Effectiveness of Small-Quantity vs Medium-Quantity Lipid-Based Nutrient Supplements for Prevention of Undernutrition in Children 6-12 Months

NCT07451951 | Recruiting

• 2 other identifiers: 118061000001355
• Study Type: interventional
• Target: 980
• Locations: 1 country
• Sites: 2

Brief Summary

Nutrition is essential for a child's growth, brain development, and protection from disease. While breastmilk provides the best nutrition for young infants, children older than six months may not get all the nutrients they need from breastmilk and regular foods alone. For this reason, some children receive special nutrient supplements to support healthy growth. Lipid-based nutrient supplements (LNS) are one type of supplement that provides important vitamins and minerals. These supplements are used in many countries to help prevent undernutrition in young children. In Pakistan, the government social safety net program currently provides medium-quantity LNS to children starting at six months of age. However, it is not known whether a smaller-quantity LNS could provide similar benefits for children in this age group from under-resourced communities that have limited access to nutritious foods. The goal of this trial is to learn whether small-quantity lipid-based nutrient supplements (SQ-LNS) work as well as medium-quantity lipid-based nutrient supplements (MQ-LNS) in preventing undernutrition in children aged six to twelve months. The main questions this study aims to answer are:

• Does SQ-LNS work as well as MQ-LNS in supporting healthy growth, including reducing stunting, wasting, and underweight?
• Does SQ-LNS work as well as MQ-LNS in reducing anemia? Researchers will compare SQ-LNS and MQ-LNS to see if SQ-LNS is as good as MQ-LNS in preventing undernutrition. Participants will:
• Receive either SQ-LNS or MQ-LNS once daily for 6 months
• Have their length, weight and mid-upper arm circumference (MUAC) measured monthly
• Have their blood tested for anemia at the start and end of supplementation

Conditions

Undernutrition

Keywords

Stunting; Wasting; Anemia; Underweight; Small-quantity lipid-based nutrient supplement; Child nutrition; Medium-quantity lipid-based nutrient supplement

Outcome Measures

Primary Outcomes (1)

• Stunting

  length-for-age z-score (LAZ) \< -2 SD

  From enrollment to the end of intervention period at 6 months

Secondary Outcomes (4)

• Wasting

  From enrollment to the end of intervention period at 6 months

• Underweight

  From enrollment to the end of intervention period at 6 months

• Morbidity

  From enrollment to the end of intervention period at 6 months

• Prevalence of anemia

  At enrollment and later at the end of intervention period at 6 months

Study Arms (2)

Medium-quantity lipid-based nutrient supplement (MQ-LNS)

ACTIVE COMPARATOR

Children receiving MQ-LNS

Dietary Supplement: Medium-quantity lipid-based nutrient supplement (MQ-LNS)

Small-quantity lipid-based nutrient supplement (SQ-LNS)

ACTIVE COMPARATOR

Children receiving SQ-LNS

Dietary Supplement: Small-quantity lipid-based nutrient supplement (SQ-LNS)

Interventions

Small-quantity lipid-based nutrient supplement (SQ-LNS) DIETARY_SUPPLEMENT

20 g/day lipid-based nutrient supplement providing energy and essential micronutrients, administered daily for 6 months.

Small-quantity lipid-based nutrient supplement (SQ-LNS)

Medium-quantity lipid-based nutrient supplement (MQ-LNS) DIETARY_SUPPLEMENT

50 g/day lipid-based nutrient supplement providing energy and essential micronutrients, administered daily for 6 months.

Medium-quantity lipid-based nutrient supplement (MQ-LNS)

Eligibility Criteria

• Age: 26 Weeks - 33 Weeks
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Children aged 6 months (26 weeks) to 7 months and 15 days (33 weeks) with weight-for-length z-score (WLZ) ≥ -2 standard deviation (SD) and mid-upper arm circumference (MUAC) ≥125 mm, born to mothers who are beneficiaries of the Benazir Income Support Programme and registered with the Benazir Nashonuma Programme (BNP) at any point during their pregnancy.
• Permanent residents of the selected districts, with no plan to relocate or migrate within the next 6 months.
• Written informed consent provided by the child's caregivers.

You may not qualify if:

• Children with moderate acute malnutrition (MAM), defined as WLZ ≥ -3 to \< -2 SD, or MUAC ≥115 mm to \<125 mm.
• Children with severe acute malnutrition (SAM), defined as WLZ \< -3 SD or MUAC \<115 mm or presence of bilateral pitting edema, who require therapeutic feeding.
• Children with known congenital anomalies, chronic illness, or conditions affecting growth or feeding (for example, cerebral palsy or congenital heart disease).
• Children already enrolled in any nutritional supplementation other than BNP or another clinical trial.
• Children whose families will be unwilling to provide informed consent, or likely to be unavailable for follow-up.

Sponsors & Collaborators

• Aga Khan University: lead
• United Nations World Food Programme (WFP): collaborator
• Benazir Income Support Programme (BISP): collaborator

Study Sites (2)

BNP Facilitation Centers

Peshawar, Khyber Pakhtunkhwa, Pakistan

NOT YET RECRUITING

BNP Facilitation Centers

Dadu, Sindh, Pakistan

RECRUITING

Related Publications (7)

• Dewey KG, Arnold CD, Wessells KR, Stewart CP. Lipid-based nutrient supplements for prevention of child undernutrition: when less may be more. Am J Clin Nutr. 2023 Dec;118(6):1133-1144. doi: 10.1016/j.ajcnut.2023.09.007. Epub 2023 Sep 23.

  PMID: 37742931 BACKGROUND

• Prado EL, Arnold CD, Wessells KR, Stewart CP, Abbeddou S, Adu-Afarwuah S, Arnold BF, Ashorn U, Ashorn P, Becquey E, Brown KH, Chandna J, Christian P, Dentz HN, Dulience SJL, Fernald LCH, Galasso E, Hallamaa L, Hess SY, Huybregts L, Iannotti LL, Jimenez EY, Kohl P, Lartey A, Le Port A, Luby SP, Maleta K, Matchado A, Matias SL, Mridha MK, Ntozini R, Null C, Ocansey ME, Parvez SM, Phuka J, Pickering AJ, Prendergast AJ, Shamim AA, Siddiqui Z, Tofail F, Weber AM, Wu LSF, Dewey KG. Small-quantity lipid-based nutrient supplements for children age 6-24 months: a systematic review and individual participant data meta-analysis of effects on developmental outcomes and effect modifiers. Am J Clin Nutr. 2021 Nov 2;114(Suppl 1):43S-67S. doi: 10.1093/ajcn/nqab277.

  PMID: 34590116 BACKGROUND

• Dewey KG, Stewart CP, Wessells KR, Prado EL, Arnold CD. Small-quantity lipid-based nutrient supplements for the prevention of child malnutrition and promotion of healthy development: overview of individual participant data meta-analysis and programmatic implications. Am J Clin Nutr. 2021 Nov 2;114(Suppl 1):3S-14S. doi: 10.1093/ajcn/nqab279.

  PMID: 34590696 BACKGROUND

• Stewart CP, Dewey KG, Lin A, Pickering AJ, Byrd KA, Jannat K, Ali S, Rao G, Dentz HN, Kiprotich M, Arnold CD, Arnold BF, Allen LH, Shahab-Ferdows S, Ercumen A, Grembi JA, Naser AM, Rahman M, Unicomb L, Colford JM Jr, Luby SP, Null C. Effects of lipid-based nutrient supplements and infant and young child feeding counseling with or without improved water, sanitation, and hygiene (WASH) on anemia and micronutrient status: results from 2 cluster-randomized trials in Kenya and Bangladesh. Am J Clin Nutr. 2019 Jan 1;109(1):148-164. doi: 10.1093/ajcn/nqy239.

  PMID: 30624600 BACKGROUND

• Siega-Riz AM, Estrada Del Campo Y, Kinlaw A, Reinhart GA, Allen LH, Shahab-Ferdows S, Heck J, Suchindran CM, Bentley ME. Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6-18 months living in the rural region of Intibuca, Honduras. Paediatr Perinat Epidemiol. 2014 May;28(3):245-54. doi: 10.1111/ppe.12117. Epub 2014 Mar 13.

  PMID: 24628577 BACKGROUND

• Abbeddou S, Yakes Jimenez E, Some JW, Ouedraogo JB, Brown KH, Hess SY. Small-quantity lipid-based nutrient supplements containing different amounts of zinc along with diarrhea and malaria treatment increase iron and vitamin A status and reduce anemia prevalence, but do not affect zinc status in young Burkinabe children: a cluster-randomized trial. BMC Pediatr. 2017 Feb 2;17(1):46. doi: 10.1186/s12887-016-0765-9.

  PMID: 28152989 BACKGROUND

• Das JK, Salam RA, Hadi YB, Sadiq Sheikh S, Bhutta AZ, Weise Prinzo Z, Bhutta ZA. Preventive lipid-based nutrient supplements given with complementary foods to infants and young children 6 to 23 months of age for health, nutrition, and developmental outcomes. Cochrane Database Syst Rev. 2019 May 2;5(5):CD012611. doi: 10.1002/14651858.CD012611.pub3.

  PMID: 31046132 BACKGROUND

Related Links

• Strategies for ensuring adequate nutrientintake for infants and young children duringthe period of complementary feeding

MeSH Terms

Conditions

Malnutrition; Growth Disorders; Cachexia; Anemia; Thinness

Condition Hierarchy (Ancestors)

Nutrition Disorders; Nutritional and Metabolic Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Weight Loss; Body Weight Changes; Body Weight; Signs and Symptoms; Hematologic Diseases; Hemic and Lymphatic Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: The statistical analysis team will remain blinded to the intervention allocation to minimize the risk of bias.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor Shabina Ariff

Study Record Dates

• First Submitted: March 2, 2026
• First Posted: March 5, 2026
• Study Start: February 26, 2026
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): March 31, 2027
• Last Updated: June 2, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ANALYTIC CODE
• Time Frame: May 2027 - May 2034
• Access Criteria: Access to de-identified IPD will be provided to researchers upon reasonable request. Data access will be subject to approval by the Principal Investigator and the ethical review committee of Aga Khan University. Data will be shared through a secure data transfer mechanism.

Locations

PA (2)