Supplementary feeding programs for young children in developing countries

Beaton, George H.; Ghassemi, Hossein

doi:10.1093/ajcn/35.4.864

Cited by 186 publications

(98 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Because growth faltering is highly resistant to energy or micronutrient supplementation [as shown in numerous studies (73–78)] and so many interventions have failed to improve the growth and gut integrity of Gambian infants (76, 79, 80), it was hoped that n−3 LC-PUFA supplementation would provide some beneficial effect. Despite the supplementation of young infants with a very large dose of n−3–rich fish oil, administration of supplements under direct observation, achievement of very high compliance rates, and the demonstration of significant shifts in plasma PUFA profiles at 9 mo, remarkably little effect was observed on tested outcomes.…”

Section: Discussionmentioning

confidence: 99%

Long-chain PUFA supplementation in rural African infants: a randomized controlled trial of effects on gut integrity, growth, and cognitive development

Merwe¹,

Moore²,

Fulford³

et al. 2013

The American Journal of Clinical Nutrition

View full text Add to dashboard Cite

Background: Intestinal damage and malabsorption caused by chronic environmental enteropathy are associated with growth faltering seen in infants in less-developed countries. Evidence has suggested that supplementary omega-3 (n−3) long-chain PUFAs (LC-PUFAs) might ameliorate this damage by reducing gastrointestinal inflammation. LC-PUFA supplementation may also benefit cognitive development.Objective: We tested whether early n−3 LC-PUFA supplementation improves infant intestinal integrity, growth, and cognitive function.Design: A randomized, double-blind, controlled trial [200 mg DHA and 300 mg EPA or 2 mL olive oil/d for 6 mo] was conducted in a population of 172 rural Gambian infants aged 3–9 mo. The primary endpoints were anthropometric measures and gut integrity [assessed by using urinary lactulose:mannitol ratios (LMRs)]. Plasma fatty acid status, intestinal mucosal inflammation (fecal calprotectin), daily morbidity, and cognitive development (2-step means-end test and an attention assessment) were secondary endpoints.Results: PUFA supplementation resulted in a significant increase in plasma n−3 LC-PUFA concentrations (P < 0.001 for both DHA and EPA) and midupper arm circumference (MUAC) (effect size: 0.31 z scores; 95% CI: 0.06, 0.56; P = 0.017) at 9 mo of age. At 12 mo, MUAC remained greater in the intervention group, and we observed significant increases in skinfold thicknesses (P ≤ 0.022 for all). No other significant differences between treatment groups were detected for growth or LMRs at 9 mo or for secondary outcomes.Conclusions: Fish-oil supplementation successfully increased plasma n−3 fatty acid status. However, in young, breastfed Gambian infants, the intervention failed to improve linear growth, intestinal integrity, morbidity, or selected measures of cognitive development. The trial was registered at www.isrctn.org as ISRCTN66645725.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-chain PUFA supplementation in rural African infants: a randomized controlled trial of effects on gut integrity, growth, and cognitive development

Merwe¹,

Moore²,

Fulford³

et al. 2013

The American Journal of Clinical Nutrition

View full text Add to dashboard Cite

show abstract

“…Vitamin A deficiency has been linked to a greater risk of stunting (Fuchs et al, 1994) and vitamin A supplementation selectively improved the linear growth of Indonesian preschool children (Hadi et al, 2000). On the other hand, supplementing programmes aimed at increasing the energy and protein intake generally showed only a small effect on physical growth (Beaton & Ghassemi, 1982).…”

Section: Discussionmentioning

confidence: 99%

Nutritional status and dietary intakes of children aged 2–5 years and their caregivers in a rural South African community

Faber

Jogessar

Benadé³

2001

International Journal of Food Sciences and Nutrition

View full text Add to dashboard Cite

The objective of this study was to determine the nutritional status regarding vitamin A, iron and anthropometric indices and dietary intakes of children aged 2-5 years and their caregivers in a rural South African community. Micronutrient, haematological, anthropometric and dietary indicators were used to assess nutritional status during a cross-sectional survey. The setting was a low socioeconomic rural African community (Ndunakazi), approximately 60 km northwest of the coastal city of Durban in KwaZulu-Natal, South Africa. The subjects were children aged 2-5 years (n = 164), and their caregivers (n = 137). Of the preschool children, 50% had a low vitamin A status (serum retinol < 20 micrograms/dL), 54% were anaemic (Hb < 11 micrograms/dL), 33% had depleted iron stores (serum ferritin levels < 10 micrograms/L), and 21% were stunted (Z-score for height-for-age < -2SD). Of the caregivers, 30% had a low vitamin A status (serum retinol < 30 micrograms/dL), 44% were anaemic (Hb < 11 micrograms/dL), 19% had depleted iron stores (serum ferritin levels < 12 micrograms/L), and 40% and 26% were overweight (BMI > or = 24 and < 30) and obese (BMI > or = 30), respectively. The children and caregivers consumed a cereal-based diet, with phutu (a stiff porridge made with maize meal), rice and bread as staple foods. Quantitative dietary analysis showed that the dietary intakes were high in carbohydrates (approximately 70% of total energy), while fat intake was within the prudent dietary guideline of 30% of total energy intake. Median dietary intakes were below 50% of the RDA for calcium, zinc (children only), vitamin A, riboflavin, niacin (children only) and vitamin B12. These preschool children and their caregivers consumed a high carbohydrate diet deficient in most of the essential micronutrients. The poor quality of the diet was reflected in a poor vitamin A and iron status, and one-fifth of the children showed linear growth retardation. Nutrition education and intervention programmes should address micronutrient deficiencies, with the focus not only on quantity, but also quality of the diet.

show abstract

“…Building on [17,18], we provide a simplified programme theory of the nutritional impact of school feeding. The school meal can be shared by children with other household members or can substitute (at least partly) for food normally consumed in the home.…”

Section: Programme Theory Of the Interventionmentioning

confidence: 99%

Improving community development by linking agriculture, nutrition and education: design of a randomised trial of “home-grown” school feeding in Mali

Masset

Gelli

2013

Trials

View full text Add to dashboard Cite

BackgroundProviding food through schools has well documented effects in terms of the education, health and nutrition of school children. However, there is limited evidence in terms of the benefits of providing a reliable market for small-holder farmers through “home-grown” school feeding approaches. This study aims to evaluate the impact of school feeding programmes sourced from small-holder farmers on small-holder food security, as well as on school children’s education, health and nutrition in Mali. In addition, this study will examine the links between social accountability and programme performance.DesignThis is a field experiment planned around the scale-up of the national school feeding programme, involving 116 primary schools in 58 communities in food insecure areas of Mali. The randomly assigned interventions are: 1) a school feeding programme group, including schools and villages where the standard government programme is implemented; 2) a “home-grown” school feeding and social accountability group, including schools and villages where the programme is implemented in addition to training of community based organisations and local government; and 3) the control group, including schools and household from villages where the intervention will be delayed by at least two years, preferably without informing schools and households. Primary outcomes include small-holder farmer income, school participation and learning, and community involvement in the programme. Other outcomes include nutritional status and diet-diversity. The evaluation will follow a mixed method approach, including household, school and village level surveys as well as focus group discussions with small-holder farmers, school children, parents and community members. The impact evaluation will be incorporated within the national monitoring and evaluation (M&E) system strengthening activities that are currently underway in Mali. Baselines surveys are planned for 2012. A monthly process monitoring visits, spot checks and quarterly reporting will be undertaken as part of the regular programme monitoring activities. Evaluation surveys are planned for 2014.DiscussionNational governments in sub-Saharan Africa have demonstrated strong leadership in the response to the recent food and financial crises by scaling-up school feeding programmes. “Home-grown” school feeding programmes have the potential to link the increased demand for school feeding goods and services to community-based stakeholders, including small-holder farmers and women’s groups. Alongside assessing the more traditional benefits to school children, this evaluation will be the first to examine the impact of linking school food service provision to small-holder farmer income, as well as the link between community level engagement and programme performance.Trial registrationISRCTN76705891

show abstract

Supplementary feeding programs for young children in developing countries

Cited by 186 publications

References 0 publications

Long-chain PUFA supplementation in rural African infants: a randomized controlled trial of effects on gut integrity, growth, and cognitive development

Long-chain PUFA supplementation in rural African infants: a randomized controlled trial of effects on gut integrity, growth, and cognitive development

Nutritional status and dietary intakes of children aged 2–5 years and their caregivers in a rural South African community

Improving community development by linking agriculture, nutrition and education: design of a randomised trial of “home-grown” school feeding in Mali

Contact Info

Product

Resources

About