A macro- and micronutrient-fortified complementary food supplement reduced acute infection, improved haemoglobin and showed a dose–response effect in improving linear growth: a 12-month cluster randomised trial
Inadequate protein quality may be a risk factor for poor growth. To examine the effect of a macronutrient–micronutrient supplement KOKO Plus (KP), provided to infants from 6 to 18 months of age, on linear growth, a single-blind cluster-randomised study was implemented in Ghana. A total of thirty-eig...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2019-01-01
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| Series: | Journal of Nutritional Science |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2048679019000181/type/journal_article |
| _version_ | 1811155904484081664 |
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| author | Shibani A. Ghosh Nicholas R. Strutt Gloria E. Otoo Devika J. Suri Judith Ankrah Thomas Johnson Paul Nsiah Chie Furuta Hitoshi Murakami Gillian Perera Kenneth Chui Kennedy Bomfeh Harold Amonoo-Kuofi Kwaku Tano-Debrah Ricardo Uauy |
| author_facet | Shibani A. Ghosh Nicholas R. Strutt Gloria E. Otoo Devika J. Suri Judith Ankrah Thomas Johnson Paul Nsiah Chie Furuta Hitoshi Murakami Gillian Perera Kenneth Chui Kennedy Bomfeh Harold Amonoo-Kuofi Kwaku Tano-Debrah Ricardo Uauy |
| author_sort | Shibani A. Ghosh |
| collection | DOAJ |
| description | Inadequate protein quality may be a risk factor for poor growth. To examine the effect of a macronutrient–micronutrient supplement KOKO Plus (KP), provided to infants from 6 to 18 months of age, on linear growth, a single-blind cluster-randomised study was implemented in Ghana. A total of thirty-eight communities were randomly allocated to receive KP (fourteen communities, n 322), a micronutrient powder (MN, thirteen communities, n 329) and nutrition education (NE, eleven communities, n 319). A comparison group was followed cross-sectionally (n 303). Supplement delivery and morbidity were measured weekly and anthropometry monthly. NE education was provided monthly. Baseline, midline and endline measurements at 6, 12 and 18 months included venous blood draws, diet, anthropometry, morbidity, food security and socio-economics. Length-for-age Z-score (LAZ) was the primary outcome. Analyses were intent-to-treat using mixed-effects regressions adjusted for clustering, sex, age and baseline. No differences existed in mean LAZ scores at endline (−1·219 (sd 0·06) KP, −1·211 (sd 0·03) MN, −1·266 (sd 0·03) NE). Acute infection prevalence was lower in the KP than NE group (P = 0·043). Mean serum Hb was higher in KP infants free from acute infection (114·02 (sd 1·87) g/l) than MN (107·8 (sd 2·5) g/l; P = 0·047) and NE (108·8 (sd 0·99) g/l; P = 0·051). Compliance was 84·9 % (KP) and 87·2 % (MN) but delivery 60 %. Adjusting for delivery and compliance, LAZ score at endline was significantly higher in the KP v. MN group (+0·2 LAZ; P = 0·026). A macro- and micronutrient-fortified supplement KP reduced acute infection, improved Hb and demonstrated a dose–response effect on LAZ adjusting consumption for delivery. |
| first_indexed | 2024-04-10T04:41:26Z |
| format | Article |
| id | doaj.art-14ec6b2f99ff457bb0b5cf8b47e3523c |
| institution | Directory Open Access Journal |
| issn | 2048-6790 |
| language | English |
| last_indexed | 2024-04-10T04:41:26Z |
| publishDate | 2019-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Nutritional Science |
| spelling | doaj.art-14ec6b2f99ff457bb0b5cf8b47e3523c2023-03-09T12:39:08ZengCambridge University PressJournal of Nutritional Science2048-67902019-01-01810.1017/jns.2019.18A macro- and micronutrient-fortified complementary food supplement reduced acute infection, improved haemoglobin and showed a dose–response effect in improving linear growth: a 12-month cluster randomised trialShibani A. Ghosh0https://orcid.org/0000-0001-5893-6774Nicholas R. Strutt1Gloria E. Otoo2Devika J. Suri3Judith Ankrah4Thomas Johnson5Paul Nsiah6Chie Furuta7Hitoshi Murakami8Gillian Perera9Kenneth Chui10Kennedy Bomfeh11Harold Amonoo-Kuofi12Kwaku Tano-Debrah13Ricardo Uauy14Nevin Scrimshaw International Nutrition Foundation, Boston, MA, USA Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USANevin Scrimshaw International Nutrition Foundation, Boston, MA, USAUniversity of Ghana, Legon, Accra, GhanaNevin Scrimshaw International Nutrition Foundation, Boston, MA, USAUniversity of Ghana, Legon, Accra, GhanaUniversity of Cape Coast, Cape Coast, GhanaUniversity of Cape Coast, Cape Coast, GhanaAjinomoto Co. Inc., Chūō, Tokyo, JapanAjinomoto Co. Inc., Chūō, Tokyo, JapanNevin Scrimshaw International Nutrition Foundation, Boston, MA, USAFriedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USAUniversity of Ghana, Legon, Accra, GhanaUniversity of Cape Coast, Cape Coast, GhanaUniversity of Ghana, Legon, Accra, GhanaNevin Scrimshaw International Nutrition Foundation, Boston, MA, USA Pontafica University of Chile, Santiago, ChileInadequate protein quality may be a risk factor for poor growth. To examine the effect of a macronutrient–micronutrient supplement KOKO Plus (KP), provided to infants from 6 to 18 months of age, on linear growth, a single-blind cluster-randomised study was implemented in Ghana. A total of thirty-eight communities were randomly allocated to receive KP (fourteen communities, n 322), a micronutrient powder (MN, thirteen communities, n 329) and nutrition education (NE, eleven communities, n 319). A comparison group was followed cross-sectionally (n 303). Supplement delivery and morbidity were measured weekly and anthropometry monthly. NE education was provided monthly. Baseline, midline and endline measurements at 6, 12 and 18 months included venous blood draws, diet, anthropometry, morbidity, food security and socio-economics. Length-for-age Z-score (LAZ) was the primary outcome. Analyses were intent-to-treat using mixed-effects regressions adjusted for clustering, sex, age and baseline. No differences existed in mean LAZ scores at endline (−1·219 (sd 0·06) KP, −1·211 (sd 0·03) MN, −1·266 (sd 0·03) NE). Acute infection prevalence was lower in the KP than NE group (P = 0·043). Mean serum Hb was higher in KP infants free from acute infection (114·02 (sd 1·87) g/l) than MN (107·8 (sd 2·5) g/l; P = 0·047) and NE (108·8 (sd 0·99) g/l; P = 0·051). Compliance was 84·9 % (KP) and 87·2 % (MN) but delivery 60 %. Adjusting for delivery and compliance, LAZ score at endline was significantly higher in the KP v. MN group (+0·2 LAZ; P = 0·026). A macro- and micronutrient-fortified supplement KP reduced acute infection, improved Hb and demonstrated a dose–response effect on LAZ adjusting consumption for delivery.https://www.cambridge.org/core/product/identifier/S2048679019000181/type/journal_articleComplementary feedingLinear growthHbKOKO Plus |
| spellingShingle | Shibani A. Ghosh Nicholas R. Strutt Gloria E. Otoo Devika J. Suri Judith Ankrah Thomas Johnson Paul Nsiah Chie Furuta Hitoshi Murakami Gillian Perera Kenneth Chui Kennedy Bomfeh Harold Amonoo-Kuofi Kwaku Tano-Debrah Ricardo Uauy A macro- and micronutrient-fortified complementary food supplement reduced acute infection, improved haemoglobin and showed a dose–response effect in improving linear growth: a 12-month cluster randomised trial Journal of Nutritional Science Complementary feeding Linear growth Hb KOKO Plus |
| title | A macro- and micronutrient-fortified complementary food supplement reduced acute infection, improved haemoglobin and showed a dose–response effect in improving linear growth: a 12-month cluster randomised trial |
| title_full | A macro- and micronutrient-fortified complementary food supplement reduced acute infection, improved haemoglobin and showed a dose–response effect in improving linear growth: a 12-month cluster randomised trial |
| title_fullStr | A macro- and micronutrient-fortified complementary food supplement reduced acute infection, improved haemoglobin and showed a dose–response effect in improving linear growth: a 12-month cluster randomised trial |
| title_full_unstemmed | A macro- and micronutrient-fortified complementary food supplement reduced acute infection, improved haemoglobin and showed a dose–response effect in improving linear growth: a 12-month cluster randomised trial |
| title_short | A macro- and micronutrient-fortified complementary food supplement reduced acute infection, improved haemoglobin and showed a dose–response effect in improving linear growth: a 12-month cluster randomised trial |
| title_sort | macro and micronutrient fortified complementary food supplement reduced acute infection improved haemoglobin and showed a dose response effect in improving linear growth a 12 month cluster randomised trial |
| topic | Complementary feeding Linear growth Hb KOKO Plus |
| url | https://www.cambridge.org/core/product/identifier/S2048679019000181/type/journal_article |
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