1. In this randomized controlled trial, infants who received milk-cereal mix with a high-protein supplementation from 6 to 12 months of age had better length-for-age scores compared to those who received no supplementation.
2. Protein supplementation did not modify risk for comorbid diseases such as pneumonia, diarrhea, or fever.
Evidence Rating Level: 1 (Excellent)
Many infants are at risk for stunted growth during the first two years of life, especially those born in low- and middle-income countries. Early stunting can lead to worse cardiometabolic health and intellectual learning later in life. It is unknown whether nutritional protein supplementation can effectively combat stunted growth. Therefore, this randomized controlled trial investigated the effect of milk-cereal mixes with modest- and high-protein supplementation on length-for-age z score (LAZ).
This study was conducted in Delhi and included 1548 infants. Infants were included if they were 6 months old and breastfed. Those who were severely malnourished or had major congenital malformations were excluded. Participants were randomized 1:1:1 at 6 months old to either of the 2 interventions (high- or modest-protein) or a no supplement control group. The intervention groups consumed 1 packet of supplemented milk-cereal mix for 180 days. Counseling on continued breastfeeding and optimal infant-care was provided to all groups. The primary outcome was LAZ at 12 months of age.
The results demonstrated that at 12 months of age, infants in the high-protein group had a significant improvement in LAZ compared to those who received no supplementation. No significant differences were observed between the modest-protein and control group or between the high- and modest-protein groups. Additionally, there were no significant differences in the number of participants with comorbidities among the three groups. This study was limited by potential bias due to lack of blinding between intervention and control, as well as the inability to ensure consumption of supplement in the intervention group. Nonetheless, this study offered insight into a potential range of effective protein supplements for preventing stunted growth in infants.
Click to read the study in The American Journal of Clinical Nutrition
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