ORCID Profile
0000-0002-9506-348X
Current Organisations
WA Country Health Service
,
International Food Policy Research Institute
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Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1093/JN/NXY090
Publisher: Elsevier BV
Date: 12-2017
Publisher: Elsevier BV
Date: 10-2016
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1093/AJCN/NQAC232
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1093/AJCN/NQAB278
Publisher: Informa UK Limited
Date: 03-08-2015
Publisher: Public Library of Science (PLoS)
Date: 25-10-2016
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1093/JN/NXY147
Publisher: Elsevier BV
Date: 10-2022
Publisher: Elsevier BV
Date: 02-2017
Abstract: Promoting adequate nutrition through interventions to improve infant and young child feeding (IYCF) has the potential to contribute to child development. We examined whether an intensive intervention package that was aimed at improving IYCF at scale through the Alive & Thrive initiative in Bangladesh also advanced language and gross motor development, and whether advancements in language and gross motor development were explained through improved complementary feeding. A cluster-randomized design compared 2 intervention packages: intensive interpersonal counseling on IYCF, mass media c aign, and community mobilization (intensive) compared with usual nutrition counseling and mass media c aign (nonintensive). Twenty subdistricts were randomly assigned to receive either the intensive or the nonintensive intervention. Household surveys were conducted at baseline (2010) and at endline (2014) in the same communities (n = ∼4000 children aged 0-47.9 mo for each round). Child development was measured by asking mothers if their child had reached each of multiple milestones, with some observed. Linear regression accounting for clustering was used to derive difference-in-differences (DID) impact estimates, and path analysis was used to examine developmental advancement through indicators of improved IYCF and other factors. The DID in language development between intensive and nonintensive groups was 1.05 milestones (P = 0.001) among children aged 6-23.9 mo and 0.76 milestones (P = 0.038) among children aged 24-47.9 mo. For gross motor development, the DID was 0.85 milestones (P = 0.035) among children aged 6-23.9 mo. The differences observed corresponded to age- and sex-adjusted effect sizes of 0.35 for language and 0.23 for gross motor development. Developmental advancement at 6-23.9 mo was partially explained through improved minimum dietary ersity and the consumption of iron-rich food. Intensive IYCF intervention differentially advanced language and gross motor development, which was partially explained through improved complementary feeding. Measuring a erse set of child outcomes, including functional outcomes such as child development, is important when evaluating integrated nutrition programs. This trial was registered at clinicaltrials.gov as NCT01678716.
Publisher: Cold Spring Harbor Laboratory
Date: 08-02-2021
DOI: 10.1101/2021.02.05.21251105
Abstract: Meta-analyses have demonstrated that small-quantity lipid-based nutrient supplements (SQ-LNS) reduce stunting and wasting prevalence among infants and young children. Identification of subgroups who benefit most from SQ-LNS may facilitate program design. Our objective was to identify study-level and in idual-level modifiers of the effect of SQ-LNS on child growth outcomes. We conducted a two-stage meta-analysis of in idual participant data from 14 randomized controlled trials of SQ-LNS provided to children 6 to 24 months of age in low- and middle-income countries (n=37,066). We generated study-specific and subgroup estimates of SQ-LNS vs. control and pooled the estimates using fixed-effects models, with random-effects models as sensitivity analyses. We used random effects meta-regression to examine study-level effect modifiers. Heterogeneity was assessed using I 2 and Tau 2 statistics. Sensitivity analyses were conducted to examine whether results differed depending on inclusion criteria for arms within trials and types of comparisons. SQ-LNS provision decreased stunting (length-for-age z-score −2) by 12% (relative reduction), wasting (weight-for-length (WLZ) z-score −2) by 14%, low mid-upper arm circumference (MUAC 125 mm or MUACZ −2) by 18%, acute malnutrition (WLZ −2 or MUAC 125 mm) by 14%, underweight (weight-for-age z-score −2) by 13%, and small head size (head-circumference z-score −2) by 9%. Effects of SQ-LNS on growth outcomes generally did not differ by study-level characteristics including region, stunting burden, malaria prevalence, sanitation, water quality, duration of supplementation, frequency of contact or average reported compliance with SQ-LNS. Effects of SQ-LNS on stunting, wasting, low MUAC and small head size were greater among girls than among boys effects on stunting, underweight and low MUAC were greater among later-born (vs. first-born) children and effects on wasting and acute malnutrition were greater among children in households with improved (vs. unimproved) sanitation. Results were similar across sensitivity analyses. The positive impact of SQ-LNS on growth is apparent across a wide variety of study-level contexts. Policy-makers and program planners should consider including SQ-LNS in the mix of interventions to prevent both stunting and wasting. This study was registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.
Publisher: Cold Spring Harbor Laboratory
Date: 17-06-2022
DOI: 10.1101/2022.06.16.22276521
Abstract: Meta-analyses show that small-quantity lipid-based nutrient supplements (SQ- LNS) reduce child wasting and stunting. There is little information regarding effects on severe wasting or stunting. We aimed to identify the effect of SQ-LNS on severe wasting (weight-for-length z- score −3) and severe stunting (length-for-age z-score −3). We conducted a two-stage meta-analysis of in idual participant data from 14 randomized controlled trials of SQ-LNS provided to children 6 to 24 mo of age. We generated study-specific and subgroup estimates of SQ-LNS vs. control and pooled the estimates using fixed-effects models. We used random effects meta-regression to examine study-level effect modifiers. In sensitivity analyses, we examined whether results differed depending on study arm inclusion criteria and types of comparisons. Q-LNS provision led to a relative reduction of 31% in severe wasting (Prevalence Ratio, PR 0.69 (0.55, 0.86), n=34,373) and 17% in severe stunting (PR 0.83 (95% CI: 0.78, 0.90), n=36,795). Results were similar in most of the sensitivity analyses but somewhat attenuated when comparisons using passive control arms were excluded: PR 0.74 (0.57, 0.96), n=26,327 for severe wasting and PR 0.88 (0.81, 0.95), n=28,742 for severe stunting. Study-level characteristics generally did not significantly modify the effects of SQ-LNS, but results suggested greater effects of SQ-LNS in sites with greater burdens of wasting or stunting, or with poorer water quality or sanitation. Including SQ-LNS in preventive interventions to promote healthy child growth and development is likely to reduce rates of severe wasting and stunting. Registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.
Location: United States of America
Location: United States of America
No related grants have been discovered for Marie Ruel.