Effect of Fortified Complementary Food Supplementation on Child Growth in Rural Bangladesh – a Cluster‐Randomized Trial

A five‐arm RCT was conducted in rural Bangladesh to test the effect of two local, lipid‐based foods (chickpea and rice‐lentil), WSB++ and Plumpy'doz (PD) provided daily to children (n=5536) from 6 to 18 mo with nutrition counseling vs. nutrition counseling alone (control) on outcomes of stunting, wasting and growth. The daily food portions provided substantial proportions of micronutrient requirements and ~125 and 250 kcal of energy to children from 6 until 12 and 12 until 18 mo of age, respectively. Anthropometric measurements were taken at 6, 9, 12, 15, and 18 mo of age. Growth deceleration occurred in all groups from 6 to 18 mo of age but monthly deceleration in LAZ and length was lower in the PD, chickpea and rice‐lentil groups, and when adjusted for baseline, in the WSB++ group. Mean length and LAZ at 18 months were significantly higher by 0·27‐0·30 cm and 0.07‐0.10, respectively, and length deficits lower by 0·23‐0·27 cm in all four food groups. The prevalence of stunting was lower by 4‐6% in the PD, chickpea, and WSB++ groups. Prevalence of wasting at 18 mo was not different between groups, but cumulative incidence was lower by 17% in the PDz group (relative risk: 0·83, 95% CI: 0·72, 0·97). Foods provided in the study were deemed equivalent to PD. Small amounts of daily, fortified complementary foods, provided for a year, in addition to nutrition counseling reduced linear growth deceleration and prevalence of stunting at 18 months of age in Bangladesh. Funded by USDA, with additional support from Nutriset, DSM, the Gates Foundation and JHU Sight and Life Research Institute.