Efficacy of 3 Nutritional Supplements to Improve Diverse Outcomes in Children Under 2 Years of Age and Pregnant Women

Summary

The Mexican poverty alleviation program, Oportunidades provides a fortified food supplement to all beneficiary children under 2 years of age, and all pregnant and lactating women. Consumption of the supplements is well below recommended levels and the impact of the program on child growth and anemia is less than anticipated. This is likely due to a high degree of dilution by sharing of the supplements with other family members. We have also found evidence of a very high prevalence of overweight and obesity among beneficiaries of Oportunidades in both women and children.

Given the micronutrient content of the fortified food, it is likely that the impact of the program on child growth and the micronutrient status of women and children would improve considerable if the supplements were consumed daily in the recommended dose. This may be difficult, given the wide-spread sharing within households - something that has been identified by many beneficiary families as a desirable behavior. At the same time, we do not know whether daily consumption of the food, which contains approximately 20% of daily energy requirements, may contribute to undesirable weight gain in this population.

In this context, we have designed a cluster randomized controlled efficacy trail to compare the nutritional impact, acceptability and use of three nutritional supplements. Supplements were randomly assigned at the community level (n=54), and pregnant women (n=750) and children 6 to 12 mo of age (n=900) invited to participate. The principal objective of the study is to compare the impact of Sprinkles and Nutrisano/Nutrivida using syrup/pills as a positive control group, on child growth, weight gain and retention in pregnant women, and micronutrient status of women and children. We hypothesize that weight gain will be greater in the food group compared to the other two supplementation groups, but impacts on micronutrient status and length growth in children will be similar.

Conditions

• Healthy

Interventions

DIETARY_SUPPLEMENT

fortified milk-based beverage

Fortified with multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.

DIETARY_SUPPLEMENT

Sprinkles

Powder with multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.

DIETARY_SUPPLEMENT

tablets

Multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.

DIETARY_SUPPLEMENT

Fortified milk-based pap

Fortified with multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for children.

DIETARY_SUPPLEMENT

Sprinkles

Powder with multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.

DIETARY_SUPPLEMENT

Syrup

Multiple vitamins and minerals (1 RDA). Identifical dose and formulation as other supplements for women.

Sponsors & Collaborators

• Secretary of Social Development

  collaborator UNKNOWN

• Inter-American Development Bank

  collaborator OTHER

• Mexican National Institute of Public Health

  lead OTHER_GOV

Principal Investigators

• Lynnette M Neufeld, PhD · National Institute of public Health

Study Design

Allocation

RANDOMIZED

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

6 Months

Max Age

12 Months

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2005-09-30

Primary Completion

2007-10-31

Completion

2007-10-31