The Journal of nutrition · 2026
Effects of Consumption of Fortified Complementary Food and Promotion of Responsive Feeding on the Hemoglobin and Micronutrient Status of Young Children in a Controlled, Cluster Randomized Trial in the District of Amparafaravola in Madagascar.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Razafindratsima Yannick, Razakandrainy Andry, Fortin Sonia, Randremanana Rindra, Ralison Charlotte, Icard-Vernière Christèle, Fioroni Nelly, Wieringa Frank T, Mouquet-Rivier Claire
Аннотация
BACKGROUND: Micronutrient deficiencies are a serious public health problem in early childhood in Madagascar.
OBJECTIVES: We aimed to evaluate the effects of responsive feeding (RF) and the consumption of fortified complementary foods (FCFs), either alone or combined, on hemoglobin (Hb) concentrations and micronutrient status of young children.
METHODS: A 2 × 2 factorial randomized controlled intervention trial in infants (n = 706), recruited at 6-7 mo of age, was conducted. The control group received counseling on water, sanitation, and hygiene (WASH) practices, whereas the 3 intervention groups received, in addition to WASH, promotion of RF, provision of daily FCF or both (FCF + RF). Hb concentrations and micronutrient status (iron, zinc, vitamin A, and thiamine) were evaluated at baseline and at the end of the intervention after 9 mo, whereas anthropometry was assessed 3 times monthly. The impact of interventions was evaluated through generalized mixed models.
RESULTS: Prevalence of micronutrient deficiency was high, with 85% of children affected by 1 or more deficiencies. Consumption of FCF increased concentrations of Hb (+5.43 g/L, 95% confidence interval [95% CI]: +2.52, +8.3) and retinol-binding protein (RBP: +0.09 μmol/L; 95% CI: +0.04, +0.14). Promotion of RF had only a positive effect on RBP (RBP: +0.06 μmol/L; 95% CI: +0.01, +0.11), but surprisingly, a negative impact on iron, zinc, and thiamine status was observed. There were significant interactions between RF and FCF for most indicators of micronutrient status.
CONCLUSIONS: The study confirms the potential of FCF on improving micronutrient status of young children, but surprisingly, RF tended to have a negative impact, warranting more research into appropriate RF training modules.
REGISTRY NUMBER: The study protocol was registered under the Pan African clinical trials registry (http://www.edctp.org/pan-african-clinical-trials-registry/) under the number PACTR201906819960554.
OBJECTIVES: We aimed to evaluate the effects of responsive feeding (RF) and the consumption of fortified complementary foods (FCFs), either alone or combined, on hemoglobin (Hb) concentrations and micronutrient status of young children.
METHODS: A 2 × 2 factorial randomized controlled intervention trial in infants (n = 706), recruited at 6-7 mo of age, was conducted. The control group received counseling on water, sanitation, and hygiene (WASH) practices, whereas the 3 intervention groups received, in addition to WASH, promotion of RF, provision of daily FCF or both (FCF + RF). Hb concentrations and micronutrient status (iron, zinc, vitamin A, and thiamine) were evaluated at baseline and at the end of the intervention after 9 mo, whereas anthropometry was assessed 3 times monthly. The impact of interventions was evaluated through generalized mixed models.
RESULTS: Prevalence of micronutrient deficiency was high, with 85% of children affected by 1 or more deficiencies. Consumption of FCF increased concentrations of Hb (+5.43 g/L, 95% confidence interval [95% CI]: +2.52, +8.3) and retinol-binding protein (RBP: +0.09 μmol/L; 95% CI: +0.04, +0.14). Promotion of RF had only a positive effect on RBP (RBP: +0.06 μmol/L; 95% CI: +0.01, +0.11), but surprisingly, a negative impact on iron, zinc, and thiamine status was observed. There were significant interactions between RF and FCF for most indicators of micronutrient status.
CONCLUSIONS: The study confirms the potential of FCF on improving micronutrient status of young children, but surprisingly, RF tended to have a negative impact, warranting more research into appropriate RF training modules.
REGISTRY NUMBER: The study protocol was registered under the Pan African clinical trials registry (http://www.edctp.org/pan-african-clinical-trials-registry/) under the number PACTR201906819960554.