HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Adu-Afarwuah, S. Articles by Dewey, K. G Search for Related Content PubMed PubMed Citation Articles by Adu-Afarwuah, S. Articles by Dewey, K. G Agricola Articles by Adu-Afarwuah, S. Articles by Dewey, K. G

Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: effects on growth and motor development^1,2,3,4

¹ From the Program in International Nutrition and Community Nutrition, University of California, Davis, CA (SA-A, KHB, and KGD); the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (AL); the Department of Paediatrics, Nutritional Sciences and Public Health Sciences, University of Toronto, Toronto, Canada (SZ); and IRD, Département Sociétés et Santé, Paris, France (AB)

Background: The low micronutrient content of complementary foods is associated with growth faltering in many populations. A potential low-cost solution is the home fortification of complementary foods with Sprinkles (SP) powder, crushable Nutritabs (NT) tablets, or energy-dense (108 kcal/d), fat-based Nutributter (NB).

Objective: The objective was to test the hypothesis that multiple micronutrients added to home-prepared complementary foods would increase growth and that the effect would be greatest in the presence of added energy from fat.

Design: We randomly assigned 313 Ghanaian infants to receive SP, NT, or NB containing 6, 16, and 19 vitamins and minerals, respectively, daily from 6 to 12 mo of age. We assessed anthropometric status at 6, 9, and 12 mo; micronutrient status at 6 and 12 mo; motor development at 12 mo; and morbidity weekly. Infants (n = 96) not randomly selected for the intervention (nonintervention; NI) were assessed at 12 mo.

Results: The groups did not differ significantly at baseline, except that the NB group had a higher proportion of boys and weighed slightly more. The dropout rate (15/313) was low. At 12 mo, after control for initial size, the NB group had a significantly greater weight-for-age z score (WAZ) (–0.49 ± 0.54) and length-for-age z score (LAZ) (–0.20 ± 0.54) than did the NT group (WAZ: –0.67 ± 0.54; LAZ: –0.39 ± 0.54) and the NT and SP groups combined (WAZ: –0.65 ± 0.54; LAZ: –0.38 ± 0.54); the difference with the NI group (WAZ: –0.74 ± 1.1; LAZ: –0.40 ± 1.0) was not significant. A lower percentage of the NI infants (25%) than of the intervention groups (SP: 39%; NT: 36%; NB: 49%) could walk independently by 12 mo.

Conclusion: All 3 supplements had positive effects on motor milestone acquisition by 12 mo compared with no intervention, but only NB affected growth.

Key Words: Multiple micronutrient supplements • home fortification • infant growth • motor development • Ghana

This article has been cited by other articles:

				J. C Phuka, K. Maleta, C. Thakwalakwa, Y. B. Cheung, A. Briend, M. J Manary, and P. Ashorn Postintervention growth of Malawian children who received 12-mo dietary complementation with a lipid-based nutrient supplement or maize-soy flour Am. J. Clinical Nutrition, January 1, 2009; 89(1): 382 - 390. [Abstract] [Full Text] [PDF]

				C. K. Lutter Iron Deficiency in Young Children in Low-Income Countries and New Approaches for Its Prevention J. Nutr., December 1, 2008; 138(12): 2523 - 2528. [Abstract] [Full Text] [PDF]

				R. J. Stoltzfus Research Needed to Strengthen Science and Programs for the Control of Iron Deficiency and Its Consequences in Young Children J. Nutr., December 1, 2008; 138(12): 2542 - 2546. [Abstract] [Full Text] [PDF]

				J. C. Phuka, K. Maleta, C. Thakwalakwa, Y. B. Cheung, A. Briend, M. J. Manary, and P. Ashorn Complementary Feeding With Fortified Spread and Incidence of Severe Stunting in 6- to 18-Month-Old Rural Malawians Arch Pediatr Adolesc Med, July 1, 2008; 162(7): 619 - 626. [Abstract] [Full Text] [PDF]

				S. Adu-Afarwuah, A. Lartey, K. H Brown, S. Zlotkin, A. Briend, and K. G Dewey Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana Am. J. Clinical Nutrition, April 1, 2008; 87(4): 929 - 938. [Abstract] [Full Text] [PDF]

				C. A. Lin, M. J. Manary, K. Maleta, A. Briend, and P. Ashorn An Energy-Dense Complementary Food Is Associated with a Modest Increase in Weight Gain When Compared with a Fortified Porridge in Malawian Children Aged 6-18 Months J. Nutr., March 1, 2008; 138(3): 593 - 598. [Abstract] [Full Text] [PDF]