ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2022) 19 4.5 | DOI: 10.1530/ey.19.4.5


Nutrients. 2021 Oct 14;13(10):3590. PMID: 34684591

Brief Summary: This multi-center, prospective, randomized, double-blind study reports the effects of two different oral nutritional supplements (ONS) on growth in ‘picky eaters’ children at risk of malnutrition in India. Anthropometric measures (weight, height, weight-for-height, body mass index (BMI), and mid-upper-arm circumference were evaluated at day 1, 30, 60 and 90. Both types of ONS improved anthropometric measures, with the only exception of height, which showed only a non-significant trend towards improvement (possibly due to the short treatment duration). Early nutritional intervention should be considered for improving growth in children at risk of malnutrition in low-income countries.

This multi-center, prospective, randomized, double-blind study aimed at evaluating the effects on growth of two different oral nutritional supplements (ONS) administered for 90 days to a cohort of young children (age between 24 and 48 months), at risk of malnutrition (defined as a weight-for-height percentile between 3rd and 15th) and defined as picky eaters. ONS1 and ONS2 (PediaSure and PediaSure Advance, respectively, Abbott Healthcare Private Limited, Mumbai, India) had similar nutrient compositions, but ONS1 was milk-based, while ONS2 was lactose-free. Both formulations contained 3 macronutrients with matching levels of protein (at 12% of energy), 28 vitamins and minerals, and the pre-biotic fiber fructo-oligosaccharide. The fat energy percent was higher and carbohydrate energy percent was lower in ONS 2 as compared to ONS 1. The administration of both type of ONS increased weight-for-height percentile, weight and BMI compared to the dietary counseling intervention. A trend toward an improvement in height was also observed in ONS treated children, though not statistically significant.

Nutrition exerts its effects on growth throughout the whole life with major impact occurring in the first year of life. Nutrition in early life has not only an immediate impact on growth but also affects future health (1). The majority of data supporting the link between nutrition and growth derive from low-income countries (2), where approximately 25% of children aged < 5 years, show impaired linear growth secondary to malnutrition.

This study suggests that an early nutritional intervention may be a therapeutic and feasible option for improving growth in low-income countries, such as India. The short intervention period may explain the non-significant effect of ONS on linear growth and so longer-term studies are warranted to test the efficacy on height.

References: 1. Inzaghi E, Pampanini V, Deodati A, Cianfarani S. The Effects of Nutrition on Linear Growth. Nutrients. 2022;14(9). 2. Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371(9609):340–57.

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