Colombian women at risk of malnutrition were enrolled in a health care program and randomly assigned to supplementation and control groups at the beginning of the third trimester of pregnancy. The net dietary intake increments resulting from supplementation amounted to 155 cal and 20 g of protein per day. Supplementation had a significant effect on the mean birth weight of male infants, but not that of female infants; the mechanisms responsible for the sex differences remain to be elucidated. The randomized trial design of the experiment and the documented similarity between the experimental and control groups at the onset permit the conclusion that the observed differences were caused by the food supplementation program. The effect of supplementation on maternal weight gain and the association of the latter with birth weight strongly suggest that improved maternal nutrition mediated the effect on birth weight.

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Protein-energy malnutrition in synergism with infection is a major problem for most developing countries, and inadequate food consumption is a critical factor in its development. Food supplementation programs can improve nutrient consumption but may also have unintended consequences. Changes in consumption of foods as well as nutrients need to be identified and evaluated. The effects of a food supplementation program on family diet patterns and protein-energy intake were investigated using data from nutritionally at risk families in Bogota, Colombia. Because food supplements are income transfers they need to substitute for purchases of similar food items. However, the results of our investigation reveal that food supplementation based on familiar foods that are part of the usual family diet are consumed in substantial quantities and result in net nutrient consumption increases. The food supplementation program increases consumption of preferred food items and introduces greater diversity into the family diet. These effects are enhanced when combined with a home education program.