wow-inequalities/02-data/intermediate/wos_sample/e6f832d38d042d238e62c31720e1ac33-kristjansson-elizab/info.yaml

abstract: 'Background

  Undernutrition contributes to five million deaths of children under five

  each year. Furthermore, throughout the life cycle, undernutrition

  contributes to increased risk of infection, poor cognitive functioning,

  chronic disease, and mortality. It is thus important for decision-makers

  to have evidence about the effectiveness of nutrition interventions for

  young children.

  Objectives

  Primary objective

  1. To assess the effectiveness of supplementary feeding interventions,

  alone or with co-intervention, for improving the physical and

  psychosocial health of disadvantaged children aged three months to five

  years.

  Secondary objectives

  1. To assess the potential of such programmes to reduce socio-economic

  inequalities in undernutrition.

  2. To evaluate implementation and to understand how this may impact on

  outcomes.

  3. To determine whether there are any adverse effects of supplementary

  feeding.

  Search methods

  We searched CENTRAL, Ovid MEDLINE, PsycINFO, and seven other databases

  for all available years up to January 2014. We also searched

  ClinicalTrials.gov and several sources of grey literature. In addition,

  we searched the reference lists of relevant articles and reviews, and

  asked experts in the area about ongoing and unpublished trials.

  Selection criteria

  Randomised controlled trials (RCTs), cluster-RCTs, controlled clinical

  trials (CCTs), controlled before-and-after studies (CBAs), and

  interrupted time series (ITS) that provided supplementary food (with or

  without co-intervention) to children aged three months to five years,

  from all countries. Adjunctive treatments, such as nutrition education,

  were allowed. Controls had to be untreated.

  Data collection and analysis

  Two or more review authors independently reviewed searches, selected

  studies for inclusion or exclusion, extracted data, and assessed risk of

  bias. We conducted meta-analyses for continuous data using the mean

  difference (MD) or the standardised mean difference (SMD) with a 95\%

  confidence interval (CI), correcting for clustering if necessary. We

  analysed studies from low-and middle-income countries and from

  high-income countries separately, and RCTs separately from CBAs. We

  conducted a process evaluation to understand which factors impact on

  effectiveness.

  Main results

  We included 32 studies (21 RCTs and 11 CBAs); 26 of these (16 RCTs and

  10 CBAs) were in meta-analyses. More than 50\% of the RCTs were judged

  to have low risk of bias for random selection and incomplete outcome

  assessment. We judged most RCTS to be unclear for allocation

  concealment, blinding of outcome assessment, and selective outcome

  reporting. Because children and parents knew that they were given food,

  we judged blinding of participants and personnel to be at high risk for

  all studies.

  Growth. Supplementary feeding had positive effects on growth in

  low-andmiddle-income countries. Meta-analysis of the RCTs showed that

  supplemented children gained an average of 0.12 kg more than controls

  over six months (95\% confidence interval (CI) 0.05 to 0.18, 9 trials,

  1057 participants, moderate quality evidence). In the CBAs, the effect

  was similar; 0.24 kg over a year (95\% CI 0.09 to 0.39, 1784

  participants, very low quality evidence). In high-income countries, one

  RCT found no difference in weight, but in a CBA with 116 Aboriginal

  children in Australia, the effect on weight was 0.95 kg (95\% CI 0.58 to

  1.33). For height, meta-analysis of nine RCTs revealed that supplemented

  children grew an average of 0.27 cm more over six months than those who

  were not supplemented (95\% CI 0.07 to 0.48, 1463 participants, moderate

  quality evidence). Meta-analysis of seven CBAs showed no evidence of an

  effect (mean difference (MD) 0.52 cm, 95\% CI -0.07 to 1.10, 7 trials,

  1782 participants, very low quality evidence). Meta-analyses of the RCTs

  demonstrated benefits for weight-for-age z-scores (WAZ) (MD 0.15, 95\%

  CI 0.05 to 0.24, 8 trials, 1565 participants, moderate quality

  evidence), and height-for-age z-scores (HAZ) (MD 0.15, 95\% CI 0.06 to

  0.24, 9 trials, 4638 participants, moderate quality evidence), but not

  for weight-for-height z-scores MD 0.10 (95\% CI -0.02 to 0.22, 7 trials,

  4176 participants, moderate quality evidence). Meta-analyses of the CBAs

  showed no effects on WAZ, HAZ, or WHZ (very low quality evidence). We

  found moderate positive effects for haemoglobin (SMD 0.49, 95\% CI 0.07

  to 0.91, 5 trials, 300 participants) in a meta-analysis of the RCTs.

  Psychosocial outcomes. Eight RCTs in low-and middle-income countries

  assessed psychosocial outcomes. Our meta-analysis of two studies showed

  moderate positive effects of feeding on psychomotor development (SMD

  0.41, 95\% CI 0.10 to 0.72, 178 participants). The evidence of effects

  on cognitive development was sparse and mixed.

  We found evidence of substantial leakage. When feeding was given at

  home, children benefited from only 36\% of the energy in the supplement.

  However, when the supplementary food was given in day cares or feeding

  centres, there was less leakage; children took in 85\% of the energy

  provided in the supplement. Supplementary food was generally more

  effective for younger children (less than two years of age) and for

  those who were poorer/less well-nourished. Results for sex were

  equivocal. Our results also suggested that feeding programmes which were

  given in day-care/feeding centres and those which provided a

  moderate-to-high proportion of the recommended daily intake (\% RDI) for

  energy were more effective.

  Authors'' conclusions

  Feeding programmes for young children in low- and middle-income

  countries can work, but good implementation is key.'
affiliation: 'Kristjansson, E (Corresponding Author), Univ Ottawa, Sch Psychol, Fac
  Social Sci, Room 407C,Montpetit Hall,125 Univ, Ottawa, ON K1N 6N5, Canada.

  Kristjansson, Elizabeth, Univ Ottawa, Sch Psychol, Fac Social Sci, Room 407C,Montpetit
  Hall,125 Univ, Ottawa, ON K1N 6N5, Canada.

  Francis, Damian K., Univ W Indies, Epidemiol Res Unit, Mona Kingston 7, Jamaica.

  Liberato, Selma, Charles Darwin Univ, Nutr Res Team, Menzies Sch Hlth Res, Darwin,
  NT 0909, Australia.

  Jandu, Maria Benkhalti, Univ Ottawa, Ctr Global Hlth, Inst Populat Hlth, Ottawa,
  ON, Canada.

  Welch, Vivian, Univ Ottawa, Bruyere Res Inst, Ottawa, ON, Canada.

  Batal, Malek, Univ Montreal, Fac Med, Dept Nutr, WHO Collaborating Ctr Nutr Changes
  \& Dev TRANSNUT, Quebec City, PQ, Canada.

  Greenhalgh, Trish, Barts \& London Queen Marys Sch Med \& Dent, Ctr Primary Care
  \& Publ Hlth, London, England.

  Rader, Tamara, Cochrane Musculoskeletal Grp, Ottawa, ON, Canada.

  Noonan, Eamonn, Norwegian Knowledge Ctr Hlth Serv, Oslo, Norway.

  Shea, Beverley; Wells, George A., Univ Ottawa, Dept Epidemiol \& Community Med,
  Ottawa, ON, Canada.

  Janzen, Laura, Hosp Sick Children, Dept Psychol, 555 Univ Ave, Toronto, ON M5G 1X8,
  Canada.

  Janzen, Laura, Hosp Sick Children, Div Hematol Oncol, Toronto, ON M5G 1X8, Canada.

  Petticrew, Mark, London Sch Hyg \& Trop Med, Dept Social \& Environm Hlth Res, Fac
  Publ Hlth \& Policy, London WC1, England.'
article-number: CD009924
author: Kristjansson, Elizabeth and Francis, Damian K. and Liberato, Selma and Jandu,
  Maria Benkhalti and Welch, Vivian and Batal, Malek and Greenhalgh, Trish and Rader,
  Tamara and Noonan, Eamonn and Shea, Beverley and Janzen, Laura and Wells, George
  A. and Petticrew, Mark
author-email: kristjan@uottawa.ca
author_list:
- family: Kristjansson
  given: Elizabeth
- family: Francis
  given: Damian K.
- family: Liberato
  given: Selma
- family: Jandu
  given: Maria Benkhalti
- family: Welch
  given: Vivian
- family: Batal
  given: Malek
- family: Greenhalgh
  given: Trish
- family: Rader
  given: Tamara
- family: Noonan
  given: Eamonn
- family: Shea
  given: Beverley
- family: Janzen
  given: Laura
- family: Wells
  given: George A.
- family: Petticrew
  given: Mark
da: '2023-09-28'
doi: 10.1002/14651858.CD009924.pub2
eissn: 1361-6137
files: []
issn: 1469-493X
journal: COCHRANE DATABASE OF SYSTEMATIC REVIEWS
keywords-plus: 'USE THERAPEUTIC FOOD; NUTRITIONAL SUPPLEMENTATION; MICRONUTRIENT

  SUPPLEMENT; UNDERNOURISHED CHILDREN; LINEAR GROWTH;

  DEVELOPING-COUNTRIES; BRAIN-DEVELOPMENT; STUNTED CHILDREN; MALNOURISHED

  CHILDREN; NUTRIENT SUPPLEMENTS'
language: English
number: '3'
number-of-cited-references: '159'
orcid-numbers: 'Greenhalgh, Trisha/0000-0003-2369-8088

  Welch, Vivian Andrea/0000-0002-5238-7097

  Rader, Tamara/0000-0002-9059-3756'
papis_id: cc4add6ab5952af355e481729fd247c0
ref: Kristjansson2015foodsupplementation
researcherid-numbers: 'Greenhalgh, Trisha/B-1825-2015

  Petticrew, Mark/AAY-6274-2021

  Rader, Tamara/H-9469-2013

  Welch, Vivian Andrea/AAD-9338-2020

  Kristjansson, Elizabeth/AAT-9709-2020

  '
tags:
- review
times-cited: '51'
title: Food supplementation for improving the physical and psychosocial health of
  socio-economically disadvantaged children aged three months to five years (Review)
type: Review
unique-id: WOS:000375542100028
usage-count-last-180-days: '3'
usage-count-since-2013: '22'
web-of-science-categories: Medicine, General \& Internal
year: '2015'