Flax Valerie L, Siega-Riz Anna Maria, Reinhart Greg A, Bentley Margaret E
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
Matern Child Nutr. 2015 Dec;11 Suppl 4(Suppl 4):203-13. doi: 10.1111/mcn.12182.
Inadequate energy intake and poor diet quality are important causes of chronic child undernutrition. Strategies for improving diet quality using lipid-based nutrient supplements (LNS) are currently being tested in several countries. To date, information on children's dietary intakes during LNS use is available only from Africa. In this study, we collected 24-h dietary recalls at baseline, 3, 6, 9 and 12 months on Honduran children (n = 298) participating in a cluster-randomised trial of LNS. Generalised estimating equations were used to examine differences in number of servings of 12 food groups in the LNS and control arms, and multi-level mixed effects models were used to compare macro- and micronutrient intakes. Models accounted for clustering and adjusted for child's age, season and breastfeeding status. Mean daily servings of 12 food groups did not differ by study arm at baseline and remained similar throughout the study with the exception of groups that were partially or entirely supplied by LNS (nuts and nut butters, fats, and sweets). Baseline intakes of energy, fat, carbohydrates, protein, folate and vitamin A, but not vitamin B12, iron and zinc were lower in the LNS than control arm. The change in all macro- and micronutrients from baseline to each study visit was larger for the LNS arm than the control, except for carbohydrates from baseline to 9 months. These findings indicate that LNS improved the macro- and micronutrient intakes of young non-malnourished Honduran children without replacing other foods in their diet.
能量摄入不足和饮食质量差是儿童慢性营养不良的重要原因。目前,几个国家正在测试使用基于脂质的营养补充剂(LNS)改善饮食质量的策略。迄今为止,关于LNS使用期间儿童饮食摄入量的信息仅来自非洲。在本研究中,我们收集了参与LNS整群随机试验的洪都拉斯儿童(n = 298)在基线、3、6、9和12个月时的24小时饮食回忆。使用广义估计方程来检验LNS组和对照组中12个食物组的食用份数差异,并使用多层次混合效应模型来比较宏量营养素和微量营养素的摄入量。模型考虑了聚类因素,并对儿童年龄、季节和母乳喂养状况进行了调整。在基线时,12个食物组的平均每日食用份数在研究组之间没有差异,并且在整个研究过程中保持相似,但由LNS部分或全部提供的组(坚果和坚果酱、脂肪和糖果)除外。LNS组的能量、脂肪、碳水化合物、蛋白质、叶酸和维生素A的基线摄入量低于对照组,但维生素B12、铁和锌的基线摄入量并非如此。从基线到每次研究访视,LNS组所有宏量营养素和微量营养素的变化都大于对照组,但从基线到9个月的碳水化合物变化除外。这些发现表明,LNS改善了非营养不良的洪都拉斯幼儿的宏量营养素和微量营养素摄入量,且未取代他们饮食中的其他食物。