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Session: Improving Nutrition for the First 1,000 Days (Poster Theater Flash Session 5)

(PTFS05-05-23) Effect of Small Quantity Lipid-Based Nutrient Supplements Provided During the First 1000 Days on Linear Growth From Birth to 9–11 Years in a Randomized Controlled Trial in Ghana

Sunday, July 23, 2023
2:21 PM – 2:25 PM ET
Location:  Fairfax
Disclosure(s):
Helena J. Bentil, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Seth Adu-Afarwuah, Professor: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: In the first randomized trial since the 1970s that has investigated the long-term effects of exposure to a fortified nutritional supplement during both pre-and post-natal life, we recently reported that small-quantity lipid-based nutrient supplements (SQ-LNS) positively affected height-for-age z-score (HAZ) at 10 y, specifically among children of non-overweight/obese women. In this current study, we aimed to determine during which period of growth the intervention positively affected linear growth.

Methods: The International Lipid-Based Nutrient Supplements (iLiNS) DYAD-Ghana trial was a randomized controlled trial conducted in 2009-2014. 1320 pregnant women ≤ 20 weeks gestation were randomly assigned to receive daily (1) iron and folic acid during pregnancy and placebo during 6 mo postpartum, (2) multiple micronutrients (18 vitamins and minerals) during pregnancy and 6 mo postpartum, or (3) SQ-LNS (20 g/d) for pregnant women during pregnancy and 6 mo postpartum and SQ-LNS for children from 6 to 18 mo of age. Child linear growth (z-score for length (LAZ) or height (HAZ)) was assessed at birth, 6 mo, 18 mo, 5 y, and 10 y. Linear growth during each interval was calculated by regressing HAZ on the prior measurement and calculating the standardized residual.

Results: Data were available for 963 children. There was a trend for differences between SQ-LNS and control groups in LAZ at birth [-0.58 vs. -0.69 (P = 0.07)] and linear growth from 6 to 18 mo [0.08 vs. -0.04 (P = 0.07)] with no differences from 0 to 6 mo, 18 mo to 5 y, or 5 to 10 y (P > 0.19). Among children of non-overweight/obese women, there was a trend for differences between SQ-LNS and control groups in LAZ at birth [-0.69 vs. -0.82 (P = 0.11)] and linear growth from birth to 6 mo [0.13 vs -0.01 (P = 0.07) and significantly higher linear growth from 6 to 18 mo [0.10 vs -0.09 (P = 0.03)]. Among children of overweight/obese women, linear growth was not significantly higher in SQ-LNS vs control children at any time.

Conclusions: SQ-LNS had effects on LAZ at birth and between 6-18 mo that were sustained through 10 years of age among children of non-overweight women. This adds to the evidence that SQ-LNS is an effective intervention for improving long-term linear growth.

Funding Sources: National Institutes of Health, Bill & Melinda Gates Foundation