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Title: 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

Author
item LIN, CAROL - WASHINGTON UNIV SCH MED
item MANARY, MARK
item MALETA, KEN - UNIV MALAWI
item BRIEND, ANDRE - INST RECHERCHE DEV
item ASHORN, PER - UNIV TAMPERE MED SCH

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/12/2007
Publication Date: 3/1/2008
Citation: Lin, C.A., Manary, M.J., Maleta, K., Briend, A., Ashorn, P. 2008. 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. Journal of Nutrition. 138(3):593-598.

Interpretive Summary: Growth faltering is common in Malawi and associated with feeding with watery porridges. This study compared growth in children who received either standard corn porridge in addition to breast milk or an energy-dense peanut/soy paste. Mothers prepared both foods in their village in rural Africa. Children who received the peanut/soy paste gained more weight between the ages of 6 and 12 months than those receiving traditonal porridge. A peanut/soy paste may be an alternative baby food for children at risk for poor growth.

Technical Abstract: Poor complementary feeding practices are associated with stunting and growth faltering throughout the developing world. The objective was to compare the effect of using peanut-/soy-based fortified spread (FS) and corn porridge fortified with fish powder (FP) as complementary foods on growth in rural Malawian children. A total of 240 children were enrolled at the age of 6 mo and randomized to receive FS or FP. Both complementary foods provided 836 kJ/d from 6 to 9 mo of age and 1254 kJ/d from 9 to 18 mo of age. Children were followed monthly for anthropometry and fortnightly for the symptoms of fever, cough, or diarrhea until they were 18 mo old. Zn and Se status were assessed at 6 and 12 mo. The primary outcomes were the rates of weight and length gain from 6 to 12 mo and from 12 to 18 mo. Children who received FS gained 110 g more (95% CI 220 to 10) from 6 to 12 mo of age than children receiving FP. Weight gain did not differ between children receiving FS and FP between 12 and 18 mo of age, nor did statural growth from 6 to 12 mo or 12 to 18 mo. A total of 23% of all children were Zn deficient at 6 mo of age, and this increased to 37% at 12 mo of age. Neither FS nor FP was associated with significantly improved Zn status. FS was associated with better weight gain from 6 to 12 mo of age and may be useful in conjunction with additional interventions to improve infant growth in the developing world.