Related Experiment Video
Updated: Aug 10, 2026
Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes
Published on: June 28, 2024
Impact of Behavior Change Communication and Small-Quantity-Lipid-Based Nutrient Supplementation on Nutrient Intake
Dadirai Fundira1, Mduduzi N N Mbuya2, Elisabeth A Larson3
1Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.
Insights
The infant and young child feeding (IYCF) intervention improved infant energy and micronutrient intake, mainly via small-quantity-lipid-based nutrient supplements (SQ-LNS). Behavior change communication (BCC) alone did not impact complementary feeding practices.
Area of Science:
- Public Health Nutrition
- Maternal and Child Health
- Nutritional Epidemiology
Background:
- Infant undernutrition is driven by poor complementary feeding practices between 6 and 24 months.
- An infant and young child feeding (IYCF) intervention was evaluated in rural Zimbabwe.
- The intervention combined behavior change communication (BCC) and small-quantity-lipid-based nutrient supplements (SQ-LNS).
Purpose of the Study:
- To assess the impact of an IYCF intervention on infant nutrient intake from complementary foods.
- Evaluate nutrient intake using 24-hour dietary recalls in infants aged 12 months.
Main Methods:
- Cluster-randomized trial (Sanitation Hygiene Infant Nutrition Efficacy - SHINE trial) in rural Zimbabwe.
- 194 caregivers of 12-month-old infants completed multipass 24-hour dietary recalls.
- Compared nutrient intake between IYCF intervention (BCC + SQ-LNS) and non-IYCF arms, with and without SQ-LNS contribution.
Main Results:
- IYCF intervention significantly increased energy intake (531 vs. 426 kcal/d).
- Micronutrient intake and adequacy (Vitamin A, Folate, Calcium, Iron, Zinc) were greater in the IYCF group (P < 0.01).
- No significant differences in intake from non-supplement foods, indicating SQ-LNS provided benefits without displacing other foods.
Conclusions:
- The IYCF intervention, primarily through SQ-LNS, improved infant energy and micronutrient intake and adequacy.
- Behavior change communication (BCC) alone showed no discernible effect on complementary feeding intake from non-supplement foods.
- Despite improvements, many children still did not meet requirements for calcium and folate.
Background:
Poor complementary feeding practices between 6 and 24 mo are a major driver of infant undernutrition. We evaluated an infant and young child feeding (IYCF) intervention combining behavior change communication (BCC) and small-quantity-lipid-based nutrient supplement (SQ-LNS) within the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) cluster-randomized trial in rural Zimbabwe.
Objectives:
We aimed to assess the impact of the IYCF intervention on infant nutrient intake from complementary foods assessed by 24-h dietary recall.
Methods:
The SHINE trial was a cluster-randomized 2 × 2 factorial trial assessing individual and combined effects of IYCF and water, sanitation, and hygiene (WASH) interventions on stunting and anemia in rural Zimbabwe (NCT01824940). We conducted multipass 24-h dietary recalls among 194 randomly selected caregivers of 12-mo-old infants. Nutrient intake and adequacy were compared between children in the IYCF intervention arms (BCC + daily SQ-LNS; n = 99) and non-IYCF arms (standard of care with or without WASH; n = 94), with analyses conducted both including and excluding the contribution of SQ-LNS-derived nutrients, using the measurement-error method.
Results:
Energy intake was higher in IYCF compared with non-IYCF infants [531 (404) compared with 426 (272) kcal/d; P = 0.03]. IYCF infants had greater micronutrient intake and adequacy (vitamin A, folate, calcium, iron and zinc; all P < 0.01). However, many children still did not meet their dietary requirements, particularly for calcium and folate. Intakes of all macronutrients and micronutrients from nonsupplement foods did not differ significantly between the IYCF and non-IYCF groups, which suggests that the SQ-LNS provided all the nutritional benefit and did not replace nonsupplement food intake.
Conclusions:
The IYCF intervention improved energy and micronutrient intake and improved micronutrient adequacy, primarily through SQ-LNS, with no displacement of other food intake. However, no differences in intake from nonsupplement foods were observed, indicating that BCC alone had no effect on complementary feeding. This trial was registered at clinicaltrials.gov as NCT01883193 (https://clinicaltrials.gov/study/NCT01824940).