Lipid-based nutrient supplements increase energy and macronutrient intakes from complementary food among Malawian infants

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Abstract

Background: Low intakes of good-quality complementary foods (CFs) contribute to undernutrition and consequently negatively affect health, growth, and development. Lipid-based nutrient supplements (LNSs) are designed to ensure dietary adequacy in micronutrients and essential fatty acids and to provide some energy and high-quality protein. In populations in which acute energy deficiency is rare, the dose-dependent effect of LNSs on CF intakes is unknown. Objective: The objective of this study was to evaluate the difference in energy and macronutrient intakes from CF between a control (no supplement) group and 3 groups that received 10, 20, or 40 g LNS/d. Methods: We collected repeated interactive 24-h dietary recalls from caregivers of rural Malawian 9-to 10-mo-old infants (n = 748) to estimate dietary intakes (LNS and all non-breast-milk foods) of energy and macronutrients and their dietary patterns. All infants were participating in a 12-mo randomized controlled trial to investigate the efficacy of various doses of LNS for preventing undernutrition. Results: Dietary energy intakeswere significantly higher among infants in the LNS intervention groups than in the control group (396, 406, and 388 kcal/d in the 10-, 20-, and 40-g LNS/d groups, respectively, comparedwith 345 kcal/d; each pairwise P < 0.05), but no significant differences were found in energy intakes between groups who were administered the different LNS doses (10 g LNS/d comparedwith 20 g LNS/d: P = 0.72; 10 g LNS/d compared with 40 g LNS/d: P ≥ 0.67; 20 g LNS/d compared with 40gLNS/d: P = 0.94). Intakes of protein and fat were significantly higher in the LNS intervention groups than in the control group. No significant intergroup differences were found inmedian intakes of energy from non-LNS CFs (357, 347, and 296 kcal/d in the 10-, 20-, and 40-g LNS/d groups, respectively, compared with 345 kcal/d in the control group; P = 0.11). Conclusion: LNSs in doses of 10-40 g/d increase intakes of energy andmacronutrients among 9-to 10-mo-old Malawian infants, without displacing locally available CFs. This trial was registered at clinicaltrials.gov as NCT00945698.

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Hemsworth, J., Kumwenda, C., Arimond, M., Maleta, K., Phuka, J., Rehman, A. M., … Ferguson, E. L. (2016). Lipid-based nutrient supplements increase energy and macronutrient intakes from complementary food among Malawian infants. Journal of Nutrition, 146(2), 326–334. https://doi.org/10.3945/jn.115.215327

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