Evidence map›Paper›PMID 34590116›Full record

SynthesisThe American journal of clinical nutrition2021

Small-quantity lipid-based nutrient supplements for children age 6-24 months: a systematic review and individual participant data meta-analysis of effects on developmental outcomes and effect modifiers.

Elizabeth L Prado, Charles D Arnold, K Ryan Wessells, Christine P Stewart, Souheila Abbeddou, Seth Adu-Afarwuah, Benjamin F Arnold, Ulla Ashorn, Per Ashorn, Elodie Becquey and 33 more

2 registry-linked trialsOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 42 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 4 pooled it
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07451951 narecruitingnot on this mapstarted 2026, after this paper: background citation

Effectiveness of Small-Quantity vs Medium-Quantity Lipid-Based Nutrient Supplements for Prevention of Undernutrition in Children Aged 6-24 Months: An Individually Randomized, Parallel-Group, Non-Inferiority Trial

TypeinterventionalSponsorAga Khan UniversityRan2026 to 2028Enrolled1,508ConditionsUndernutritionArmsMedium-quantity lipid-based nutrient supplement (MQ-LNS), Small-quantity lipid-based nutrient supplement (SQ-LNS)
NCT07592260 narecruitingnot on this mapstarted 2025, after this paper: background citation

OptiMAx: Incentivizing EPI Vaccination Via Distribution of SQ-LNS Nutritional Supplementation to Children From Age 6-11 Months Until 18 Months of Age in Rural Chad and Niger, With a Cost Effectiveness Analysis Protocol for a Research Study Nested in the OptiMA Research Study in Ngouri Health District, Lake Region, Chad and Mirriah Health District, Zinder Region, Niger

TypeinterventionalSponsorAlliance for International Medical ActionRan2025 to 2026Enrolled20,000ConditionsMalnutrition Severe, VaccinationArmssmall quantity lipid-based supplement (SQ-LNS)
3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.

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  17. The gut microbiota in malnutrition.Nature reviews. Microbiology · 2026
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

43 authors at 20 institutions in 9 countries.

Elizabeth L PradoInstitute for Global Nutrition & Department of Nutrition, University of California Davis, Davis, CA, USA.ORCID 0000-0002-5388-081X
Charles D ArnoldInstitute for Global Nutrition & Department of Nutrition, University of California Davis, Davis, CA, USA.ORCID 0000-0001-6510-3172
K Ryan WessellsInstitute for Global Nutrition & Department of Nutrition, University of California Davis, Davis, CA, USA.ORCID 0000-0002-5485-7144
Christine P StewartInstitute for Global Nutrition & Department of Nutrition, University of California Davis, Davis, CA, USA.ORCID 0000-0003-4575-8571
Souheila AbbeddouPublic Health Nutrition, Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium.ORCID 0000-0002-1363-0170
Seth Adu-AfarwuahDepartment of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana.ORCID 0000-0002-2720-5474
Benjamin F ArnoldFrancis I Proctor Foundation, University of California, San Francisco, San Francisco, CA, USA.ORCID 0000-0001-6105-7295
Ulla AshornCenter for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID 0000-0002-1720-868X
Per AshornCenter for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID 0000-0003-2311-2593
Elodie BecqueyPoverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.ORCID 0000-0002-8748-7637
Kenneth H BrownInstitute for Global Nutrition & Department of Nutrition, University of California Davis, Davis, CA, USA.ORCID 0000-0001-6498-3120
Jaya ChandnaDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.ORCID 0000-0001-9836-0554
Parul ChristianProgram in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.ORCID 0000-0002-2908-1030
Holly N DentzInstitute for Global Nutrition & Department of Nutrition, University of California Davis, Davis, CA, USA.
Sherlie J L DulienceBrown School, Washington University in St. Louis, St Louis, MO, USA.
Lia C H FernaldSchool of Public Health, University of California, Berkeley, Berkeley, CA, USA.ORCID 0000-0003-1555-4607
Emanuela GalassoDevelopment Research Group, World Bank, Washington, DC, USA.ORCID 0000-0001-8620-057X
Lotta HallamaaCenter for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID 0000-0001-9211-3288
Sonja Y HessInstitute for Global Nutrition & Department of Nutrition, University of California Davis, Davis, CA, USA.ORCID 0000-0002-4661-277X
Lieven HuybregtsPoverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.ORCID 0000-0002-3068-2853
Lora L IannottiBrown School, Washington University in St. Louis, St Louis, MO, USA.ORCID 0000-0001-8826-0867
Elizabeth Y JimenezDepartments of Pediatrics and Internal Medicine and College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Patricia KohlBrown School, Washington University in St. Louis, St Louis, MO, USA.
Anna LarteyDepartment of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana.ORCID 0000-0002-7870-2606
Agnes Le PortIndependent consultant, Dakar, Senegal.ORCID 0000-0002-8337-6569
Stephen P LubyDivision of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA.
Kenneth MaletaDepartment of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.ORCID 0000-0002-2536-3938
Andrew MatchadoMalawi Epidemiology and Intervention Research Unit, Karonga, Malawi.ORCID 0000-0002-0302-5591
Susana L MatiasDepartment of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, CA, USA.ORCID 0000-0002-3635-7445
Malay K MridhaCenter for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, Dhaka, Bangladesh.ORCID 0000-0001-9226-457X
Robert NtoziniZvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.ORCID 0000-0002-8543-2835
Clair NullMathematica, Washington, DC, USA.ORCID 0000-0003-0819-536X
Maku E OcanseyCDC Foundation, Atlanta, GA, USA.ORCID 0000-0001-9275-7526
Sarker M ParvezInfectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.ORCID 0000-0003-2004-5065
John PhukaDepartment of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.ORCID 0000-0003-4951-8145
Amy J PickeringSchool of Engineering, Tufts University, Medford, MA, USA.ORCID 0000-0001-6193-2221
Andrew J PrendergastBlizard Institute, Queen Mary University of London, London, United Kingdom.ORCID 0000-0001-7904-7992
Abu A ShamimCenter for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, Dhaka, Bangladesh.
Zakia SiddiquiHealthy Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Fahmida TofailNutrition and Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.ORCID 0000-0003-2301-9196
Ann M WeberDivision of Epidemiology, School of Community Health Sciences, University of Nevada, Reno, Reno, NV, USA.ORCID 0000-0001-8130-5858
Lee S F WuProgram in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Kathryn G DeweyInstitute for Global Nutrition & Department of Nutrition, University of California Davis, Davis, CA, USA.ORCID 0000-0002-4185-3451
University of California, Davis · USInternational Centre for Diarrhoeal Disease Research · BDTampere University · FIWashington University in St. Louis · USInternational Food Policy Research Institute · USJohns Hopkins University · USUniversity of Ghana · GHUniversity of Malawi · MWBerkeley Public Health Division · USCDC Foundation · USGhent University · BEHelen Keller International · USInternational School of Dakar · SNLondon School of Hygiene & Tropical Medicine · GBMalawi Epidemiology and Intervention Research Unit · MWMathematica Policy Research · USQueen Mary University of London · GBStanford University · USTufts University · USUniversity of California, Berkeley · US

Funding

Washington University Center for Diabetes Translation Research P30DK092950 · NIDDK · WASHINGTON UNIVERSITY · PI Ross C Brownson, Debra Haire-Joshu · 2011 to 2026
$11.7M
NIDDK NIH HHS P30 DK092950
6 · The paper itself

Abstract

backgroundSmall-quantity (SQ) lipid-based nutrient supplements (LNSs) provide many nutrients needed for brain development.

objectivesWe aimed to generate pooled estimates of the effect of SQ-LNSs on developmental outcomes (language, social-emotional, motor, and executive function), and to identify study-level and individual-level modifiers of these effects.

methodsWe conducted a 2-stage meta-analysis of individual participant data from 14 intervention against control group comparisons in 13 randomized trials of SQ-LNSs provided to children age 6-24 mo (total n = 30,024).

resultsIn 11-13 intervention against control group comparisons (n = 23,588-24,561), SQ-LNSs increased mean language (mean difference: 0.07 SD; 95% CI: 0.04, 0.10 SD), social-emotional (0.08; 0.05, 0.11 SD), and motor scores (0.08; 95% CI: 0.05, 0.11 SD) and reduced the prevalence of children in the lowest decile of these scores by 16% (prevalence ratio: 0.84; 95% CI: 0.76, 0.92), 19% (0.81; 95% CI: 0.74, 0.89), and 16% (0.84; 95% CI: 0.76, 0.92), respectively. SQ-LNSs also increased the prevalence of children walking without support at 12 mo by 9% (1.09; 95% CI: 1.05, 1.14). Effects of SQ-LNSs on language, social-emotional, and motor outcomes were larger among study populations with a higher stunting burden (≥35%) (mean difference: 0.11-0.13 SD; 8-9 comparisons). At the individual level, greater effects of SQ-LNSs were found on language among children who were acutely malnourished (mean difference: 0.31) at baseline; on language (0.12), motor (0.11), and executive function (0.06) among children in households with lower socioeconomic status; and on motor development among later-born children (0.11), children of older mothers (0.10), and children of mothers with lower education (0.11).

conclusionsChild SQ-LNSs can be expected to result in modest developmental gains, which would be analogous to 1-1.5 IQ points on an IQ test, particularly in populations with a high child stunting burden. Certain groups of children who experience higher-risk environments have greater potential to benefit from SQ-LNSs in developmental outcomes.This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020159971.

Indexed as

Dietary SupplementsInfant Nutritional Physiological PhenomenaAfrica South of the SaharaBangladeshChild DevelopmentChild, PreschoolEffect Modifier, EpidemiologicFemaleHaitiHumansInfantLanguage DevelopmentLipidsMaleMotor SkillsRandomized Controlled Trials as TopicLipidschild undernutritioncomplementary feedingexecutive functionlanguage developmentmotor developmentnutrient supplementssocial-emotional development

Identifiers

PMID34590116
PMCPMC8560311
OpenAlexW3203193597

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.