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Published on: September 20, 2019
Sustained effects of small-quantity lipid-based nutrient supplements provided during the first 1000 days on child
Helena J Bentil1, Seth Adu-Afarwuah2, Elizabeth L Prado1
1Department of Nutrition, University of California-Davis, Davis, CA, United States.
Insights
Small-quantity lipid-based nutrient supplements (SQ-LNS) given during pregnancy and early childhood improved long-term growth in girls. This nutritional intervention showed sustained benefits for female children and those born to mothers with a healthy BMI.
Area of Science:
- Maternal and child nutrition
- Nutritional epidemiology
- Public health interventions
Background:
- Limited research exists on the long-term effects of nutritional supplementation during the first 1000 days of life on child development.
- Previous studies demonstrated that small-quantity lipid-based nutrient supplements (SQ-LNS) improved birth weight and child length at 18 months in Ghana.
Purpose of the Study:
- To investigate the long-term impact of prenatal and postnatal SQ-LNS on child growth and blood pressure up to 9-11 years of age.
- To assess the sustained effects of early-life nutritional interventions on child health outcomes.
Main Methods:
- The International Lipid-Based Nutrient Supplements (iLiNS)-DYAD-Ghana trial randomized 1320 pregnant women to receive iron-folic acid (IFA), multiple micronutrients (MMNs), or SQ-LNS.
- A follow-up study re-enrolled 966 children at 9-11 years to assess growth (height-for-age z-score, BMI-for-age z-score) and blood pressure.
- Statistical analyses compared outcomes between the SQ-LNS group and the control group (IFA + MMN), adjusting for child's age.
Main Results:
- No significant differences were observed in overall height-for-age z-score (HAZ) between SQ-LNS and control groups at 9-11 years (P=0.060).
- However, HAZ was significantly higher in girls supplemented with SQ-LNS compared to controls (P=0.010).
- Children of mothers with a pre-pregnancy BMI <25 also showed higher HAZ with SQ-LNS supplementation (P=0.004), while no difference was seen for children of mothers with BMI ≥25.
Conclusions:
- Prenatal and postnatal SQ-LNS supplementation has a sustained positive impact on linear growth in female children.
- The benefits of SQ-LNS on growth were more pronounced in children whose mothers had a normal pre-pregnancy BMI.
- These findings highlight the importance of early-life nutrition for long-term child development, particularly for girls and children from non-overweight mothers.
Background:
There is limited research on whether nutritional supplementation in the first 1000 d affects long-term child outcomes. We previously demonstrated that pre- and postnatal small-quantity lipid-based nutrient supplements (SQ-LNS) increased birth weight and child length at 18 mo of age in Ghana.
Objectives:
We aimed to investigate the effect of pre- and postnatal SQ-LNS on child growth and blood pressure at 9-11 y.
Methods:
In the International Lipid-Based Nutrient Supplements (iLiNS)-DYAD-Ghana trial, 1320 females ≤20 weeks of gestation were randomly assigned to receive daily: iron and folic acid (IFA) during pregnancy and placebo during 6 mo postpartum or multiple micronutrients (MMNs) during pregnancy and 6 mo postpartum, or SQ-LNS during pregnancy and 6 mo postpartum and for their children aged from 6 to 18 mo. We re-enrolled 966 children aged 9-11 y and assessed child blood pressure, height-for-age z-score (HAZ), body mass index (BMI)-for-age z-score, waist-to-height ratio, triceps skinfold, and midupper arm circumference. We compared SQ-LNS with control (IFA + MMN) groups adjusting for child's age.
Results:
Mean (standard deviation [SD]) HAZ in SQ-LNS and control group was -0.04 (0.96) and -0.16 (0.99); P = 0.060. There were no indications of group differences in the other outcomes (P > 0.10). Effects on HAZ varied by child sex (P-interaction = 0.075) and maternal prepregnancy BMI (kg/m2; P-interaction = 0.007). Among females, HAZ was higher in the SQ-LNS [0.08 (1.04)] than in the control group [-0.16 (1.01)] (P = 0.010); among males, SQ-LNS [-0.16 (0.85)] and control groups [-0.16 (0.96)] did not differ (P = 0.974). Among children of females with BMI of <25, HAZ was higher in the SQ-LNS [-0.04 (1.00)] than in the control group [-0.29 (0.94)] (P = 0.004); among females with BMI of ≥25, SQ-LNS [-0.04 (0.91)] and control groups [0.07 (1.00)] did not differ (P = 0.281).
Conclusions:
There is a sustained impact of prenatal and postnatal SQ-LNS on linear growth among female children and children whose mothers were not overweight. This trial was registered at clinicaltrials.gov as NCT00970866 (https://clinicaltrials.gov/ct2/show/record/NCT00970866).
