Effect of Added Sugar on the Consumption of A Lipid-Based Nutrient Supplement Among 7–24-Month-Old Children

Abstract

Small-quantity lipid-based nutrient supplements (SQ-LNS) could help prevent malnutrition. Our primary objective was to examine the acceptability and consumption of sweetened and unsweetened versions of SQ-LNS before and after 14-days of repeated exposure. A total of 78 mother-infant dyads recruited from health centers in Morelos, Mexico, were randomized to two groups of SQ-LNS (sweetened, LNS-S; unsweetened, LNS-U). During the study, infants were fed SQ-LNS (20 g) mixed with 30 g of complementary food of the caregiver’s choice. The amount of supplement-food mixture consumed was measured before, during and after a 14-day home exposure period. We defined acceptability as consumption of at least 50% of the offered food mixture. At initial exposure, LNS-U consumption was on average 44.0% (95% CI: 31.4, 58.5) and LNS-S 34.8% (25.3, 44.0); at final exposure, LNS-U and LNS-S consumption were 38.5% (27.8, 54.0) and 31.5% (21.6, 43.0). The average change in consumption did not differ between the groups (2.2 p.p. (−17.2, 24.4)). We conclude that the acceptability of sweetened and unsweetened SQ-LNS was low in this study population. Since consumption did not differ between supplement versions, we encourage the use of the unsweetened version given the potential effects that added sugar may have on weight gain especially in regions facing the double burden of malnutrition.

Development of a live coding method to assess infant/toddler food acceptance

“…Infants and toddlers consumed an average of 21.3 g (range = 0–46 g; SD = 15.1) of the food‐supplement mixture across the entire feeding. Consistent with the results of the main trial (Okronipa et al, 2020 ), there were no significant differences in consumption of the sweetened ( M = 26.10, SD = 15.57) and unsweetened version ( M = 16.29, SD = 13.55) of the supplement when mixed with a local food ( t = −1.35, p = 0.20).…”

“…Second, acceptance and consumption of the target food could be due to preferred flavours of the supplement mixed with sweet local foods. However, in our prior work (Okronipa et al, 2020), there were no significant differences in consumption based on supplement version or the local food mixed with the supplement. These results were replicated here, as there were no significant differences in consumption or acceptance by supplement version.…”

“…The decision to allow caregivers to select the local food was made to increase ecological validity since there is no universally consumed complementary food in Mexico. Study procedures and results of the main trials have been published previously (Okronipa et al, 2020 ).…”