Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials

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dc.creatorWessells, K. Ryan
dc.creatorArnold, Charles D.
dc.creatorStewart, Christine P.
dc.creatorPrado, Elizabeth L.
dc.creatorAbbeddou, Souheila
dc.creatorBecquey, Elodie
dc.creatorHuybregts, Lieven
dc.creatorLeroy, Jef L.
dc.date2021-09-29
dc.date2024-05-22T12:10:19Z
dc.date2024-05-22T12:10:19Z
dc.date.accessioned2026-06-27T15:24:18Z
dc.descriptionBackground: Small-quantity lipid-based nutrient supplements (SQ-LNSs) have been shown to reduce the prevalence of child anemia and iron deficiency, but effects on other micronutrients are less well known. Identifying subgroups who benefit most from SQ-LNSs could support improved program design. Objectives: We aimed to identify study-level and individual-level modifiers of the effect of SQ-LNSs on child hemoglobin (Hb), anemia, and inflammation-adjusted micronutrient status outcomes. Methods: We conducted a 2-stage meta-analysis of individual participant data from 13 randomized controlled trials of SQ-LNSs provided to children 6–24 mo of age (n = 15,946). We generated study-specific and subgroup estimates of SQ-LNSs compared with control, and pooled the estimates using fixed-effects models. We used random-effects meta-regression to examine potential study-level effect modifiers. Results: SQ-LNS provision decreased the prevalence of anemia (Hb < 110 g/L) by 16% (relative reduction), iron deficiency (plasma ferritin < 12 µg/L) by 56%, and iron deficiency anemia (IDA; Hb < 110 g/L and plasma ferritin <12 µg/L) by 64%. We observed positive effects of SQ-LNSs on hematological and iron status outcomes within all subgroups of the study- and individual-level effect modifiers, but effects were larger in certain subgroups. For example, effects of SQ-LNSs on anemia and iron status were greater in trials that provided SQ-LNSs for >12 mo and provided 9 (as opposed to <9) mg Fe/d, and among later-born (than among first-born) children. There was no effect of SQ-LNSs on plasma zinc or retinol, but there was a 7% increase in plasma retinol-binding protein (RBP) and a 56% reduction in vitamin A deficiency (RBP < 0.70 µmol/L), with little evidence of effect modification by individual-level characteristics. Conclusions: SQ-LNSs can substantially reduce the prevalence of anemia, iron deficiency, and IDA among children across a range of individual, population, and study design characteristics. Policy-makers and program planners should consider SQ-LNSs within intervention packages to prevent anemia and iron deficiency. This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020156663.
dc.identifierhttps://hdl.handle.net/10568/142329
dc.identifier.urihttp://hdl.handle.net/123456789/103382
dc.languageen
dc.publisherAmerican Society for Nutrition
dc.relationhttps://doi.org/10.1093/jn/nxab292
dc.relationhttps://doi.org/10.1093/ajcn/nqab278
dc.rightsOpen Access
dc.sourceWessells, K. Ryan; Arnold, Charles D.; Stewart, Christine P.; Prado, Elizabeth L.; Abbeddou, Souheila; Becquey, Elodie; Huybregts, Lieven; Leroy, Jef L.; et al. 2021. Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition 114(Supplement 1): 68S-94S. https://doi.org/10.1093/ajcn/nqab276
dc.subjectanaemia
dc.subjectchild nutrition
dc.subjectmicronutrient deficiency
dc.subjectnutrition
dc.subjectfood supplementation
dc.subjecttrace elements
dc.subjectchildren
dc.subjectfeeding
dc.subjectiron
dc.subjectfortification
dc.titleCharacteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized controlled trials
dc.typeJournal Article

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