RESUMO
BACKGROUND: Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children. METHODS: A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months' blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data. RESULTS: At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence. CONCLUSION: These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children.
Assuntos
Gorduras na Dieta/administração & dosagem , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Desnutrição/prevenção & controle , Micronutrientes/administração & dosagem , Populações Vulneráveis , Desenvolvimento Infantil , Análise por Conglomerados , Feminino , Ácido Fólico/sangue , Seguimentos , Honduras/epidemiologia , Humanos , Lactente , Ferro/sangue , Lipídeos/sangue , Masculino , Micronutrientes/deficiência , Estado Nutricional , Riboflavina/sangue , População Rural , Resultado do Tratamento , Vitamina B 12/sangue , Zinco/sangueRESUMO
OBJECTIVE: To identify factors associated with the presence and severity of food insecurity among a sample of Honduran caregivers of young children. DESIGN: Cross-sectional study in which the dependent variable, household food insecurity, was measured using a fourteen-item questionnaire developed and validated in a population of similar cultural context. A predictive modelling strategy used backwards elimination in logistic regression and multinomial logit regression models to compute odds ratios and 95% confidence intervals for food insecurity. SETTING: Rural Honduras in the department of Intibucá, between March and April 2009. SUBJECTS: Two-hundred and ninety-eight Honduran caregivers of children aged 6-18 months. RESULTS: Ninety-three per cent of households were classified as having some degree of food insecurity (mild, moderate or severe). After controlling for caregiver age and marital status, compared with caregivers with more than primary-school education, those with less than primary-school education had 3·47 (95% CI 1·34, 8·99) times the odds of severe food insecurity and 2·29 (95% CI 1·00, 5·25) times the odds of moderate food insecurity. Our results also found that child anthropometric status was not associated with the presence or severity of food insecurity. CONCLUSIONS: These results show that among the sociodemographic factors assessed, food insecurity in rural Honduras is associated with maternal education. Understanding key factors associated with food insecurity that are unique to Honduras can inform the design of interventions to effectively mitigate the negative impact of food insecurity on children.