Iannotti Lora L, Henretty Nicole M, Delnatus Jacques Raymond, Previl Windy, Stehl Tom, Vorkoper Susan, Bodden Jaime, Maust Amanda, Smidt Rachel, Nash Marilyn L, Tamimie Courtney A, Owen Bridget C, Wolff Patricia B
Institute for Public Health, George Warren Brown School of Social Work, Washington University, St. Louis, MO;
Edesia, Providence, RI;
J Nutr. 2015 Apr;145(4):813-22. doi: 10.3945/jn.114.203182. Epub 2015 Feb 11.
In Haiti and other countries, large-scale investments in school feeding programs have been made with marginal evidence of nutrition outcomes.
We aimed to examine the effectiveness of a fortified ready-to-use supplementary food (RUSF), Mamba, on reduced anemia and improved body composition in school-aged children compared to an unfortified cereal bar, Tablet Yo, and control groups.
A cluster, randomized trial with children ages 3-13 y (n = 1167) was conducted in the north of Haiti. Six schools were matched and randomized to the control group, Tablet Yo group (42 g, 165 kcal), or Mamba group (50 g, 260 kcal, and >75% of the RDA for critical micronutrients). Children in the supplementation groups received the snack daily for 100 d, and all were followed longitudinally for hemoglobin concentrations, anthropometry, and bioelectrical impedance measures: baseline (December 2012), midline (March 2013), and endline (June 2013). Parent surveys were conducted at baseline and endline to examine secondary outcomes of morbidities and dietary intakes. Longitudinal regression modeling using generalized least squares and logit with random effects tested the main effects.
At baseline,14.0% of children were stunted, 14.5% underweight, 9.1% thin, and 73% anemic. Fat mass percentage (mean ± SD) was 8.1% ± 4.3% for boys and 12.5% ± 4.4% for girls. In longitudinal modeling, Mamba supplementation increased body mass index z score (regression coefficient ± SEE) 0.25 ± 0.06, fat mass 0.45 ± 0.14 kg, and percentage fat mass 1.28% ± 0.27% compared with control at each time point (P < 0.001). Among boys, Mamba increased fat mass (regression coefficient ± SEE) 0.73 ± 0.19 kg and fat-free mass 0.62 ± 0.34 kg compared with control (P < 0.001). Mamba reduced the odds of developing anemia by 28% compared to control (adjusted OR: 0.72; 95% CI: 0.57, 0.91; P < 0.001). No treatment effect was found for hemoglobin concentration.
To our knowledge, this is the first study to give evidence of body composition effects from an RUSF in school-aged children.
在海地及其他国家，已对学校供餐计划进行了大规模投资，但关于营养成果的证据却很有限。
我们旨在研究强化即食补充食品曼巴（Mamba）与未强化谷物棒Tablet Yo及对照组相比，对降低学龄儿童贫血率和改善身体成分的效果。
在海地北部对3至13岁的儿童（n = 1167）进行了一项整群随机试验。六所学校进行匹配并随机分为对照组、Tablet Yo组（42克，165千卡）或曼巴组（50克，260千卡，关键微量营养素含量超过推荐膳食摄入量的75%）。补充组的儿童每天接受该零食，为期100天，并对所有儿童进行血红蛋白浓度、人体测量和生物电阻抗测量的纵向跟踪：基线（2012年12月）、中期（2013年3月）和末期（2013年6月）。在基线和末期进行家长调查，以检查发病率和饮食摄入量等次要结果。使用广义最小二乘法和带随机效应的logit进行纵向回归建模，以检验主要效应。
在基线时，14.0%的儿童发育迟缓，14.5%体重不足，9.1%消瘦，73%贫血。男孩的体脂百分比（均值±标准差）为8.1%±4.3%，女孩为12.5%±4.4%。在纵向建模中，与对照组相比，每次测量时曼巴补充剂均使体重指数z评分（回归系数±标准误）增加0.25±0.06，体脂增加0.45±0.14千克，体脂百分比增加1.28%±0.27%（P < 0.001）。在男孩中，与对照组相比，曼巴使体脂（回归系数±标准误）增加0.73±0.19千克，去脂体重增加0.62±0.34千克（P < 0.001）。与对照组相比，曼巴使患贫血的几率降低了28%（调整后的比值比：0.72；95%置信区间：0.57，0.91；P < 0.001）。未发现对血红蛋白浓度有治疗效果。
据我们所知，这是第一项证明即食补充食品对学龄儿童身体成分有影响的研究。
