Peer-reviewed article
Childhood stunting and micronutrient status unaffected by RCT of micronutrient fortified drink
Victor Alfonso Mayén, Abimbola Ogunlusi, Charlotte Margaret Wright, Ada Lizbeth Garcia ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This randomised trial tested whether a hot drink (atole) fortified with micronutrients could reduce stunting in young children in a region where stunting is common. 971 children aged 6 to 72 months received either the fortified drink or lactose-free milk for 18 months. Most children in the fortified group took at least half of their daily zinc and iron needs. After 18 months, the two groups did not differ in growth, stunting, blood iron and zinc measures, or illness. The authors question whether large-scale micronutrient supplementation is worthwhile.
Key points
- 73% of children in the fortified drink group consumed at least half their daily zinc and iron requirement.
- Mean change in height-for-age score was -0.02 (95% CI -0.12, 0.08) between groups, which is no difference.
- Stunting at 18 months was 41% in both the fortified drink and milk groups (RR 0.99, 95% CI 0.84, 1.19).
- Zinc deficiency remained equally common in both groups (35% each), and no child had iron deficiency anaemia at outcome.
- There was no difference in illness between the groups, and micronutrient status was unrelated to height-for-age.
Limitations
The abstract does not name the country or setting, so we cannot say where the findings apply. The comparison group received lactose-free milk rather than no supplement, and only the abstract was available, so details of the methods and analysis are missing.
Abstract
AbstractMicronutrient supplementation is widely used to prevent stunting in children under 5 years in low‐ and middle‐income countries (LMIC), but the impact of treatment has been disappointing, possibly due to non‐compliance. Our aim was to deliver long‐term micronutrient supplementation via a novel, culturally acceptable liquid food to improve linear growth in a high stunting prevalence region.In a randomised control trial, 971 children aged 6–72 months received either ‘Chispuditos®’ (n = 681), a hot drink (atole) fortified with micronutrients (atole + MN) (9 mg/zinc, 12.5 mg/iron), or lactose‐free milk (n = 290) for 18 months. Primary outcomes were changes in length/height‐for‐age (HAZ) score and the prevalence of stunting at 18‐month follow‐up. Adherence was monitored monthly, and 73% children in atole + MN group consumed at least half their daily zinc and iron requirement. At 18 months, there was no difference between the treatments in growth [mean change in HAZ −0.02 (95% CI −0.12, 0.08)] or stunting [atole + MN 41%, milk 41%; RR 0.99 (95% CI 0.84, 1.19)]. There were no differences in haemoglobin (HB), ferritin or zinc. No children had iron deficiency anaemia (IDA) at outcome, but zinc deficiency remained equally prevalent in both groups: atole + MN 35%, milk 35% [RR 1.02 (95% CI 0.83, 1.24)]. There was no difference in morbidity between the groups, and micronutrient status was unrelated to HAZ. Long‐term micronutrient supplementation via a culturally acceptable food had no impact on stunting or morbidity, raising the question of whether large‐scale micronutrient supplementation is worthwhile.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Daily micronutrient-fortified hot drink (atole, 'Chispuditos', with 9 mg zinc and 12.5 mg iron) for 18 months, compared with lactose-free milk
- Population
- 971 children aged 6 to 72 months (681 fortified drink, 290 milk) in a region with high stunting prevalence
Key finding
Mean change in height-for-age score: -0.02 (95% CI -0.12, 0.08), no difference between groups.
Mayén et al. · Crossref · 6 Aug 2021