Research on LNS

LNS for prevention

• Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: effects on growth and motor development. (abstract and free full-text)
  Adu-Afarwuah S, Lartey A, Brown KH, Zlotkin S, Briend A, Dewey KG. Am J Clin Nutr. 2007 Aug;86(2):412-20.
  

  Randomized controlled trial to test the effect of three different approaches for home-fortification of complementary food (multi-micronutrient powder, LNS and a crushable micronutrient tablet) on child growth (between 6 and 12 months of age) and motor development in Ghana.

• Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana. (abstract and free full-text)
  Adu-Afarwuah S, Lartey A, Brown KH, Zlotkin S, Briend A, Dewey KG. Am J Clin Nutr. 2008 Apr;87(4):929-38.
  

  Randomized controlled trial to test the acceptability and effect of three different approaches to home-fortification of complementary food (multi-micronutrient powder, LNS and a crushable micronutrient tablet) on micronutrient status (iron and zinc) and anemia in Ghanaian children between 6 and 12 months of age.
  

• A large-scale distribution of milk-based fortified spreads: Evidence for a new approach in regions with high burden of acute malnutrition. (abstract and free full-text)
  Defourny I, Minetti A, Harczi G, Doyon S, Shepherd S, Tectonidis M, Bradol JH, Golden M. PLoS ONE 4(5): e5455. Doi:10.1371/journal.pone.0005455.
  

  Evaluation of a preventive distribution program implemented during the hungry-season (May-October 2007) in the Maradi region of Niger that provided a monthly ration of Plumpy’doz to children 6-36 months of age. The prevalence and incidence of severe acute malnutrition (SAM) and SAM treatment admission trends were compared to previous years, where no preventive program was in place.
  

• Breast milk intake is not reduced more by the introduction of energy dense complementary food than by typical infant porridge. (abstract and free full-text)
  Galpin L, Thakwalakwa C, Phuka J, Ashorn P, Maleta K, Wong WW, Manary MJ. J Nutr. 2007 Jul;137(7):1828-33.
  

  Randomized controlled trial to assess the effect of providing LNS as a complementary food on breast-milk intake in 6-month old infants as compared to a micronutrient-fortified maize-soy flour (likuni phala) used in Malawi for complementary feeding.
  

• Prenatal food supplementation fortified with multiple micronutrients increases birth length: a randomized controlled trial in rural Burkina Faso. (abstract and free full-text)
  Huybregts L, Roberfroid D, Lanou H, Menten J, Meda N, Van Camp J, Kosteren P, for the MISAME Study Group. Am J Clin Nutr 2009 Jan; 90: 1593-600.
  

  Randomized controlled trial in Burkina Faso to determine whether a daily prenatal multiple-micronutrient (MMN)-fortified food supplement (composed of peanut butter, soy flour, vegetable oil and sugar) improved anthropometric measures at birth compared with a daily prenatal MMN pill alone.
  

• Effect of preventive supplementation with ready-to-use therapeutic food on the nutritional status, mortality, and morbidity of children aged 6 to 60 months in Niger: a cluster randomized trial. (abstract and free full-text)
  Isanaka S, Nombela N, Djibo A, Poupard M, Van Beckhoven D, Gaboulaud V, Guerin PJ, Grais RF. JAMA. 2009 Jan 21;301(3):277-85.
  

  Cluster-randomized controlled trial that evaluated the effect of providing three months of LNS (RUTF) to 6-60 month-old children in Niger on the prevention of moderate and severe wasting during an 8-month follow-up period.
  

• Reducing wasting in young children with preventive supplementation: a cohort study in Niger. (abstract)
  Isanaka S, Roederer T, Djibo A, Luquero FJ, Nombela N, Guerin PJ, Grais RF. Pediatrics. 2010 Aug;126(2):e442-50. Epub 2010 Jul 26.

  Cohort study assessing the relative impact on wasting, stunting and mortality of two follow-up interventions. RUSF (6 mo, daily dose of 46 g) or RUTF (4 mo, daily dose of 92 g) were distributed in villages where RUTF was provided the previous year, during the “hunger gap” each year.

• An energy-dense complementary food is associated with a modest increase in weight gain when compared with a fortified porridge in Malawian children aged 6-18 months. (abstract and free full-text)
  Lin CA, Manary MJ, Maleta K, Briend A, Ashorn P. J Nutr. 2008 Mar;138(3):593-8.
  

  Randomized comparison of the effects of a peanut-/soy-based LNS and a corn porridge fortified with fish powder as complementary foods on growth and micronutrient status (zinc and selenium) in rural Malawian children between 6 and 18 months of age.
  

• Breast-milk intake of 9-10-mo-old rural infants given a ready-to-use complementary food in South Kivu, Democratic Republic of Congo. (abstract)
  Owino VO, Bahwere P, Bisimwa G, Mwangi CM, Collins S. Am J Clin Nutr. 2011 Jun;93(6):1300-4. Epub 2011 Mar 30.
  

  Sub-study within a cluster-randomized controlled trial; sub-study compared breast milk intakes of 9 mo old infants who had received, since 6 mo of age, either a lipid-rich ready-to-use complementary food  or a standard corn-soy blend.

• Developmental outcomes among 18-month-old Malawians after a year of complementary feeding with lipid-based nutrient supplements or corn-soy flour. (abstract)
  Phuka JC, Gladstone M, Maleta K, Thakwalakwa C, Cheung YB, Briend A, Manary MJ, Ashorn, P. Matern Child Nutr. Epub ahead of print 2011 Feb 22.
  

  Randomized-controlled trial comparing supplementation for 12 months with LNS (two different doses) or a micronutrient-fortified maize-soy flour (likuni phala). Infant development was assessed at 18 mo; there were no differences between the three micronutrient-supplemented groups.
  

• Complementary feeding with fortified spread and incidence of severe stunting in 6- to 18-month-old rural Malawians. (abstract and free full-text)
  Phuka JC, Maleta K, Thakwalakwa C, Cheung YB, Briend A, Manary MJ, Ashorn P. Arch Pediatr Adolesc Med. 2008 Jul;162(7):619-26. Erratum in: Arch Pediatr Adolesc Med. 2008 Oct;162(10):942.
  

  Randomized-controlled trial that compared supplementation for 12 months with LNS or a micronutrient-fortified maize-soy flour (likuni phala) on child growth and incidence of malnutrition between 6 and 18 months of age.
  

• Postintervention growth of Malawian children who received 12-mo dietary complementation with a lipid-based nutrient supplement or maize-soy flour. (abstract and free full-text)
  Phuka JC, Maleta K, Thakwalakwa C, Cheung YB, Briend A, Manary MJ, Ashorn P. Am J Clin Nutr. 2009 Jan;89(1):382-90.
  

  Follow-up study of Malawian children at 36 months of age to assess the long-term impact on growth and incidence of malnutrition from exposure to 12-months of supplementation with either LNS or a micronutrient-fortified maize-soy flour (likuni phala) between 6 and 18 months of age.

• A lipid-based nutrient supplement but not corn-soy blend modestly increases weight gain among 6- to 18-month-old moderately underweight children in rural Malawi. (abstract)
  Thakwalakwa C, Ashorn P, Phuka J, Cheung YB, Briend A, Puumalainen T, Maleta K. J Nutr. 2010 Nov;140(11):2008-13. Epub 2010 Sep 22.
  

  Randomized controlled trial testing the growth-promoting effect and other health benefits of daily provision of LNS (daily dose 43 g) or CSB (daily dose 71 g) for 12 wk to infants aged 6-15 mo at baseline. The primary outcome measure was weight change during the follow-up period.
  

   

Acceptability and use of LNS

• Acceptability of lipid-based nutrient supplements (LNS) among Ghanaian infants and pregnant or lactating women. (abstract)
  Adu-Afarwuah S, Lartey A, Zeilani M, Dewey KG. Matern Child Nutr. Epub ahead of print 2010 Dec 23.
  

  Study of the acceptability of two LNS (20 g doses) designed for infants and for pregnant/lactating women. Methods included direct observation of consumption of test meals by infants and mothers, maternal sensory reaction to the products (and her perception of infant’s reaction), and maternal reports of experiences and reactions during a 2-week home-feeding trial.
  

• Feeding patterns and behaviors during home supplementation of underweight Malawian children with lipid-based nutrient supplements or corn-soy blend. (abstract)
  Flax VL, Phuka J, Cheung YB, Ashorn U, Maleta K, Ashorn P. Appetite. 2010 Jun; 54(3):504-11. Epub 2010 Feb 11.
  

  Based on in-home direct observations, detailed comparison of feeding and hygiene practices of caregivers of underweight infants aged 6-17 months; infants were supplemented with either LNS or corn-soy blend.
  

• Malawian mother's attitudes towards the use of two supplementary foods for moderately malnourished children. (abstract)
  Flax VL, Thakwalakwa C, Phuka J, Ashorn U, Cheung YB, Maleta K, Ashorn P. Appetite. 2009 Oct;53(2):195-202. Epub 2009 Jun 21.
  

  Evaluation of maternal attitudes towards LNS and corn-soy-blend for feeding moderately malnourished children in Malawi, including acceptability, use during illness, and willingness to pay.

• Acceptability of zinc-fortified, lipid-based nutrient supplements (LNS) prepared for young children in Burkina Faso. (abstract)
  Hess SY, Bado L, Aaron GJ, Ouédraogo JB, Zeilani M, Brown KH. Matern Child Nutr. 2011 Oct; 7(4): 357-67. Epub 2010 Dec 15.
  

  Study of the acceptability of LNS containing either 0 or 10 mg of zinc per daily 20 g LNS dose, among 9-15 month-old infants and their mothers in Burkina Faso. Included direct observation of consumption by infants, maternal sensory reaction to the products (and her perception of infant’s reaction), and maternal reports of infant-feeding experiences during a 2-week home-feeding trial.

• Examination of facilitators and barriers to home-based supplemental feeding with ready-to-use food for underweight children in western Uganda. (abstract)
  Ickes SB, Jilcott SB, Myhre JA, Adair LS, Thirumurthy H, Handa S, Bentley ME, Ammerman AS. Matern Child Nutr. Epub ahead of print 2010 Jul 19.
  

  During a supplemental feeding program, caregivers, RUF producers, and program staff were interviewed regarding facilitators and barriers to appropriate use of RUF. Locally produced RUF was well received by caregivers and children, and was perceived to be a healthy supplemental food for malnourished children. Child feeding practices, including sharing of RUF, compromised the nutrient delivery to the intended child.
  

• Heat Treatment of Expressed Breast Milk Is a Feasible Option for Feeding HIV-Exposed, Uninfected Children after 6 Months of Age in Rural Zimbabwe. (abstract)
  Mbuya MN, Humphrey JH, Majo F, Chasekwa B, Jenkins A, Israel-Ballard K, Muti M, Paul KH, Madzima RC, Moulton LH, Stoltzfus RJ. J Nutr. 2010 Jun 23. [Epub ahead of print]
  

  Evaluation of the feasibility of expressing and heat treating all breast milk fed to HIV-exposed, uninfected infants in rural Zimbabwe, following 6 months of exclusive breastfeeding. LNS (Nutributter®) was provided along with instruction on EHT and counseling on complementary feeding using local foods.

• Complementary feeding messages that target cultural barriers enhance both the use of lipid-based nutrient supplements and underlying feeding practices to improve infant diets in rural Zimbabwe. (abstract)
  Paul KH, Muti M, Chasekwa B, Mbuya MN, Madzima RC, Humphrey JH, Stoltzfus RJ. Matern Child Nutr. Epub ahead of print 2010 Aug 4.
  

  Formative research was conducted in rural Zimbabwe to develop feeding messages to improve complementary feeding with and without LNS. Common feeding problems were poor dietary diversity and low energy density. While provision of LNS was crucial to ensure adequate intakes of iron and zinc for infants 6-11 mo, educational messages that were barrier-specific and delivered directly to mothers were crucial to improving the underlying diet.

• The Acceptance and Feasibility of Replacement Feeding at 6 Months as an HIV Prevention Method in Lilongwe, Malawi: Results From the BAN Study. (abstract)
  Parker ME, Bentley ME, Chasela C, Adair L, Piwoz EG, Jamieson DJ, Ellington S, Kayira D, Soko A, Mkhomawanthu C, Tembo M, Martinson F, Van der Horst CM. AIDS Educ Prev. 2011 Jun;23(3):281-95.
  

  This study investigated the use and acceptability of a lipid-based nutrient supplement (LNS) as a breast milk substitute when provided to infants (6-12mo) of HIV-positive mothers, as part of the Breast-feeding, Antiretroviral, and Nutrition (BAN) Study. At the time the study was implemented, WHO recommended exclusive breastfeeding for 6 months with rapid weaning thereafter.

• Acceptability of three novel lipid-based nutrient supplements among Malawian infants and their caregivers. (abstract) 
  Phuka J, Ashorn U, Ashorn P, Zeilani M, Cheung YB, Dewey KG, Manary M, Maleta K. Matern Child Nutr. 2011 Apr 21. doi: 10.1111/j.1740-8709.2011.00297.x. [Epub ahead of print]
  

  Study of the acceptability of three new lipid-based nutrient supplements (LNS) designed for preventing undernutrition among infants 6-18 mo of age. Included direct observation of consumption by infants, maternal sensory reaction to the products (and her perception of infant’s reaction), and maternal reports of infant-feeding experiences during a 2-week home-feeding trial.