Effect of lipid-based nutrient supplements on morbidity among children with stunting: secondary analysis of a randomized trial in Uganda.

IF 3.6 3区医学 Q2 NUTRITION & DIETETICS

European Journal of Clinical Nutrition Pub Date : 2025-03-31 DOI:10.1038/s41430-025-01611-3

Rolland Mutumba, Joseph Mbabazi, Hannah Pesu, Jack I Lewis, Christian Mølgaard, Christian Ritz, Mette F Olsen, Andre Briend, Nicolette Nabukeera-Barungi, Jonathan C Wells, Henrik Friis, Benedikte Grenov, Ezekiel Mupere

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引用次数: 0

Abstract

Background: Children with stunting are at risk of infections. We assessed the effect of lipid-based nutrient supplement (LNS) on morbidity in children with stunting.

Methods: This was a secondary analysis of a randomized, 2×2 factorial trial among 12-59 months-old, stunted children in Uganda. Children were randomized to LNS containing milk or soy protein and whey permeate or maltodextrin, or no supplementation, for 12 weeks. The outcomes were caregiver-reported morbidity after 2, 4, 8 and 12 weeks, serum C-reactive protein (S-CRP), α₁-acid glycoprotein (S-AGP), and phase-angle (PhA) by bioimpedance.

Results: Of 750 children, mean (SD) age was 32.0 (11.7) months, 55% (n = 412) were male. LNS increased diarrhoea prevalence (18.1% vs 7.3%, P = 0.001) during the first two weeks, but not thereafter. There was no effect of LNS on cough or fever. LNS resulted in greater decline in S-AGP (-0.10 g/L, 95% CI: -0.17, -0.03, P = 0.003) but not S-CRP (25%, 95% CI: -11, 74, P = 0.193), and greater increase in PhA (0.10 degrees, 95% CI: 0.01, 0.18, P = 0.030), explained by greater fat-free mass. Milk compared to soy protein in LNS resulted in higher PhA (0.10 degrees, 95% CI: 0.02, 0.17, P = 0.013), not explained by fat-free mass.

Conclusion: LNS supplementation in children with stunting had no effect on morbidity but resulted in a small reduction in sub-acute systemic inflammation. The possible effect of LNS supplementation on inflammation in stunted children requires further evaluation. ( www.isrctn.com : ISRCTN13093195).

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背景：发育迟缓儿童面临感染风险。我们评估了脂质营养补充剂（LNS）对发育迟缓儿童发病率的影响：这是一项针对乌干达 12-59 个月大发育迟缓儿童的 2×2 因式随机试验的二次分析。儿童被随机分配到含牛奶或大豆蛋白和乳清渗透物或麦芽糊精的 LNS 中，或不补充 LNS，为期 12 周。研究结果为 2、4、8 和 12 周后护理人员报告的发病率、血清 C 反应蛋白（S-CRP）、α1-酸糖蛋白（S-AGP）和生物阻抗法相角（PhA）：在 750 名儿童中，平均（标清）年龄为 32.0（11.7）个月，55%（n = 412）为男性。LNS 会增加头两周的腹泻率（18.1% vs 7.3%，P = 0.001），但此后不会再增加。LNS 对咳嗽或发烧没有影响。LNS 导致 S-AGP 下降幅度更大（-0.10 克/升，95% CI：-0.17，-0.03，P = 0.003），但未导致 S-CRP 下降（25%，95% CI：-11，74，P = 0.193），PhA 上升幅度更大（0.10 度，95% CI：0.01，0.18，P = 0.030），原因是无脂肪质量更大。与大豆蛋白相比，牛奶在 LNS 中会导致更高的 PhA（0.10 度，95% CI：0.02，0.17，P = 0.013），而无脂质量则无法解释这一点：结论：对发育迟缓的儿童补充 LNS 对发病率没有影响，但可使亚急性全身炎症略有减轻。补充 LNS 对发育迟缓儿童炎症可能产生的影响需要进一步评估。( www.isrctn.com : ISRCTN13093195)。

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来源期刊

European Journal of Clinical Nutrition 医学-营养学

CiteScore

10.60

自引率

2.10%

发文量

189

审稿时长

3-6 weeks

期刊介绍： The European Journal of Clinical Nutrition (EJCN) is an international, peer-reviewed journal covering all aspects of human and clinical nutrition. The journal welcomes original research, reviews, case reports and brief communications based on clinical, metabolic and epidemiological studies that describe methodologies, mechanisms, associations and benefits of nutritional interventions for clinical disease and health promotion. Topics of interest include but are not limited to: Nutrition and Health (including climate and ecological aspects) Metabolism & Metabolomics Genomics and personalized strategies in nutrition Nutrition during the early life cycle Health issues and nutrition in the elderly Phenotyping in clinical nutrition Nutrition in acute and chronic diseases The double burden of ''malnutrition'': Under-nutrition and Obesity Prevention of Non Communicable Diseases (NCD)