Maternal and Child Supplementation with Lipid-Based Nutrient Supplements, but Not Child Supplementation Alone, Decreases Self-Reported Household Food Insecurity in Some Settings

Abstract

Background: It is unknown whether self-reported measures of household food insecurity change in response to food-based nutrient supplementation.Objective: We assessed the impacts of providing lipid-based nutrient supplements (LNSs) to women during pregnancy and postpartum and/or to their children on self-reported household food insecurity in Malawi [DOSE and DYAD trial in Malawi (DYAD-M)], Ghana [DYAD trial in Ghana (DYAD-G)], and Bangladesh [Rang-Din Nutrition Study (RDNS) trial].Methods: Longitudinal household food-insecurity data were collected during 3 individually randomized trials and 1 cluster-randomized trial testing the efficacy or effectiveness of LNSs (generally 118 kcal/d). Seasonally adjusted Household Food Insecurity Access Scale (HFIAS) scores were constructed for 1127 DOSE households, 732 DYAD-M households, 1109 DYAD-G households, and 3671 RDNS households. The impact of providing LNSs to women during pregnancy and the first 6 mo postpartum and/or to their children from 6 to 18–24 mo on seasonally adjusted HFIAS scores was assessed by using negative binomial models (DOSE, DYAD-M, and DYAD-G trials) and mixed-effect negative binomial models (RDNS trial).Results: In the DOSE and DYAD-G trials, seasonally adjusted HFIAS scores were not different between the LNS and non-LNS groups. In the DYAD-M trial, the average household food-insecurity scores were 14% lower (P = 0.01) in LNS households than in non-LNS households. In the RDNS trial, compared with non-LNS households, food-insecurity scores were 17% lower (P = 0.02) during pregnancy and the first 6 mo postpartum and 15% lower (P = 0.02) at 6–24 mo postpartum in LNS households.Conclusions: The daily provision of LNSs to mothers and their children throughout much of the “first 1000 d” may improve household food security in some settings, which could be viewed as an additional benefit that may accrue in households should policy makers choose to invest in LNSs to promote child growth and development. These trials were registered at clinicaltrials.gov as NCT00945698 (DOSE) NCT01239693 (DYAD-M), NCT00970866 (DYAD-G) and NCT01715038 (RDNS).

Newborn physical condition and breastfeeding behaviours: Secondary outcomes of a cluster‐randomized trial of prenatal lipid‐based nutrient supplements in Bangladesh

“…We previously demonstrated that LNS-PL increased birth weight and reduced newborn stunting and that the group receiving both LNS-PL and LNS-C had improved child growth status at 18 to 24 months of age compared with the group in which the mothers received IFA and the children received MNP from 6 to 24 months (Dewey et al, 2017). We also found that daily provision of LNS during pregnancy and to children from 6 to 24 months improved household food security (Adams et al, 2017) and LNS during pregnancy increased mid-upper arm circumference among women aged 25 years or older and those with short stature . Considering the effects of LNS-PL on birth size, food insecurity, and maternal anthropometric status, it is possible that LNS-PL may also have a beneficial impact on general newborn condition and breastfeeding behaviours by directly improving newborn health or increasing maternal confidence in her ability to breastfeed.…”

Longitudinal Assessment of Prenatal, Perinatal, and Early-Life Aflatoxin B1 Exposure in 828 Mother–Child Dyads from Bangladesh and Malawi

“…Poor dietary diversity has been shown to be related to the magnitude of aflatoxin exposure and increasing dietary diversity is a valuable strategy for reducing exposure to aflatoxins ( 4 ). Thus, whether strategies focus on increasing dietary diversity or on reducing household food insecurity—such as by provision of LNSs ( 58 )—a diminished dietary reliance on maize is likely to reduce aflatoxin exposure in Malawi.…”

Healthy pregnancies and essential fats: focus group discussions with Zambian women on dietary need and acceptability of a novel RUSF containing fish oil DHA

“…Both women and children diagnosed with severe or moderate malnutrition have positive outcomes when provided Ready to Use Therapeutic or Supplemental Foods (RUTF and RUSF, respectively) as part of their therapeutic care [8,12,24,39,40]. Studies surrounding such small quantity lipid based nutritional supplements (LNS) were the focus of the International Lipid-Based Nutrient Supplements Project (iLiNS), which sought to evaluate a wide variety of impacts using various formulations of small quantity LNS (i.e.…”