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Clinical Trial
. 2024 Aug 24;16(17):2832.
doi: 10.3390/nu16172832.

Comparative Analysis of Nutritional Advice and a Combined Approach for Addressing Impending Stunting in Infants: A Clinical Trial

Conny Tanjung  1 , Bahrul Fikri  2 , Titis Prawitasari  3 , Nasrum Massi  4 , Andi Alfian Zainuddin  5 , Aidah Juliaty  2 , Dwi Sora Yullyana  6 , Sarah Dwitya  7 , Naoki Shimojo  8 , Hiroshi Ohno  9 , Berthold Koletzko  10
Affiliations
Clinical Trial

Comparative Analysis of Nutritional Advice and a Combined Approach for Addressing Impending Stunting in Infants: A Clinical Trial

Conny Tanjung et al. Nutrients. .

Abstract

Weight faltering (WF) has been associated with stunting and with long-term adverse consequences for health and development. Nutritional care for managing WF may consist of giving nutritional advice (NA) and/or provision of oral nutrition supplements (ONSs). In this study, we aimed to evaluate practical management options in the community for infants with WF aged 6-12 months. This nonrandomized clinical trial was conducted in the community of Makassar, South Sulawesi, from March 2022 to March 2023. A total of 1013 infants were enrolled for screening. Anthropometric measures were performed in 913 infants, of which 170 showed WF below the 15th percentile of the WHO weight increment table without stunting. Infants with a weight increment below P5th were assigned to receive NA plus ONS, while infants between P5th and below P15th were assigned to receive only NA. At the second and third months, ONSs were administered to WF infants who were below P15th. One month after the intervention, 87/105 infants in the NA-plus-ONS group (82.8%) and 52/65 infants in the NA-only group (80%) were no longer WF. After 3 months, infants in the NA-plus-ONS group achieved greater weight gain than infants in the NA group (264.1 g vs. 137.4 g, p < 0.001) as well as greater length gain (2.35 cm vs. 2.14 cm, p < 0.001). WF management should be started at below P15th to achieve a better result. Infants with greater nutritional deficits should be assigned to receive the combination of NA plus ONSs to achieve a higher rate of resolution of growth.

Keywords: nutritional advice; oral nutritional supplements; weight faltering; weight increment.

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Conflict of interest statement

C.T. received support for scientific activities from Danone Specialized Nutrition. All other authors have no conflicts of interest regarding this manuscript. B.K. is the Else Kröner Senior Professor of Paediatrics at LMU—University of Munich, financially supported by the charitable Else Kröner-Fresenius-Foundation, LMU Medical Faculty and LMU University Hospitals. B.K. received support for scientific and educational activities from Danone Research/Danone. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Subject selection flow. HAZ = height-for-age-z score; WHZ = weight-for-height z-score; WF = weight faltering.
Figure 2
Figure 2
The changes in weight, length, and WHZ within groups during the intervention. Notes: ONS = oral nutritional supplement; NA = nutritional advice; phase one = consumption of ONSs starts from p-value < 0.05, ** p-value < 0.001.
Figure 3
Figure 3
Changes in non-WF and WF condition after each phase of the intervention, excluding those who were dropped out in the study. In phase one, those with a weight increment < P5th were assigned NA plus ONSs and those with a weight increment P5th to < P15th were assigned NA only; in phases two and three, only those who still had a weight increment < P15th (still WF) were assigned NA plus ONSs.
See this image and copyright information in PMC

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