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document
Complementary feeding with fortified spread and incidence of severe stunting in 6- to 18-month-old rural Malawians . OBJECTIVE To compare growth and incidence of malnutrition in infants receiving long-term dietary supplementation with ready-to-use fortified spread ( FS ) or micronutrient-fortified maize-soy flour ( likuni phala [ LP ] ) . DESIGN Randomized , controlled , single-blind trial . SETTING Rural Malawi . PARTICIPANTS A total of 182 six-month-old infants . INTERVENTION Participants were randomized to receive 1 year of daily supplementation with 71 g of LP ( 282 kcal ) , 50 g of FS ( FS50 ) ( 256 kcal ) , or 25 g of FS ( FS25 ) ( 130 [ corrected ] kcal ) . OUTCOME MEASURES Weight and length gains and the incidences of severe stunting , underweight , and wasting . RESULTS Mean weight and length gains in the LP , FS50 , and FS25 groups were 2.37 , 2.47 , and 2.37 kg ( P = .66 ) and 12.7 , 13.5 , and 13.2 cm ( P = .23 ) , respectively . In the same groups , the cumulative 12-month incidence of severe stunting was 13.3 % , 0.0 % , and 3.5 % ( P = .01 ) , of severe underweight was 15.0 % , 22.5 % , and 16.9 % ( P = .71 ) , and of severe wasting was 1.8 % , 1.9 % , and 1.8 % ( P > .99 ) . Compared with LP-supplemented infants , those given FS50 gained a mean of 100 g more weight and 0.8 cm more length . There was a significant interaction between baseline length and intervention ( P = .04 ) ; in children with below-median length at enrollment , those given FS50 gained a mean of 1.9 cm more than individuals receiving LP . CONCLUSION One-year-long complementary feeding with FS does not have a significantly larger effect than LP on mean weight gain in all infants , but it is likely to boost linear growth in the most disadvantaged individuals and , hence , decrease the incidence of severe stunting .
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Intervention_Pharmacological
fortified spread ( FS )
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Intervention_Pharmacological
micronutrient-fortified maize-soy flour ( likuni phala
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Intervention_Pharmacological
LP
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Intervention_Pharmacological
FS
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Intervention_Pharmacological
FS ( FS25 )
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Intervention_Pharmacological
LP
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Intervention_Pharmacological
LP-supplemented
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Intervention_Pharmacological
LP .
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Intervention_Pharmacological
FS
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Intervention_Pharmacological
LP
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Outcome_Physical
severe stunting
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Outcome_Other
growth
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Outcome_Physical
malnutrition
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Outcome_Physical
Weight and length gains
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Outcome_Physical
incidences of severe stunting
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Outcome_Physical
underweight
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Outcome_Physical
wasting
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Outcome_Physical
Mean weight and length gains
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Outcome_Physical
severe stunting
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Outcome_Physical
underweight
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Outcome_Physical
severe wasting
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Outcome_Physical
weight
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Outcome_Physical
length
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Outcome_Physical
mean weight gain
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Outcome_Physical
linear growth
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Outcome_Physical
incidence of severe stunting
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Participant_Condition
infants receiving long-term dietary supplementation with ready-to-use fortified spread ( FS ) or micronutrient-fortified maize-soy flour ( likuni phala [ LP ] ) .