Maternal and Infant Lipid-Based Nutritional Supplementation Increases Height of Ghanaian Children at 4-6 Years Only if the Mother Was Not Overweight Before Conception

Sika M Kumordzie; Seth Adu-Afarwuah; Mary Arimond; Rebecca R Young; Theodosia Adom; Rose Boatin; Maku E Ocansey; Harriet Okronipa; Elizabeth L Prado; Brietta M Oaks; Kathryn G Dewey

doi:10.1093/jn/nxz005

Maternal and Infant Lipid-Based Nutritional Supplementation Increases Height of Ghanaian Children at 4-6 Years Only if the Mother Was Not Overweight Before Conception

J Nutr. 2019 May 1;149(5):847-855. doi: 10.1093/jn/nxz005.

Authors

Affiliations

¹ Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA.
² Department of Nutrition and Food Science, University of Ghana, Ghana.
³ Intake - Center for Dietary Assessment, FHI 360, Washington, DC.
⁴ Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Legon, Ghana.
⁵ Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI.

Abstract

Background: Few studies have evaluated the long-term effects of nutritional supplementation during the first 1000 d of life. We previously reported that maternal and child lipid-based nutrient supplements (LNS) increased child length by 18 mo.

Objective: The aim of this study was to examine the effects of LNS on later growth and body composition at 4-6 y of age.

Design: This was a follow-up of children in the International Lipid-based Nutrient Supplements (iLiNS)-DYAD trial in Ghana. Women (n = 1320) at ≤20 weeks of gestation were randomly assigned to: 1) iron and folic acid during pregnancy and 200 mg calcium/d for 6 mo postpartum, 2) multiple micronutrients (1-2 RDA of 18 vitamins and minerals) during both periods, or 3) maternal LNS during both periods plus child LNS from 6 to 18 mo. At 4-6 y, we compared height, height-for-age z score (HAZ), and % body fat (deuterium dilution method) between the LNS group and the 2 non-LNS groups combined.

Results: Data were available for 961 children (76.5% of live births). There were no significant differences between LNS compared with non-LNS groups in height [106.7 compared with 106.3 cm (mean difference, MD, 0.36; P = 0.226)], HAZ [-0.49 compared with -0.57 (MD = 0.08; P = 0.226)], stunting (< -2 SD) [6.5 compared with 6.3% (OR = 1.00; P = 0.993)], or % body fat [15.5 compared with 15.3% (MD = 0.16; P = 0.630)]. However, there was an interaction with maternal prepregnancy BMI (kg/m2) (P-interaction = 0.046 before correction for multiple testing): among children of women with BMI < 25 , LNS children were taller than non-LNS children (+1.1 cm, P = 0.017), whereas there was no difference among children of women with BMI ≥ 25 (+0.1 cm; P = 0.874).

Conclusions: There was no overall effect of LNS on height at 4-6 y in this cohort, which had a low stunting rate, but height was greater in the LNS group among children of nonoverweight/obese women. There was no adverse impact of LNS on body composition. This trial was registered at clinicaltrials.gov as NCT00970866.

Keywords: body composition; follow-up; growth; lipid-based nutrient supplements; prenatal supplementation.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adipose Tissue / metabolism
Adult
Body Composition
Body Height / drug effects*
Body Mass Index*
Child
Child, Preschool
Dietary Supplements*
Female
Ghana
Growth Disorders* / prevention & control
Humans
Infant
Infant, Newborn
Lipids / administration & dosage
Micronutrients / pharmacology*
Micronutrients / therapeutic use
Mothers
Obesity / complications*
Pregnancy
Pregnancy Complications
Prenatal Nutritional Physiological Phenomena*

Substances

Lipids
Micronutrients

Associated data

ClinicalTrials.gov/NCT00970866