# Effect of lipid-based nutrient supplements on morbidity among children with stunting: secondary analysis of a randomized trial in Uganda

## TL;DR

A study in Uganda found that lipid-based supplements for stunted children increased early diarrhea but had no overall effect on infections and reduced some markers of inflammation.

## Contribution

This study evaluates the impact of lipid-based supplements on morbidity and inflammation in stunted children using a randomized trial.

## Key findings

- LNS increased diarrhoea prevalence in the first two weeks but not later.
- LNS caused a greater decline in S-AGP and increase in PhA, indicating reduced inflammation and improved body composition.
- Milk-based LNS resulted in higher phase-angle compared to soy-based LNS.

## Abstract

Children with stunting are at risk of infections. We assessed the effect of lipid-based nutrient supplement (LNS) on morbidity in children with stunting.

This was a secondary analysis of a randomized, 2×2 factorial trial among 12–59 months-old, stunted children in Uganda. Children were randomized to LNS containing milk or soy protein and whey permeate or maltodextrin, or no supplementation, for 12 weeks. The outcomes were caregiver-reported morbidity after 2, 4, 8 and 12 weeks, serum C-reactive protein (S-CRP), α1-acid glycoprotein (S-AGP), and phase-angle (PhA) by bioimpedance.

Of 750 children, mean (SD) age was 32.0 (11.7) months, 55% (n = 412) were male. LNS increased diarrhoea prevalence (18.1% vs 7.3%, P = 0.001) during the first two weeks, but not thereafter. There was no effect of LNS on cough or fever. LNS resulted in greater decline in S-AGP (−0.10 g/L, 95% CI: −0.17, −0.03, P = 0.003) but not S-CRP (25%, 95% CI: −11, 74, P = 0.193), and greater increase in PhA (0.10 degrees, 95% CI: 0.01, 0.18, P = 0.030), explained by greater fat-free mass. Milk compared to soy protein in LNS resulted in higher PhA (0.10 degrees, 95% CI: 0.02, 0.17, P = 0.013), not explained by fat-free mass.

LNS supplementation in children with stunting had no effect on morbidity but resulted in a small reduction in sub-acute systemic inflammation. The possible effect of LNS supplementation on inflammation in stunted children requires further evaluation. (www.isrctn.com: ISRCTN13093195).