Effectiveness of locally produced ready to use supplementary food on hemoglobin, anthropometrics, and plasma micronutrients concentrations of 6 to 23 months age children: a non-randomized community-based trial from Pakistan

Effect of Locally Formulated Complementary Foods on Anthropometric Parameters and Micronutrient Status in Children (6-23 Months) in Enugu State, Nigeria: A Randomized Controlled Trial

Malnutrition remains a significant challenge in low- and middle-income countries, contributing to stunting, wasting, and micronutrient deficiencies. This study investigated the effect of locally formulated complementary foods on anthropometric parameters and micronutrient status in children aged 6 to 23 months. A randomized controlled trial involving 40 infants explored the effects of experimental diets, including Maize-Soybean, Maize-Soybean-Termite flour, Maize-Soybean-Fishbone powder, and Maize-Soybean-Termite-Fishbone-Pawpaw-Pumpkin (MaSoTFPP), and a control diet on children over a period of 90 days. Anthropometric measurements of weight, height, and mid-upper arm circumference (MUAC) as well as biochemical analyses of blood samples were carried out. Dietary intake was monitored over the 90-day feeding trial period. The data obtained were analyzed using Statistical Product for Service Solution, version 23. Significance was set at P<0.05. The findings revealed significant improvements in the anthropometric parameters, particularly in the MaSoTFPP group, which exhibited the largest percentage increase in height and MUAC. The children fed with the experimental diets demonstrated enhanced serum hemoglobin, iron, and zinc levels, which increased most significantly in the MaSoTFPP group (by 308%, 264%, and 58%, respectively). The study underscores the potential of incorporating locally available food crops in community-based management of acute malnutrition and supports the World Health Organization's recognition of fortified staple foods in improving child growth and development.

Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction-A Narrative Review

Stunting is a major global health concern, particularly in low- and middle-income countries, due to its persistently high prevalence. It often originates from chronic malnutrition during the critical first 1000 days of life. Maternal and child nutrition are critical determinants of a child's growth and development. This article aimed to explore the impact, causes, and evidence-based strategies to accelerate the reduction of stunting incidence worldwide. This review was undertaken with sources from PubMed, Scopus, Google Scholar, Science Direct, and MEDLINE from October 2024 to January 2025. This review was undertaken with sources from PubMed, Scopus, Google Scholar, Science Direct, and MEDLINE from October 2024 to January 2025 using the keyword "Stunting", "Causes of stunting", "Stunting Impact", "Stunting Intervention", and "Stunting Prevention". The findings highlight the multifactorial causes of stunting, including maternal malnutrition, inadequate breastfeeding and complementary feeding, poor sanitation, and socioeconomic factors. Stunting is associated with impaired linear growth, cognitive deficits, gut dysbiosis, endocrine disruption, anemia, and increased risk of chronic diseases later in life. Addressing stunting demands multisectoral strategies focusing on maternal and child nutrition, infection prevention, improved WASH (Water, Sanitation, and Hygiene) practices, and socioeconomic support. The evidence presented may guide policy development and targeted interventions to prevent stunting and its long-term effects.

Effectiveness of locally produced ready-to-use supplementary foods on the prevention of stunting in children aged 6-23 months: a community-based trial from Pakistan

Undernutrition is a major public health problem in developing countries. Around 40·2 % of children are stunted in Pakistan. This longitudinal study aimed to assess the effectiveness of locally produced ready-to-use supplementary foods in the prevention of stunting by detecting change in of children in intervention v. control arm against the 2006 WHO growth reference. A community-based non-randomised cluster-controlled trial was conducted from January 2018 to December 2020 in the district of Kurram, Khyber Pakhtunkhwa, Pakistan. A total of 80 clusters (each cluster comprising ≈ 250-300 households) were defined in the catchment population of twelve health facilities. Children aged 6-18 months were recruited n 1680. The intervention included a daily ration of 50 g - locally produced ready-to-use-supplementary food (Wawa-Mum). The main outcome of this study was a change in length for age z-score (LAZ) v. WHO growth standards. Comparison between the interventions was by t test and ANOVA. Cox proportional hazard models were used to assess the association between stunting occurrence and the utilisation of locally produced supplement. Out of the total 1680, fifty-one out of the total 1680, 51·1 out of the total 1680 and 51·1 % (n 859) were male. Mean age 13·9 months (sd + 859) were male. Mean age 13·9 months (sd + -4·4). At baseline, 36·9 % (n 618) were stunted. In the intervention group, mean LAZ score significantly increased from -1·13(2·2 sd) at baseline to -0·93(1·8 sd) at 6-month follow-up (P value 0·01) compared with the control group. The incidence rate of stunting in the intervention arm was 1·3 v. 3·4 per person year in the control arm. The control group had a significantly increased likelihood of stunting (Hazard Ratio (HR) 1·7, 95 % CI 1·46, 2·05, P value < 0·001) v. the intervention group. Locally produced ready-to-use supplementary food is an effective intervention for reducing stunting in children below 2 years of age. This can be provided as part of a malnutrition prevention package to overcome the alarming rates of stunting in Pakistan.