{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Wessells KR"],"funding":["Bill and Melinda Gates Foundation"],"pagination":["68S-94S"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC8560313"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["114(Suppl 1)"],"pubmed_abstract":["<h4>Background</h4>Small-quantity lipid-based nutrient supplements (SQ-LNSs) have been shown to reduce the prevalence of child anemia and iron deficiency, but effects on other micronutrients are less well known. Identifying subgroups who benefit most from SQ-LNSs could support improved program design.<h4>Objectives</h4>We aimed to identify study-level and individual-level modifiers of the effect of SQ-LNSs on child hemoglobin (Hb), anemia, and inflammation-adjusted micronutrient status outcomes.<h4>Methods</h4>We conducted a 2-stage meta-analysis of individual participant data from 13 randomized controlled trials of SQ-LNSs provided to children 6-24 mo of age (n = 15,946). We generated study-specific and subgroup estimates of SQ-LNSs compared with control, and pooled the estimates using fixed-effects models. We used random-effects meta-regression to examine potential study-level effect modifiers.<h4>Results</h4>SQ-LNS provision decreased the prevalence of anemia (Hb < 110 g/L) by 16% (relative reduction), iron deficiency (plasma ferritin < 12 µg/L) by 56%, and iron deficiency anemia (IDA; Hb < 110 g/L and plasma ferritin <12 µg/L) by 64%. We observed positive effects of SQ-LNSs on hematological and iron status outcomes within all subgroups of the study- and individual-level effect modifiers, but effects were larger in certain subgroups. For example, effects of SQ-LNSs on anemia and iron status were greater in trials that provided SQ-LNSs for >12 mo and provided 9 (as opposed to <9) mg Fe/d, and among later-born (than among first-born) children. There was no effect of SQ-LNSs on plasma zinc or retinol, but there was a 7% increase in plasma retinol-binding protein (RBP) and a 56% reduction in vitamin A deficiency (RBP < 0.70 µmol/L), with little evidence of effect modification by individual-level characteristics.<h4>Conclusions</h4>SQ-LNSs can substantially reduce the prevalence of anemia, iron deficiency, and IDA among children across a range of individual, population, and study design characteristics. Policy-makers and program planners should consider SQ-LNSs within intervention packages to prevent anemia and iron deficiency.This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020156663."],"journal":["The American journal of clinical nutrition"],"pubmed_title":["Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: an individual participant data meta-analysis of randomized controlled trials."],"pmcid":["PMC8560313"],"funding_grant_id":["OPP49817"],"pubmed_authors":["Campbell RK","Maleta K","Okronipa H","Arnold BF","Jorgensen JM","Hess SY","Matias SL","Pickering AJ","Christian P","Mridha MK","Weber AM","Stewart CP","Wessells KR","Leroy JL","Brown KH","Zongrone A","Galasso E","Lartey A","Mutasa K","Adu-Afarwuah S","Fan YM","Smith LE","Paul RR","Ouedraogo JB","Prado EL","Kiprotich M","Becquey E","Naser AM","Abbeddou S","Ashorn P","Byrd KA","Ashorn U","Arnold CD","Rahman M","Le Port A","Dewey KG","Lin A","Kortekangas E","Mbuya MNN","Huybregts L","Fernald LCH","Schulze K"],"additional_accession":[]},"is_claimable":false,"name":"Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: an individual participant data meta-analysis of randomized controlled trials.","description":"<h4>Background</h4>Small-quantity lipid-based nutrient supplements (SQ-LNSs) have been shown to reduce the prevalence of child anemia and iron deficiency, but effects on other micronutrients are less well known. Identifying subgroups who benefit most from SQ-LNSs could support improved program design.<h4>Objectives</h4>We aimed to identify study-level and individual-level modifiers of the effect of SQ-LNSs on child hemoglobin (Hb), anemia, and inflammation-adjusted micronutrient status outcomes.<h4>Methods</h4>We conducted a 2-stage meta-analysis of individual participant data from 13 randomized controlled trials of SQ-LNSs provided to children 6-24 mo of age (n = 15,946). We generated study-specific and subgroup estimates of SQ-LNSs compared with control, and pooled the estimates using fixed-effects models. We used random-effects meta-regression to examine potential study-level effect modifiers.<h4>Results</h4>SQ-LNS provision decreased the prevalence of anemia (Hb < 110 g/L) by 16% (relative reduction), iron deficiency (plasma ferritin < 12 µg/L) by 56%, and iron deficiency anemia (IDA; Hb < 110 g/L and plasma ferritin <12 µg/L) by 64%. We observed positive effects of SQ-LNSs on hematological and iron status outcomes within all subgroups of the study- and individual-level effect modifiers, but effects were larger in certain subgroups. For example, effects of SQ-LNSs on anemia and iron status were greater in trials that provided SQ-LNSs for >12 mo and provided 9 (as opposed to <9) mg Fe/d, and among later-born (than among first-born) children. There was no effect of SQ-LNSs on plasma zinc or retinol, but there was a 7% increase in plasma retinol-binding protein (RBP) and a 56% reduction in vitamin A deficiency (RBP < 0.70 µmol/L), with little evidence of effect modification by individual-level characteristics.<h4>Conclusions</h4>SQ-LNSs can substantially reduce the prevalence of anemia, iron deficiency, and IDA among children across a range of individual, population, and study design characteristics. Policy-makers and program planners should consider SQ-LNSs within intervention packages to prevent anemia and iron deficiency.This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020156663.","dates":{"release":"2021-01-01T00:00:00Z","publication":"2021 Nov","modification":"2025-04-19T08:08:37.211Z","creation":"2022-02-11T12:28:51.691Z"},"accession":"S-EPMC8560313","cross_references":{"pubmed":["34590114"],"doi":["10.1093/ajcn/nqab276"]}}