An Atole Fortified with 21 Vitamins and Minerals Improves Nutritional Status of 6 to 72 Month‐Old Children in 6 Nurseries in Guatemala City

Abstract

Chispuditos® is a corn/soy atole fortified with 21 vitamins and minerals designed to reduce micronutrient deficiency of Central American children. A portion of atole (18.75g) was provided for 5 days/week to 6‐72 month‐old children. Seven hundred and forty seven children completed 1 year of the nutritional intervention. Hemoglobin, anthropometry and incidence of respiratory tract infections and diarrhea were analyzed at baseline, six months and one year. Repeated measures ANOVA indicated an increase in hemoglobin from baseline=11.76±1.17g/dL to endline=12.39±1.05 g/dL, p<0.001. HAZ scores increased from ‐1.25±1.02 to ‐1.07±0.96, p<0.001 over the time course of the intervention. Furthermore, there was a 57.1% reduction in respiratory tract infections, p<0.001 after 12 months. No changes in the incidence of diarrhea from baseline to one year were observed. Overall, children in this study had an improvement in HAZ scores, hemoglobin concentrations and respiratory tract infections after 12 months of intervention, while previous studies in comparable settings took approximately 24 months for HAZ scores to improve.Funded by The Mathile Institute for the Advancement of Human Nutrition.

Childhood stunting and micronutrient status unaffected by RCT of micronutrient fortified drink

“…This trial found that 18 months' use of a liquid food supplement fortified with micronutrients had no impact on either the growth or the micronutrient status of rural Guatemalan infants and preschool children, compared with an isoenergetic lactose‐free milk. This is disappointing, as reduction in the rates of stunting and IDA was observed when the same atole + MN (Chispuditos®) was given as a supplement to urban toddlers in an uncontrolled study in nurseries in Guatemala City (Villanueva et al, 2015 ; Villanueva & Reinhart, 2013 ).…”

“…In order to increase the acceptability and thus compliance with supplementation programmes, a drink‐based supplement (Chispuditos®) was developed, which was fortified with high levels of zinc iron and other vitamins and minerals, thought to be important for longitudinal growth. This novel food was administered in two different longitudinal cohorts of toddlers attending nurseries in Guatemala city over a period of 2.5 and 4 years with pre‐ and post‐measurements of growth and findings suggesting small but promising improvements in stunting and iron status (Villanueva et al, 2015 ; Villanueva & Reinhart, 2013 ). Thus, the aim of this study was to test in a randomised control trial (RCT) the hypothesis that providing extra micronutrients via this culturally acceptable liquid food over an extended period would reduce stunting, improve zinc and iron status and reduce morbidity compared to an energy/protein‐matched milk with no added micronutrients.…”