Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: an individual participant data meta-analysis of randomized controlled trials - INRAE - Institut national de recherche pour l’agriculture, l’alimentation et l’environnement Access content directly
Journal Articles The American Journal of Clinical Nutrition Year : 2022

Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: an individual participant data meta-analysis of randomized controlled trials

Kathryn Dewey
Charles Arnold
K Ryan Wessells
Elizabeth Prado
Seth Adu-Afarwuah
Hasmot Ali
Benjamin Arnold
Ulla Ashorn
Sania Ashraf
Kenneth Brown
Parul Christian
John Colford, Jr
Sherlie Jl Dulience
  • Function : Author
Lia Ch Fernald
Emanuela Galasso
Lotta Hallamaa
Sonja Hess
Jean Humphrey
Lieven Huybregts
Lora Iannotti
Kaniz Jannat
Anna Lartey
Jef Leroy
Stephen Luby
Kenneth Maleta
Susana Matias
Mduduzi Nn Mbuya
Malay Mridha
Minyanga Nkhoma
Clair Null
Rina Paul
Harriet Okronipa
Jean-Bosco Ouédraogo
  • Function : Author
Amy Pickering
Andrew Prendergast
Marie Ruel
Saijuddin Shaikh
Ann Weber
Patricia Wolff
  • Function : Author
Amanda Zongrone
Christine Stewart

Abstract

Background: Meta-analyses show that small-quantity lipid-based nutrient supplements (SQ-LNSs) reduce child wasting and stunting. There is little information regarding effects on severe wasting or stunting. Objectives: We aimed to identify the effect of SQ-LNSs on prevalence of severe wasting (weight-for-length z score < −3) and severe stunting (length-for-age z score < −3). Methods: We conducted a 2-stage meta-analysis of individual participant data from 14 randomized controlled trials of SQ-LNSs provided to children 6–24 mo of age. We generated study-specific and subgroup estimates of SQ-LNS compared with control and pooled the estimates using fixed-effects models. We used random- effects meta-regression to examine study-level effect modifiers. In sensitivity analyses, we examined whether results differed depending on study arm inclusion criteria and types of comparisons. Results: SQ-LNS provision led to a relative reduction of 31% in severe wasting [prevalence ratio (PR): 0.69; 95% CI: 0.55, 0.86; n = 34,373] and 17% in severe stunting (PR: 0.83; 95% CI: 0.78, 0.90; n = 36,795) at endline. Results were similar in most of the sensitivity analyses but somewhat attenuated when comparisons using passive control arms were excluded (PR: 0.74; 95% CI: 0.57, 0.96; n = 26,327 for severe wasting and PR: 0.88; 95% CI: 0.81, 0.95; n = 28,742 for severe stunting). Study-level characteristics generally did not significantly modify the effects of SQ-LNSs, but results suggested greater effects of SQ-LNSs in sites with greater burdens of wasting or stunting, or with poorer water quality or sanitation. Conclusions: Including SQ-LNSs in preventive interventions to promote healthy child growth and development is likely to reduce rates of severe wasting and stunting. This meta-analysis was registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.
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Dates and versions

hal-04053910 , version 1 (23-11-2023)

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Kathryn Dewey, Charles Arnold, K Ryan Wessells, Elizabeth Prado, Souheila Abbeddou, et al.. Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: an individual participant data meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition, 2022, 116 (5), pp.1314-1333. ⟨10.1093/ajcn/nqac232⟩. ⟨hal-04053910⟩
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