Impact of lipid‐based nutrient supplements and corn–soy blend on energy and nutrient intake among moderately underweight 8–18‐month‐old children participating in a clinical trial

Abstract

Nutrition interventions have an effect on growth, energy and nutrient intake, and development, but there are mixed reports on the effect of supplementation of energy-dense foods on dietary intake. This substudy aimed at assessing the effect of supplementation with corn-soy blend (CSB) or lipid-based nutrient supplement (LNS) on energy and nutrient intake in moderately underweight children participating in a clinical trial. A total of 188 children aged 8-18 months participated and received daily either 284 kcal from CSB or 220 kcal from LNS and no supplements (control). An interactive 24-h recall method was used to estimate energy and nutrient intakes in the groups. Total mean energy intake was 548 kcal, 551 kcal and 692 kcal in the control, CSB and LNS groups, respectively (P = 0.011). The mean (95% confidence interval) intake of energy and protein were 144 (37-250; P < 0.001) and 46 (1.5-7.6; P < 0.001) larger, respectively, in the LNS group than among the controls. No significant differences were observed between the control and CSB groups. Energy intake from non-supplement foods was significantly lower in the CSB group compared with the control group, but not in the LNS group, suggesting a lower displacement of non-supplement foods with LNS. Both CSB and LNS supplementation resulted in higher intakes of calcium, iron, zinc and vitamin C compared with controls (all P ≤ 0.001). This study indicates that LNS might be superior to CSB to supplement underweight children as it results in higher energy intake, but this requires confirmation in other settings.

Supplementation of Maternal Diets during Pregnancy and for 6 Months Postpartum and Infant Diets Thereafter with Small-Quantity Lipid-Based Nutrient Supplements Does Not Promote Child Growth by 18 Months of Age in Rural Malawi: A Randomized Controlled Trial

“…Such an outcome could be mediated for instance by displacement of breast milk or nutritious complementary foods from the childÕs diet, an increase of malaria or other infectious disease morbidity because of the iron content of the supplement, or a change in the recipientsÕ intestinal microbiota (22)(23)(24). Earlier studies in Malawi have, however, suggested that LNS provision does not decrease breast milk or complementary food intake (25)(26)(27), and no indication was found of a slower postnatal growth velocity among children were received LNSs than children who did not receive supplements (9,10). In addition, no indication was found of increased infectious disease morbidity either in the present study or an earlier LNS trial in Malawi (28).…”

Effect of complementary food supplementation on breastfeeding and home diet in rural Bangladeshi children

“…Better nutritional status may, itself, improve appetite (29), and increased energy density of the diet may also have benefits for appetite (13, 30, 31). In addition, better growth and a larger body size may, themselves, increase dietary intake.…”

“…To our knowledge, no direct experimental evidence of that substitution exists, but evidence of a tradeoff between complementary food energy density and breastmilk intake (10, 11) has suggested that increasing the energy density of the diet with CFSs may lead to reduced breastmilk consumption. Two studies in Malawi also reported reduced intake of staple foods in children who received fortified blended food supplements, although children who were given lipid-based supplements had no decline in their intake of other complementary foods (12, 13). In other trials of lipid-based nutrient supplements, substitution for foods or breastmilk was not observed (14–16).…”

Effects of maternal and child lipid-based nutrient supplements on infant development: a randomized trial in Malawi

“…Thus, it is possible that insufficient dietary quality did not constrain infant development in this population. It is not likely that provision of LNSs changed infant feeding patterns in this sample, because previous studies in Malawi have shown that LNS provision does not decrease breast milk or complementary food intake (34,35).…”