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News

Nutritional advice improves health of children in developing countries

Improvement of nutrition education delivered through health services can decrease the prevalence of stunted growth in childhood in areas where access to food is not a limiting factor, finds recent research in the The Lancet.

News image

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Malnutrition is the underlying cause of half of child mortality.

Many programmes attempt to remedy this issue but there is a lack of evidence on effective ways to decrease child malnutrition.

Dr Mary Penny and colleagues undertook a cluster-randomized trial of an educational intervention in a poor periurban area of Peru.

Guided by formative research, the researchers aimed to enhance the quality and coverage of existing nutrition education.

In addition, the research team aimed to introduce an accreditation system in 6 government health facilities compared with 6 control facilities.

The primary outcome measure was growth that was measured by weight, length, and Z scores for weight-for-age and length-for-age at age 18 months.

The main secondary outcomes were the percentage of children receiving recommended feeding practices and the 24-hour dietary intake of energy, iron, and zinc from complementary food at ages 6, 9, 12, and 18 months.

The investigative team conducted the analysis by intention to treat.

Failure of dietary requirements for zinc at 9 months was 77% with intervention versus 87% in controls
The Lancet

The researchers enrolled a birth cohort of 187 infants from the catchment areas of intervention centres and 190 from control areas.

The team found that caregivers in intervention areas were more likely to report receiving nutrition advice from the health service than were caregivers in control health facilities.

At 6 months 31% of babies in intervention areas were fed nutrient-dense thick foods at lunch, a recommended complementary feeding practice, versus 20% in controls.

The researchers noted that fewer children in intervention areas failed to meet dietary requirements for energy, with 18% versus 27% in controls at 8 months.

The team also noted that at 12 months, the proportion of children failing to meet dietary requirements for energy was 38% at intervention versus 49% in controls.

The research team reported that fewer children in intervention failed to meet dietary requirements for iron, with 91 % at 8 months versus 96% in controls and at 9 months this was 93 % with intervention versus 99% in controls.

The proportion of children not meeting the dietary requirements for zinc at 9 months was 77% with intervention and 87% in controls.

The investigators observed that children in control areas were more likely to have stunted growth with 16% than children in intervention groups with 5% at 18 months.

Adjusted mean changes in weight gain, length gain, and Z scores were all significantly better in the intervention area than in the control area.

Dr Penny's team concluded, “Improvement of nutrition education delivered through health services can decrease the prevalence of stunted growth in childhood in areas where access to food is not a limiting factor.”

The Lancet Early Online Publication, May 2005: DOI:10.1016/S0140-6736(05)66427-6
18 May 2005

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