Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
Paediatr Perinat Epidemiol. 2014 May;28(3):245-54. doi: 10.1111/ppe.12117. Epub 2014 Mar 13.
Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children.
A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months' blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data.
At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence.
These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children.
脂类营养素补充剂（LNS）已被证明可有效治疗儿童急性营养不良。我们评估了 LNS 补充剂在改善幼儿微量营养素状况方面的作用。
在洪都拉斯因蒂布卡进行了一项为期 12 个月的随机对照试验，纳入年龄在 6-18 个月之间的儿童。社区（n=18）按贫困指标（9 个干预组，n=160 和 9 个对照组，n=140）进行分组。干预组参与者接受 LNS 补充。所有儿童均获得食物券和营养教育。主要结局指标包括微量营养素状况的测量：基线、6 个月和 12 个月时采集血液以评估叶酸、铁、锌、核黄素和维生素 B12 状况；每 3 个月测量血红蛋白；每月收集饮食和人体测量数据。基于意向治疗和 LNS 依从性进行纵向分析。广义估计方程用于估计针对数据指定的广义线性回归模型。
在 6 个月的随访中，干预组中 B12 缺乏的儿童比例（43.6%）低于对照组（67.7%；P=0.03）。干预组的叶酸浓度在 6 个月时更高（P=0.06），并且这种情况持续到 12 个月，叶酸（P=0.002）和维生素 A 缺乏（P=0.03）都有所改善。基于 LNS 依从性的亚组分析结果显示，这种结果模式具有更高的显著意义。
这些数据表明，LNS 改善了洪都拉斯非营养不良幼儿的某些微量营养素状况。
