Evidence map›Paper›PMID 34590672›Full record

SynthesisThe American journal of clinical nutrition2021

Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: an individual participant data meta-analysis of randomized controlled trials.

Kathryn G Dewey, K Ryan Wessells, Charles D Arnold, Elizabeth L Prado, Souheila Abbeddou, Seth Adu-Afarwuah, Hasmot Ali, Benjamin F Arnold, Per Ashorn, Ulla Ashorn and 36 more

Open access · hybridAbstract readMeta-Analysis
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. Cited by 61 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 8 pooled it
7.9field-weighted citation impact, top 2% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 8 syntheses or guidelines pooled it, 84 citations in OpenAlex.

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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

46 authors at 20 institutions in 11 countries.

Kathryn G DeweyInstitute for Global Nutrition and Department of Nutrition, University of California, Davis, Davis, CA, USA.ORCID 0000-0002-4185-3451
K Ryan WessellsInstitute for Global Nutrition and Department of Nutrition, University of California, Davis, Davis, CA, USA.ORCID 0000-0002-5485-7144
Charles D ArnoldInstitute for Global Nutrition and Department of Nutrition, University of California, Davis, Davis, CA, USA.ORCID 0000-0001-6510-3172
Elizabeth L PradoInstitute for Global Nutrition and Department of Nutrition, University of California, Davis, Davis, CA, USA.ORCID 0000-0002-5388-081X
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
Hasmot AliThe JiVitA Project of Johns Hopkins University, Bangladesh, Paschimpara, Bangladesh.ORCID 0000-0003-0044-1992
Benjamin F ArnoldFrancis I Proctor Foundation, University of California, San Francisco, San Francisco, CA, USA.ORCID 0000-0001-6105-7295
Per AshornCenter for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID 0000-0003-2311-2593
Ulla AshornCenter for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID 0000-0002-1720-868X
Sania AshrafCenter for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, PA, USA.ORCID 0000-0001-7305-8922
Elodie BecqueyPoverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.ORCID 0000-0002-8748-7637
Jaden BendabendaDepartment of Nutrition and Food Safety, WHO, Geneva, Switzerland.ORCID 0000-0001-6231-1224
Kenneth H BrownInstitute for Global Nutrition and Department of Nutrition, University of California, Davis, Davis, CA, USA.ORCID 0000-0001-6498-3120
Parul ChristianProgram in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
John M ColfordSchool of Public Health, University of California, Berkeley, Berkeley, CA, USA.ORCID 0000-0002-3288-6956
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 and Department of Nutrition, University of California, Davis, Davis, CA, USA.ORCID 0000-0002-4661-277X
Jean H HumphreyProgram in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.ORCID 0000-0001-6974-2975
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
Kaniz JannatSchool of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia.ORCID 0000-0002-2993-1955
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
Jef L LeroyPoverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.ORCID 0000-0001-9371-3832
Stephen P LubyDivision of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA.ORCID 0000-0001-5385-899X
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
Susana L MatiasDepartment of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, CA, USA.ORCID 0000-0002-3635-7445
Mduduzi N N MbuyaZvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.ORCID 0000-0003-1230-2367
Malay K MridhaCenter for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, Dhaka, Bangladesh.ORCID 0000-0001-9226-457X
Minyanga NkhomaDepartment of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.ORCID 0000-0002-5002-2246
Clair NullMathematica, Washington, DC, USA.ORCID 0000-0003-0819-536X
Rina R PaulCenter for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, Dhaka, Bangladesh.ORCID 0000-0002-1186-4854
Harriet OkronipaDepartment of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA.ORCID 0000-0002-5373-6754
Jean-Bosco OuédraogoHealth Sciences Research Institute (IRSS), Bobo-Dioulasso, Burkina Faso.ORCID 0000-0003-0412-8733
Amy J PickeringSchool of Engineering, Tufts University, Medford, MA, USA.ORCID 0000-0001-6193-2221
Andrew J PrendergastZvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.ORCID 0000-0001-7904-7992
Marie RuelPoverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.ORCID 0000-0002-9506-348X
Saijuddin ShaikhThe JiVitA Project of Johns Hopkins University, Bangladesh, Paschimpara, Bangladesh.ORCID 0000-0001-5095-1478
Ann M WeberDivision of Epidemiology, School of Community Health Sciences, University of Nevada, Reno, Reno, NV, USA.ORCID 0000-0001-8130-5858
Patricia WolffMeds & Foods for Kids, St. Louis, MO, USA.
Amanda ZongroneIndependent consultant, Washington, DC, USA.ORCID 0000-0003-1134-088X
Christine P StewartInstitute for Global Nutrition and Department of Nutrition, University of California, Davis, Davis, CA, USA.ORCID 0000-0003-4575-8571
University of California, Davis · USInternational Food Policy Research Institute · USJohns Hopkins University · USTampere University · FIBerkeley Public Health Division · USUniversity of Ghana · GHUniversity of Malawi · MWWashington University in St. Louis · USAmerican Society for Nutrition · USCornell University · USGhent University · BEHelen Keller International · USIndependent Sector · USInstitut de Recherche en Sciences de la Santé · BFInternational School of Dakar · SNMathematica Policy Research · USQueen Mary University of London · GBStanford University · USTufts University · USUniversity of California, Berkeley · US

Funding

Washington University Nutrition Obesity Research CenterP30DK056341 · NIDDK · WASHINGTON UNIVERSITY · PI Dominic N Reeds · 1999 to 2026
$30.2M
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 DK056341NIDDK NIH HHS P30 DK092950World Health Organization 001
6 · The paper itself

Abstract

backgroundMeta-analyses show that small-quantity lipid-based nutrient supplements (SQ-LNSs) reduce child stunting and wasting. Identification of subgroups who benefit most from SQ-LNSs may facilitate program design.

objectivesWe aimed to identify study-level and individual-level modifiers of the effect of SQ-LNSs on child growth outcomes.

methodsWe conducted a 2-stage meta-analysis of individual participant data from 14 randomized controlled trials of SQ-LNSs provided to children 6-24 mo of age (n = 37,066). We generated study-specific and subgroup estimates of SQ-LNS compared with control and pooled the estimates using fixed-effects models. We used random-effects meta-regression to examine study-level effect modifiers. In sensitivity analyses, we examined whether results differed depending on study arm inclusion criteria and types of comparisons.

resultsSQ-LNS provision decreased stunting (length-for-age z score < -2) by 12% (relative reduction), wasting [weight-for-length (WLZ) z score < -2] by 14%, low midupper arm circumference (MUAC) (<125 mm or MUAC-for-age z score < -2) by 18%, acute malnutrition (WLZ < -2 or MUAC < 125 mm) by 14%, underweight (weight-for-age z score < -2) by 13%, and small head size (head circumference-for-age z score < -2) by 9%. Effects of SQ-LNSs generally did not differ by study-level characteristics including region, stunting burden, malaria prevalence, sanitation, water quality, duration of supplementation, frequency of contact, or average compliance with SQ-LNS. Effects of SQ-LNSs on stunting, wasting, low MUAC, and small head size were greater among girls than among boys; effects on stunting, underweight, and low MUAC were greater among later-born (than among firstborn) children; and effects on wasting and acute malnutrition were greater among children in households with improved (as opposed to unimproved) sanitation.

conclusionsThe positive impact of SQ-LNSs on growth is apparent across a variety of study-level contexts. Policy-makers and program planners should consider including SQ-LNSs in packages of interventions to prevent both stunting and wasting.This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.

Indexed as

Dietary SupplementsInfant Nutritional Physiological PhenomenaNutritional StatusAfrica South of the SaharaBangladeshChild DevelopmentChild Nutrition DisordersChild, PreschoolEffect Modifier, EpidemiologicFemaleHaitiHumansInfantLipidsMaleRandomized Controlled Trials as TopicLipidschild undernutritioncomplementary feedinghome fortificationnutrient supplementsstuntingwasting

Identifiers

PMID34590672
PMCPMC8560308
OpenAlexW3127455064

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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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.