Micronutrient Status and Energy Intake in Moderate Acute Malnourished Children After Intake of High Energy Nutritional Supplements for Four Weeks: A Randomized Controlled Study

Abstract

Background: Undernutrition including micronutrient deficiency results in adverse health-related outcomes in children of low-medium income countries. This study aims to explore the effect of four weeks of Lipid-based nutritional supplement (LNS) on energy intake, anthropometry and micronutrient status in moderate acute malnourished children. Methods Thirty-four children with mean age 7.08±1.47 years and a BMI Z score between -2 and -3 SDS were randomized into LNS and Placebo groups in a single blind randomized control trial. Energy intake, fasting blood samples, and anthropometric measurements were obtained prior to and after four weeks of LNS (535 kcal) or Placebo (92kcal) supplementation in addition to their habitual dietary intake. Results: During four weeks of supplementation, energy intake (kcal) [(611±155) to (987±224), p<0.001)], weight (kg) [(17.5±2.83) to (18.1±3.24), p< 0.001], mid-upper arm circumference (cm) [(14.8±0.91) to (15.1±0.84), p=0.005)] and BMI (kg/m2) [(12.9±0.33) to (13.3±0.45), p=0.002] was significantly improved in the LNS group compared to Placebo. A significant increase in hemoglobin (g/ml) [(12.2±1.14) to (13.7±1.69), p<0.01] and iron levels (µg/dl) [(0.36±0.09) to (0.67±0.20), p<0.001] were observed in the LNS group. No significant differences were detected in the copper and zinc levels. Conclusion: Lipid-based nutritional supplement is effective in improving energy intake, nutritional outcomes and iron but not copper and zinc. The trial was registered at www.isrctn.com under reference: ISRCTN147181521.

Effects of Oral Lipid‐Based nutritional supplements on appetite, energy intake, and lipid profile of moderately underweight children

“…However, prolonged energy suppression was observed in our study which extended up to lunch in contrast to other two studies (Fatima, Gerasimidis, Wright, & Malkova, 2015 ; Fatima, et al, 2015 ). Similar prolonged energy suppression after the use of LNS was observed in a recent study on malnourished children (Nawab et al, 2022 ) which shows that energy is compensated due to intake of high caloric supplement. On second trial day, the total energy intake was higher in the LNS group than in the PLACEBO group during breakfast and lunch.…”

“…On second trial day, the total energy intake was higher in the LNS group than in the PLACEBO group during breakfast and lunch. Similarly, no energy suppression is reported previously in other studies (Fatima, Gerasimidis, Wright, & Malkova, 2015 ; Nawab et al, 2022 ). This suggests that children can accommodate the feeding of supplement if it is given on daily basis and energy consumption is not reduced.…”

Micronutrient deficiency and supplements in schoolchildren and teenagers

“…A high energy intake RCT tested a daily lipid-based 500 kcal supplement in 34 malnourished children aged 7.1 ± 1.5 years and conducted over 4 weeks [21]: anthropometric variables, haemoglobin (Hb) and iron levels ( P < 0.001) improved.…”

Estudos Multidisciplinares Sobre Saúde Da Criança E Do Adolescente

“…do organismo, principalmente, para a recuperação nutricional da saúde da desnutrição aguda moderada(NAWAB et al, 2022).…”