Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg C, Denmark.
Department of Paediatrics and Child Health, Makerere University, Kampala P.O. Box 7072, Uganda.
Nutrients. 2023 Jun 7;15(12):2659. doi: 10.3390/nu15122659.
Stunting affects 22% children globally, putting them at risk of adverse outcomes including delayed development. We investigated the effect of milk protein (MP) vs. soy and whey permeate (WP) vs. maltodextrin in large-quantity, lipid-based nutrient supplement (LNS), and LNS itself vs. no supplementation, on child development and head circumference among stunted children aged 1-5 years. We conducted a randomized, double-blind, community-based 2 × 2 factorial trial in Uganda (ISRCTN1309319). We randomized 600 children to one of four LNS formulations (~535 kcal/d), with or without MP ( = 299 vs. = 301) or WP ( = 301 vs. = 299), for 12 weeks or to no supplementation ( = 150). Child development was assessed using the Malawi Development Assessment Tool. Data were analyzed using linear mixed-effects models. Children had a median [interquartile range] age of 30 [23; 41] months and mean ± standard deviation height-for-age z-score of -3.02 ± 0.74. There were no interactions between MP and WP for any of the outcomes. There was no effect of either MP or WP on any developmental domain. Although LNS itself had no impact on development, it resulted in 0.07 (95%CI: 0.004; 0.14) cm higher head circumference. Neither dairy in LNS, nor LNS in itself, had an effect on development among already stunted children.
发育迟缓影响全球 22%的儿童，使他们面临发育迟缓等不良后果的风险。我们研究了在大量脂基营养素补充剂（LNS）中，乳蛋白（MP）与大豆和乳清渗透物（WP）与麦芽糊精，以及 LNS 本身与不补充，对 1-5 岁发育迟缓儿童的儿童发育和头围的影响。我们在乌干达进行了一项随机、双盲、基于社区的 2×2 析因试验（ISRCTN82620110）。我们将 600 名儿童随机分为四组 LNS 配方（~535 千卡/天）中的一组，一组有 MP（=299 名），一组有 WP（=301 名），或 LNS 本身（=301 名），或不补充（=150 名），为期 12 周。使用马拉维发育评估工具评估儿童发育情况。使用线性混合效应模型进行数据分析。儿童的中位（四分位间距）年龄为 30 [23；41]个月，平均身高年龄 z 评分±标准差为-3.02±0.74。在任何结果中，MP 和 WP 之间都没有相互作用。MP 或 WP 对任何发育领域都没有影响。尽管 LNS 本身对发育没有影响，但它使头围增加了 0.07（95%CI：0.004；0.14）cm。LNS 中的乳制品或 LNS 本身对已经发育迟缓的儿童的发育都没有影响。
