Impact of the lipid-based nutrient supplements on prevention and treatment of childhood moderate undernutrition

Abstract

Purpose: This review aims at assessing the effectiveness of LNS interventions for prevention and/or treatment of moderate acute malnutrition (MAM), stunting and other anthropometric indicators for undernutrition in children younger than 5 years. Methodology: Eighteen clinical trials on LNS (soybased or milk-based) supplementation in children were compared with habitual diet/control or corn-soy blend (CSB). Mean changes in height for age (HAZ), weight for age (WAZ) and weight for height z-scores (WHZ) were assessed as primary outcomes. The secondary outcomes included: weight gain, height, mid upper arm circumference (MUAC), recovery from MAM, occurrence of fever, diarrhoea and cough. Findings: The pooled estimate revealed a statistically significant increase in WAZ (weighted mean difference [WMD] =0.09; 95%CI= 0.02, 0.15; p=0.01), WHZ (WMD=0.14; 95%CI= 0.01, 0.26; p=0.000) and improved recovery from MAM (Risk Ratio [RR] = 1.37; 95%CI= 1.14, 1.65; p=0.000) in children receiving LNS compared with control or CBS. No significant effect was observed in HAZ (WMD=0.00;95%CI=-0.02,0.03: p=0.578). Children fed with milk-based LNS (RR=1.68; 95%CI=1.17, 2.39; p=0.005) were more likely to recover significantly from MAM when compared with CSB. Conclusion: Although there is evidence that LNS yield better nutritional outcomes than CSB and control, it is impossible to conclude that the milk-based LNS are superior to soy-based LNS and whether age and duration of intervention significantly affect the effectiveness of LNS on childhood undernutrition. Further research is required before these products can be recommended at scale