Effect of lipid-based nutrient supplements on morbidity among children with stunting: secondary analysis of a
Rolland Mutumba1,2, Joseph Mbabazi3,4, Hannah Pesu4
1Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. mutumbarolland@gmail.com.
Insights
Lipid-based nutrient supplements (LNS) did not affect child morbidity but reduced inflammation markers in stunted children. Further research is needed to evaluate LNS effects on inflammation in this population.
Area of Science:
- Pediatric Nutrition
- Nutritional Immunology
- Growth and Development
Background:
- Childhood stunting is linked to increased infection risk.
- Assessing the impact of lipid-based nutrient supplements (LNS) on morbidity in stunted children is crucial.
Purpose of the Study:
- To evaluate the effect of LNS on morbidity and inflammation in stunted children aged 12-59 months.
- To compare LNS with milk or soy protein and no supplementation.
Main Methods:
- Secondary analysis of a 2x2 factorial randomized trial in Uganda.
- 12-week intervention with LNS or no supplementation.
- Outcomes included caregiver-reported morbidity, serum C-reactive protein (S-CRP), α1-acid glycoprotein (S-AGP), and phase-angle (PhA).
Main Results:
- LNS increased diarrhea prevalence in the first two weeks but had no effect on cough or fever.
- LNS led to a significant decline in S-AGP and an increase in PhA, indicating reduced inflammation and increased fat-free mass.
- Milk-based LNS resulted in higher PhA compared to soy-based LNS.
Conclusions:
- LNS supplementation in stunted children did not impact morbidity but showed a modest reduction in sub-acute systemic inflammation.
- The potential role of LNS in modulating inflammation in stunted children warrants further investigation.
Background:
Children with stunting are at risk of infections. We assessed the effect of lipid-based nutrient supplement (LNS) on morbidity in children with stunting.
Methods:
This was a secondary analysis of a randomized, 2×2 factorial trial among 12-59 months-old, stunted children in Uganda. Children were randomized to LNS containing milk or soy protein and whey permeate or maltodextrin, or no supplementation, for 12 weeks. The outcomes were caregiver-reported morbidity after 2, 4, 8 and 12 weeks, serum C-reactive protein (S-CRP), α1-acid glycoprotein (S-AGP), and phase-angle (PhA) by bioimpedance.
Results:
Of 750 children, mean (SD) age was 32.0 (11.7) months, 55% (n = 412) were male. LNS increased diarrhoea prevalence (18.1% vs 7.3%, P = 0.001) during the first two weeks, but not thereafter. There was no effect of LNS on cough or fever. LNS resulted in greater decline in S-AGP (-0.10 g/L, 95% CI: -0.17, -0.03, P = 0.003) but not S-CRP (25%, 95% CI: -11, 74, P = 0.193), and greater increase in PhA (0.10 degrees, 95% CI: 0.01, 0.18, P = 0.030), explained by greater fat-free mass. Milk compared to soy protein in LNS resulted in higher PhA (0.10 degrees, 95% CI: 0.02, 0.17, P = 0.013), not explained by fat-free mass.
Conclusion:
LNS supplementation in children with stunting had no effect on morbidity but resulted in a small reduction in sub-acute systemic inflammation. The possible effect of LNS supplementation on inflammation in stunted children requires further evaluation. ( www.isrctn.com : ISRCTN13093195).
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