will support nutrition program planning and evaluation efforts by allowing users to model changes in intervention coverage on both stunting and wasting.
Authors: Nancy F Krebs; K Michael Hambidge; Jamie L Westcott; Ana L Garcés; Lester Figueroa; Antoinette K Tshefu; Adrien L Lokangaka; Shivaprasad S Goudar; Sangappa M Dhaded; Sarah Saleem; Sumera Aziz Ali; Melissa S Bauserman; Richard J Derman; Robert L Goldenberg; Abhik Das; Dhuly Chowdhury Journal: Am J Clin Nutr Date: 2022-07-06 Impact factor: 8.472
Authors: Elizabeth T Rogawski McQuade; James A Platts-Mills; Jean Gratz; Jixian Zhang; Lawrence H Moulton; Kuda Mutasa; Florence D Majo; Naume Tavengwa; Robert Ntozini; Andrew J Prendergast; Jean H Humphrey; Jie Liu; Eric R Houpt Journal: J Infect Dis Date: 2020-03-28 Impact factor: 5.226
Authors: Jean H Humphrey; Mduduzi N N Mbuya; Robert Ntozini; Lawrence H Moulton; Rebecca J Stoltzfus; Naume V Tavengwa; Kuda Mutasa; Florence Majo; Batsirai Mutasa; Goldberg Mangwadu; Cynthia M Chasokela; Ancikaria Chigumira; Bernard Chasekwa; Laura E Smith; James M Tielsch; Andrew D Jones; Amee R Manges; John A Maluccio; Andrew J Prendergast Journal: Lancet Glob Health Date: 2019-01 Impact factor: 26.763