Instituto Nacional de Salud Publica (INSP), Cuernavaca, Morelos, Mexico.
Autonomous University of the State of Morelos, Cuernavaca, Morelos, Mexico.
Nutr J. 2018 Aug 13;17(1):76. doi: 10.1186/s12937-018-0385-3.
Nutritional supplements are an important source of complementary food for young children, since they may either complement or substitute nutrients obtained from other food sources. Assessing how the introduction of different types of supplements modifies the consumption of other food sources may help in designing supplementation programs that aim to improve the nutrition of vulnerable populations. The objetive is to quantify dietary energy and nutrient intake among children aged 6-12 months who received one of three nutritional supplements.
A cluster-randomized trial was conducted from 2005 to 2007. Urban communities were randomly allocated to one of three intervention groups receiving one of the following: a milk-based fortified food, micronutrient powders, or syrup. Each supplement was fortified with equal amounts of micronutrients. Dietary intake was estimated using a food frequency questionnaire (FFQ) to reflect the average consumption over the month prior to the interview. Children between 6 and 12 months of age were recruited. Median regression was performed with adjusted standard errors for clustered data, and the linear predictors for the median included the study group, study stage and their interaction. Adjusted medians by study group and study stage were obtained as post-estimations.
No statistically significant differences between study groups were observed at baseline. After four months of supplementation, the children in the fortified food group had a smaller increase in median dietary energy (183.7 kcal, CI95%: 59.9, 307.5) and dietary protein (6.6 g, CI95%: 2.6, 10.6) intake from their home diet than those in the syrup group (p < 0.05). These differences remained significant after adjusting for group differences at baseline. Regarding covariate-adjusted median changes from baseline to follow-up at 10 months, the children in the fortified food group had a smaller median increase in dietary energy intake than those in the syrup group (698 vs 915 kcal), with a difference of 217.9 kcal (CI95%: 20.4, 415.4).
Children in the fortified food group consumed less dietary energy, protein, and micronutrients than those in the micronutrient powder and syrup groups. It is possible that absolute nutrient intake may be overestimated by the FFQ, but this possibility does not compromise the ability to compare study groups. Given the observed differences in dietary energy consumption among the three supplemented groups, it can be concluded that supplementation with micronutrient powders is an adequate option for urban children who have met their minimum energy and protein requirements.
营养补充品是幼儿补充食物的重要来源，因为它们可以补充或替代其他食物来源的营养。评估不同类型的补充品引入如何改变其他食物来源的消费情况，有助于设计旨在改善弱势群体营养状况的补充计划。本研究的目的是定量评估接受三种营养补充品之一的 6-12 月龄儿童的膳食能量和营养素摄入情况。
这是一项于 2005 年至 2007 年进行的群组随机试验。将城市社区随机分配到三个干预组中的一个，分别接受以下三种补充品之一：一种基于牛奶的强化食品、微量营养素粉末或糖浆。每种补充剂都添加了等量的微量营养素。膳食摄入量是通过食物频率问卷（FFQ）来估计的，反映了在接受访谈前一个月的平均摄入量。招募了 6-12 月龄的儿童。采用校正聚类数据的标准误差进行中位数回归，中位数的线性预测因子包括研究组、研究阶段及其相互作用。以研究组和研究阶段的校正中值作为事后估计。
在基线时，各组间无统计学差异。在补充四个月后，与糖浆组相比，强化食品组儿童的家庭饮食中膳食能量（183.7kcal，95%CI：59.9，307.5）和膳食蛋白质（6.6g，95%CI：2.6，10.6）的摄入量增加较小（p<0.05）。在调整基线时的组间差异后，这些差异仍然具有统计学意义。关于从基线到 10 个月随访时的校正中值变化，强化食品组儿童的膳食能量摄入增加中位数低于糖浆组（698 比 915kcal），差值为 217.9kcal（95%CI：20.4，415.4）。
与微量营养素粉末和糖浆组相比，强化食品组儿童的膳食能量、蛋白质和微量营养素摄入较少。尽管 FFQ 可能会高估绝对营养素摄入量，但这并不会影响比较研究组的能力。鉴于三种补充组之间的膳食能量消耗存在差异，可以得出结论，对于已经满足最低能量和蛋白质需求的城市儿童，补充微量营养素粉末是一种合适的选择。
