Childhood stunting and micronutrient status unaffected by RCT of micronutrient fortified drink

Mayén, V. A., Ogunlusi, A., Wright, C. M. and Garcia, A. L. (2022) Childhood stunting and micronutrient status unaffected by RCT of micronutrient fortified drink. Maternal and Child Nutrition, 18(1), e13256. (doi: 10.1111/mcn.13256) (PMID:34355514) (PMCID:PMC8710120)

Abstract

Micronutrient supplementation is widely used to prevent stunting in children under 5 years in low- and middle-income countries (LMIC), but the impact of treatment has been disappointing, possibly due to non-compliance. Our aim was to deliver long-term micronutrient supplementation via a novel, culturally acceptable liquid food to improve linear growth in a high stunting prevalence region. In a randomised control trial, 971 children aged 6–72 months received either ‘Chispuditos®’ (n = 681), a hot drink (atole) fortified with micronutrients (atole + MN) (9 mg/zinc, 12.5 mg/iron), or lactose-free milk (n = 290) for 18 months. Primary outcomes were changes in length/height-for-age (HAZ) score and the prevalence of stunting at 18-month follow-up. Adherence was monitored monthly, and 73% children in atole + MN group consumed at least half their daily zinc and iron requirement. At 18 months, there was no difference between the treatments in growth [mean change in HAZ −0.02 (95% CI −0.12, 0.08)] or stunting [atole + MN 41%, milk 41%; RR 0.99 (95% CI 0.84, 1.19)]. There were no differences in haemoglobin (HB), ferritin or zinc. No children had iron deficiency anaemia (IDA) at outcome, but zinc deficiency remained equally prevalent in both groups: atole + MN 35%, milk 35% [RR 1.02 (95% CI 0.83, 1.24)]. There was no difference in morbidity between the groups, and micronutrient status was unrelated to HAZ. Long-term micronutrient supplementation via a culturally acceptable food had no impact on stunting or morbidity, raising the question of whether large-scale micronutrient supplementation is worthwhile.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Garcia, Dr Ada and Wright, Professor Charlotte
• Authors: Mayén, V. A., Ogunlusi, A., Wright, C. M., and Garcia, A. L.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Maternal and Child Nutrition
• Publisher: Wiley
• ISSN: 1740-8695
• ISSN (Online): 1740-8709
• Published Online: 06 August 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in Maternal and Child Nutrition 18(1): e13256
• Publisher Policy: Reproduced under a Creative Commons License