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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Randomized controlled trial of meat compared with multimicronutrient- fortified cereal in infants and toddlers with high stunting rates in diverse settings
American Journal of Clinical Nutrition, Volume 96, No. 4, Year 2012
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Description
Background: Improved complementary feeding is cited as a critical factor for reducing stunting. Consumption of meats has been advocated, but its efficacy in low-resource settings has not been tested. Objective: The objective was to test the hypothesis that daily intake of 30 to 45 g meat from 6 to 18 mo of age would result in greater linear growth velocity and improved micronutrient status in comparison with an equicaloric multimicronutrient-fortified cereal. Design: This was a cluster randomized efficacy trial conducted in the Democratic Republic of Congo, Zambia, Guatemala, and Pakistan. Individual daily portions of study foods and education messages to enhance complementary feeding were delivered to participants. Blood tests were obtained at trial completion. Results: A total of 532 (86.1%) and 530 (85.8%) participants from the meat and cereal arms, respectively, completed the study. Linear growth velocity did not differ between treatment groups: 1.00 (95% CI: 0.99, 1.02) and 1.02 (95% CI: 1.00, 1.04) cm/mo for the meat and cereal groups, respectively (P = 0.39). From baseline to 18 mo, stunting [length-for-age z score (LAZ) <-2.0] rates increased from ̃33% to nearly 50%. Years of maternal education and maternal height were positively associated with linear growth velocity (P = 0.0006 and 0.003, respectively); LAZ at 6 mo was negatively associated (P < 0.0001). Anemia rates did not differ by group; iron deficiency was significantly lower in the cereal group. Conclusion: The high rate of stunting at baseline and the lack of effect of either the meat or multiple micronutrient-fortified cereal intervention to reverse its progression argue for multifaceted interventions beginning in the pre- and early postnatal periods. This trial was registered at clinicaltrials.gov as NCT01084109. © 2012 American Society for Nutrition.
Authors & Co-Authors
Krebs, Nancy F.
United States, Aurora
University of Colorado Anschutz Medical Campus
Mazariegos, Manolo
Guatemala, Guatemala City
Institute of Nutrition of Central America and Panama Guatemala
Chomba, Elwyn Nachanya
Zambia, Lusaka
University Teaching Hospital Lusaka
Sami, Neelofar
Pakistan, Karachi
The Aga Khan University
Pasha, Omrana
Pakistan, Karachi
The Aga Khan University
Tshefu, Antoinette Kitoto
Congo, Kinshasa
Kinshasa School of Public Health
Carlo, Waldemar A.
United States, Birmingham
The University of Alabama at Birmingham
Goldenberg, Robert L.
United States, Philadelphia
Drexel University College of Medicine
Bose, Carl Lewis
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Wright, Linda L.
United States, Bethesda
National Institute of Child Health and Human Development Nichd
Koso-Thomas, Marion W.
United States, Bethesda
National Institute of Child Health and Human Development Nichd
Goco, Norman J.
United States, Research Triangle Park
Rti International
Kindem, Mark
United States, Research Triangle Park
Rti International
McClure, Elizabeth M.
United States, Research Triangle Park
Rti International
Westcott, Jamie E.
United States, Aurora
University of Colorado Anschutz Medical Campus
Garcés, Ana Lucía
Guatemala, Guatemala City
Institute of Nutrition of Central America and Panama Guatemala
Lokangaka, Adrien L.
Congo, Kinshasa
Kinshasa School of Public Health
Manasyan, Albert
Zambia, Lusaka
University Teaching Hospital Lusaka
Imenda, Edna
Zambia, Lusaka
University Teaching Hospital Lusaka
Hartwell, Tyler D.
United States, Research Triangle Park
Rti International
Hambidge, K. Michael
United States, Aurora
University of Colorado Anschutz Medical Campus
Statistics
Citations: 84
Authors: 21
Affiliations: 10
Identifiers
Doi:
10.3945/ajcn.112.041962
ISSN:
00029165
e-ISSN:
19383207
Research Areas
Food Security
Maternal And Child Health
Study Design
Randomised Control Trial
Study Approach
Quantitative
Study Locations
Congo
Zambia