Probability, plausibility, and adequacy evaluations of the Oriente Study demonstrate that supplementation improved child growth.

This article presents evidence that the high-nutrient supplement in the Oriente study (Atole) improved child growth. The evidence is presented at 4 levels. There was a causal effect of the intervention on child length, as assessed by probability analyses of the randomized, controlled trial (P < 0.05). The plausibility analyses, which included an examination of wasting, showed that the nutritional impact was due to the Atole, especially in those who were <3 y old and who suffered from diarrhea. The adequacy analyses revealed excellent biological efficacy of the Atole at the individual level. At the level of the whole population, the efficacy of impact was much less, because many children did not participate fully in the supplementation program. The external validity of the biological impact is likely to be good for populations with similar diets and medical care.