Ready-to-Use Supplementary Food Increases Fat Mass and BMI in Haitian School-Aged Children

Iannotti, Lora; Henretty, Nicole; Delnatus, Jacques Raymond; Previl, Windy; Stehl, Tom; Vorkoper, Susan; Bodden, Jaime; Maust, Amanda; Smidt, Rachel; Nash, Marilyn; Tamimie, Courtney; Owen, Bridget C; Wolff, Patrícia

doi:10.3945/jn.114.203182

Cited by 19 publications

(39 citation statements)

References 27 publications

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“…The fortified snack, Mamba, reduced the odds of anemia by 28% compared with control for individual children. 9 Mamba contains higher levels of critical micronutrients than the cereal bar, suggesting a potential role for nutrient deficiencies in causing anemia. Our analysis supported this hypothesis by showing an association between vitamin A supplementation and ASF consumption and Hb concentration and anemia outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Details of the trial are described elsewhere. 9 In brief, children were considered eligible based on the following criteria: aged 3-13 years; good health (no fever, congenital health condition, or peanut or soy allergy); not severely malnourished (weight-for-height z score [WHZ] < −3); and registration in study school for 2012-2013. Of the 1,169 eligible children, 1,167 were enrolled; for this analysis, we included *Address correspondence to Lora L. Iannotti, Washington University in St. Louis, Campus Box 1196, St. Louis, MO 63130.…”

Section: Methodsmentioning

confidence: 99%

“…9 At the start of the study, anemia was found to be highly prevalent (73.3%) across all children. Although a small, positive effect was found for reduced odds of developing anemia among children receiving the Mamba nutrition intervention compared with the control (adjusted odds ratio [OR]: 0.72, 95% confidence interval [CI]: 0.57-0.91, P < 0.001), there were no evident differences by group for increased Hb concentration or for overall reduced anemia prevalence.…”

Section: Introductionmentioning

confidence: 93%

“…Although a small, positive effect was found for reduced odds of developing anemia among children receiving the Mamba nutrition intervention compared with the control (adjusted odds ratio [OR]: 0.72, 95% confidence interval [CI]: 0.57-0.91, P < 0.001), there were no evident differences by group for increased Hb concentration or for overall reduced anemia prevalence. 9 These findings raised questions regarding other potential causes of anemia among Haitian school-aged children. In this analysis, we aimed to investigate the observed determinants of Hb concentration, anemia, and severe anemia collected from the intervention trial, in recognition of the limitations presented by applying proxy markers, but with the intent to use the findings as a basis for further study.…”

Section: Introductionmentioning

confidence: 99%

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Determinants of Anemia and Hemoglobin Concentration in Haitian School-Aged Children

Iannotti¹,

Delnatus²,

Odom³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Anemia diminishes oxygen transport in the body, resulting in potentially irreversible growth and developmental consequences for children. Limited evidence for determinants of anemia exists for school-aged children. We conducted a cluster randomized controlled trial in Haiti from 2012 to 2013 to test the efficacy of a fortified school snack. Children (N = 1,047) aged 3-13 years were followed longitudinally at three time points for hemoglobin (Hb) concentrations, anthropometry, and bioelectrical impedance measures. Dietary intakes, infectious disease morbidities, and socioeconomic and demographic factors were collected at baseline and endline. Longitudinal regression modeling with generalized least squares and logit models with random effects identified anemia risk factors beyond the intervention effect. At baseline, 70.6% of children were anemic and 2.6% were severely anemic. Stunting increased the odds of developing anemia (adjusted odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.05-2.08) and severe anemia (adjusted OR: 2.47, 95% CI: 1.30-4.71). Parent-reported vitamin A supplementation and deworming were positively associated with Hb concentrations, whereas fever and poultry ownership showed a negative relationship with Hb concentration and increased odds of severe anemia, respectively. Further research should explore the full spectrum of anemia etiologies in school children, including genetic causes.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Determinants of Anemia and Hemoglobin Concentration in Haitian School-Aged Children

Iannotti¹,

Delnatus²,

Odom³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…Our previous trial in six urban schools of Cap-Haitien aimed to test the effects of a fortified peanut butter snack, Vita Mamba (then called Mamba), on anemia and other nutrition outcomes [5]. Vita Mamba contains 260 kcal and meets >75% of the Recommended Dietary Allowance (RDA) for critical micronutrients for children in the age range, 4–8 years.…”

Section: Introductionmentioning

confidence: 99%

Fortified Snack Reduced Anemia in Rural School-Aged Children of Haiti: A Cluster-Randomized, Controlled Trial

et al. 2016

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BackgroundNutrition in the school-aged child matters for brain development and public policy investments globally. Our group previously conducted a trial in urban schools of Haiti to examine the effects of a fortified peanut butter snack, Vita Mamba, with limited findings for anemia.ObjectiveWe aimed to test the hypothesis that Vita Mamba, with systematic deworming in both study arms, would significantly reduce anemia among rural, school-aged children.MethodsA cluster, randomized longitudinal study was conducted in two rural communities of the North-East Department of Haiti, 2014–2015. Healthy children ages 3–16 years were enrolled (n = 321) and assigned by school to intervention (Vita Mamba and deworming) and control (deworming). Vita Mamba contains 260 kcal and meets >75% of the Recommended Dietary Allowance for critical micronutrients. Multivariate regression analyses including propensity score matching techniques to correct for potential group imbalance (Kernel-based Matching and Propensity Score Weighting) were applied to examine difference-in-difference intervention effects.ResultsAt baseline, 51% of the children were anemic with no significant differences between study groups. Vita Mamba supplementation showed a consistent, positive effect across regression models on increasing Hb concentration and reducing the odds of anemia compared to the control group after adjusting for child age, vitamin A supplementation, milk consumption, and height-for-age z score. The average treatment effect for the treated in the Propensity Score Weighting models was 0.62±0.27 grams per 100 milliliters (g/dL) for Hb concentration (F = 4.64, P = 0.001), and the odds of anemia were reduced by 88% (Wald χ² = 9.77, P = 0.02). No differences in change in anthropometric markers were evident.ConclusionsSchool feeding programs that integrate fortified foods with deworming could reduce anemia burden with important implications for learning, health, and well-being. The rural-urban differences in anemia require further study.

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Land degradation and the link to increased livelihood vulnerabilities among indigenous populations in the Andes of Ecuador

Blackmore

Iannotti

Rivera³

et al. 2021

Land Use Policy

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Ready-to-Use Supplementary Food Increases Fat Mass and BMI in Haitian School-Aged Children

Abstract: To our knowledge, this is the first study to give evidence of body composition effects from an RUSF in school-aged children.

Cited by 19 publications

References 27 publications

Determinants of Anemia and Hemoglobin Concentration in Haitian School-Aged Children

Determinants of Anemia and Hemoglobin Concentration in Haitian School-Aged Children

Fortified Snack Reduced Anemia in Rural School-Aged Children of Haiti: A Cluster-Randomized, Controlled Trial

Land degradation and the link to increased livelihood vulnerabilities among indigenous populations in the Andes of Ecuador

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