Underweight and stunting become more prevalent among children between 6 and 24 months of age, a time when milk is being replaced by other foods.  Complementary foods may be supplemented to enhance linear growth and body composition during this susceptible period of growth.  However, most work done in this area has not determined whether supplementation impacts the distribution of fat free mass and fat mass.  A study by Shaikh and colleagues explored this subject and the results are published  in the July 2020 issue of The Journal of Nutrition.

Subjects for this study were children (n = 3592) enrolled in an unblinded, cluster-randomized, controlled trial conducted in Bangladesh.  Four complementary food supplements were provided for 1 year, starting at 6 months of age.  The treatments included a control group receiving no supplement as well as the four supplements containing either chickpea, rice-lentil, Plumpy’doz (a lipid-based nutrient supplement), or a wheat-soy-blend.  Body composition was estimated at 6, 9, 12, 15, 18, and 24 months.

Fat free mass and fat mass were both higher in children receiving the Plumpy’doz and chickpea supplements when compared to those in the control group at 9 and 18 months.  The rice-lentil supplemented children had a greater fat free mass than the control group children.  The wheat-soy-blend did not affect either fat free mass or fat mass.  There was no effect of Plumpy’doz or rice-lentil foods on the growth of boys, but these treatments resulted in higher fat free mass and fat mass in girls.  Fat free mass and fat mass were still higher at 24 months in girls that had received the Plumpy’doz supplement.  These data led the authors to conclude that small improvements in body composition were possible in girls receiving specific supplements.

Martorell provided a commentary on this article in the same issue of the journal.  In this article, he points out that the effects were modest and not surprising since interventions were not provided to the mothers prior to conception or during pregnancy and did not impact any of the other known contributors to stunting.  He concluded that the development and evaluation of locally-produced food supplements must be pursued to identify cost-effective measures to improve child health in poor areas.  He also described the need to address other social determinants of health, and that by doing so, it may be possible to reduce the need for supplements.

References Shaikh S, Campbell RK, Mehra S, Kabir A, Schulze K, Wu L, Ali H, Shamim AA, West KP, Christian P.  Supplementation with fortified lipid-based and blended complementary foods has variable impact on body composition among rural Bangladeshi children:  A cluster-randomized controlled trial. The Journal of Nutrition, Volume 150, Issue 7, July 2020, Pages 1924–1932, https://doi.org/10.1093/jn/nxaa061.

Martorell R. Complementary food supplementation helps build fat-free mass, a little anyway. The Journal of Nutrition, Volume 150, Issue 7, July 2020, Pages 1676–1677, https://doi.org/10.1093/jn/nxaa122.

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