TY - JOUR
T1 - Maternal supplementation with small-quantity lipid-based nutrient supplements compared with multiple micronutrients, but not with iron and folic acid, reduces the prevalence of low gestational weight gain in semi-urban Ghana
T2 - A randomized controlled trial
AU - Adu-Afarwuah, Seth
AU - Lartey, Anna
AU - Okronipa, Harriet
AU - Ashorn, Per
AU - Ashorn, Ulla
AU - Zeilani, Mamane
AU - Arimond, Mary
AU - Vosti, Stephen A.
AU - Dewey, Kathryn G.
N1 - Publisher Copyright:
© 2017 American Society for Nutrition.
PY - 2017
Y1 - 2017
N2 - Background: It is unclear whether maternal supplementation with small-quantity lipid-based nutrient supplements (SQ-LNSs; 118 kcal/d) affects maternal weight. Objective: We compared several secondary anthropometric measures between 3 groups of women in the iLiNS (International Lipid-based Nutrient Supplements)-DYAD trial in Ghana. Methods: Women (n = 1320; < 20 wk of gestation) were randomly assigned to receive 60 mg Fe + 400 mg folic acid/d (IFA), 18 vitamins and minerals/d [multiple micronutrients (MMNs)], or 20 g SQ-LNSs with 22 micronutrients/d (LNS) during pregnancy and a placebo (200 mg Ca/d), MMNs, or SQ-LNSs, respectively, for 6 mo postpartum. Weight, midupper arm circumference (MUAC), and triceps skinfold (TSF) thickness at 36wk of gestation and 6mo postpartumwere analyzed, as were changes from estimated prepregnancy values.We assessed the adequacy of estimated gestational weight gain (GWG) by using Institute of Medicine (IOM) and International Fetal and Newborn Growth Standards for the 21st Century (INTERGROWTH-21st) guidelines. Results: The estimated prepregnancy prevalence of overweight or obesity was 38.5%. By 36 wk of gestation, women (n = 1015) had a mean 6 SD weight gain of 7.4 6 3.7 kg and changes of 21.0 6 1.7 cm in MUAC and 22.8 6 4.1 mm in TSF thickness. The LNS group had a lower prevalence of inadequateGWGon the basis of IOM guidelines (57.4%) than the MMN (67.2%) but not the IFA (63.1%) groups (P = 0.030), whereas the prevalence of adequate (26.9% overall) and excessive (10.4% overall) GWG did not differ by group. The percentages of normal-weight women (in kg/m2: 18.5 < body mass index < 25.0; n = 754) whose GWG was less than the third centile of the INTERGROWTH-21st standards were 23.0%, 28.7%, and 28.5% for the LNS, MMN, and IFA groups, respectively (P = 0.36). At 6 mo postpartum, the prevalence of overweight or obesity was 45.3%, and the risk of becoming overweight or obese did not differ by group. Conclusion: SQ-LNS supplementation is one potential strategy to address the high prevalence of inadequateGWGinwomen in settings similar to Ghana, without increasing the risk of excessive GWG.
AB - Background: It is unclear whether maternal supplementation with small-quantity lipid-based nutrient supplements (SQ-LNSs; 118 kcal/d) affects maternal weight. Objective: We compared several secondary anthropometric measures between 3 groups of women in the iLiNS (International Lipid-based Nutrient Supplements)-DYAD trial in Ghana. Methods: Women (n = 1320; < 20 wk of gestation) were randomly assigned to receive 60 mg Fe + 400 mg folic acid/d (IFA), 18 vitamins and minerals/d [multiple micronutrients (MMNs)], or 20 g SQ-LNSs with 22 micronutrients/d (LNS) during pregnancy and a placebo (200 mg Ca/d), MMNs, or SQ-LNSs, respectively, for 6 mo postpartum. Weight, midupper arm circumference (MUAC), and triceps skinfold (TSF) thickness at 36wk of gestation and 6mo postpartumwere analyzed, as were changes from estimated prepregnancy values.We assessed the adequacy of estimated gestational weight gain (GWG) by using Institute of Medicine (IOM) and International Fetal and Newborn Growth Standards for the 21st Century (INTERGROWTH-21st) guidelines. Results: The estimated prepregnancy prevalence of overweight or obesity was 38.5%. By 36 wk of gestation, women (n = 1015) had a mean 6 SD weight gain of 7.4 6 3.7 kg and changes of 21.0 6 1.7 cm in MUAC and 22.8 6 4.1 mm in TSF thickness. The LNS group had a lower prevalence of inadequateGWGon the basis of IOM guidelines (57.4%) than the MMN (67.2%) but not the IFA (63.1%) groups (P = 0.030), whereas the prevalence of adequate (26.9% overall) and excessive (10.4% overall) GWG did not differ by group. The percentages of normal-weight women (in kg/m2: 18.5 < body mass index < 25.0; n = 754) whose GWG was less than the third centile of the INTERGROWTH-21st standards were 23.0%, 28.7%, and 28.5% for the LNS, MMN, and IFA groups, respectively (P = 0.36). At 6 mo postpartum, the prevalence of overweight or obesity was 45.3%, and the risk of becoming overweight or obese did not differ by group. Conclusion: SQ-LNS supplementation is one potential strategy to address the high prevalence of inadequateGWGinwomen in settings similar to Ghana, without increasing the risk of excessive GWG.
KW - Gestational weight gain
KW - Iron and folic acid supplementation
KW - Lipid-based nutrient supplements
KW - Maternal supplementation
KW - Multiple micronutrient supplementation
UR - http://www.scopus.com/inward/record.url?scp=85015900310&partnerID=8YFLogxK
U2 - 10.3945/jn.116.242909
DO - 10.3945/jn.116.242909
M3 - Article
C2 - 28275100
AN - SCOPUS:85015900310
SN - 0022-3166
VL - 147
SP - 697
EP - 705
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 4
ER -