Child Deaths Significantly Reduced With Nutrient Supplements

Nutrient Supplement Packets

Christine Stewart holds packets of nutrient supplements. They are typically a mixture of a legume — peanut, lentil or chickpea paste — plus milk powder, oil, and a full complement of the vitamins and minerals children need. Credit: Karin Higgins/UC Davis

Study Finds 27 Percent Drop in Child Mortality in Low- and Middle-Income Countries

More than half of child deaths worldwide stem from preventable causes, such as adverse effects from malnutrition. A new study led by researchers at the University of California, Davis, finds that child mortality significantly drops when children receive nutritional supplements rich in vitamins, minerals and essential fatty acids. It found that supplements may decrease mortality among children 6-24 months old by as much as 27 percent in low- and middle-income countries. The researchers published their findings on November 7, 2019, in The American Journal of Clinical Nutrition.

International Lipid-Based Nutrient Supplements

A mother and child take part in the International Lipid-Based Nutrient Supplements (iLiNS) trial in Burkina Faso. Credit: Sonja Hess

Nutrient supplements typically consist of a mixture of a legume — peanut, lentil or chickpea paste — plus milk powder, oil and a full complement of the vitamins and minerals children need.

“Picture a tiny package of fortified peanut butter that only has 100 calories,” said Christine Stewart, an associate professor in the Department of Nutrition and interim director of the Institute for Global Nutrition. “It’s enough to spread on a single piece of bread or it can be mixed with other foods.” The packets are designed to be added to the child’s diet daily as they transition from breastfeeding to complementary foods or family foods.

Previous studies have examined how supplements given to young children improve growth, but this is the first to evaluate the impact of the supplements on childhood deaths.

“The results show supplements could have effects beyond just preventing stunting, wasting and malnutrition,” said Stewart.

To assess mortality risk among children who received the supplements compared to those who did not, the researchers identified 18 trials conducted in 11 countries. Among those, their primary analysis used data from 13 trials with 34,051 children. The trials were conducted in multiple countries in different geographic regions and are likely generalizable to other low- and middle-income countries. 

“From these data, we estimate that for every 227 children who receive the supplements for at least six months, one child death can be prevented,” said Stewart. “Malnutrition is an underlying cause of child mortality. This study really reiterates that.” The common causes of death are illnesses like diarrhea and respiratory infection. “These diseases are rarely fatal in places like the United States because the children are well-nourished,” said Stewart.

Lipid-Based Nutrient Supplements Researchers

Left to right: K. Ryan Wessells, Project Scientist; Christine Stewart, associate professor of nutrition; Charles Arnold, statistician; and Kathryn Dewey, distinguished professor emerita of nutrition. Credit: Karin Higgins/UC Davis

Kathryn Dewey, a distinguished professor emerita in the Department of Nutrition and one of the co-authors of the study, developed the use of small-quantity lipid-based nutrient supplements along with other colleagues. “It is encouraging to see that this intervention can reduce deaths after the age of 6 months, as there are few effective strategies beyond that age,” she said.

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Reference: “Lipid-based nutrient supplements and all-cause mortality in children 6–24 months of age: a meta-analysis of randomized controlled trials” by Christine P Stewart, K Ryan Wessells, Charles D Arnold, Lieven Huybregts, Per Ashorn, Elodie Becquey, Jean H Humphrey and Kathryn G Dewey, 7 November 2019, The American Journal of Clinical Nutrition.
DOI: 10.1093/ajcn/nqz262

Additional authors on the paper are Charles D. Arnold and K. Ryan Wessells, Institute for Global Nutrition at UC Davis (formerly Program in International and Community Nutrition); Per Ashorn, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; Jean H. Humphrey, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and Elodie Becquey and Lieven Huybregts, International Food Policy Research Institute, Washington, D.C.

The work was supported by a grant from the Bill & Melinda Gates Foundation and funding from the Consultative Group for International Agricultural Research Program on Agriculture for Nutrition and Health, led by the International Food Policy Research Institute.

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