Exposure to a Slightly Sweet Lipid-Based Nutrient Supplement During Early Life Does Not Increase the Preference for or Consumption of Sweet Foods and Beverages by 4–6-y-Old Ghanaian Preschool Children: Follow-up of a Randomized Controlled Trial

Harriet Okronipa,Mary Arimond,Rebecca R Young,Charles D Arnold,Seth Adu-Afarwuah,Solace M Tamakloe,Helena J Bentil,Maku E Ocansey,Sika M Kumordzie,Brietta M Oaks,Kathryn G Dewey

doi:10.1093/jn/nxy293

Abstract

ABSTRACTBackgroundWhether consuming sweet foods early in life affects sweet food preferences and consumption later in childhood is unknown.ObjectiveWe tested the hypothesis that exposure to a slightly sweet lipid-based nutrient supplement (LNS) early in life would not increase preference for or consumption of sweet items at preschool age.MethodsWe followed up children who had participated in a randomized trial in Ghana in which LNS was provided to 1 group of women during pregnancy and 6 mo postpartum and to their infants from ages 6–18 mo (LNS group). The control group (non-LNS group) received iron and folic acid during pregnancy or multiple micronutrients during pregnancy and 6 mo postpartum, with no infant supplementation. At 4–6 y, we obtained data from caregivers on children's food and beverage preferences and consumption (n = 985). For a randomly selected subsample (n = 624), we assessed preference for sweet items using a photo game (range in potential scores, 0–15). For the photo game and reported consumption of sweet items, we examined group differences using predetermined noninferiority margins equivalent to an effect size of 0.2.ResultsMedian (quartile 1, quartile 3) reported consumption of sweet items (times in previous week) was 14 (8, 23) in the LNS group and 16 (9, 22) in the non-LNS group; in the photo game, the number of sweet items selected was 15 (11, 15) and 15 (11, 15), respectively. The upper level of the 95% CI of the mean difference between LNS and non-LNS groups did not exceed the noninferiority margins for these outcomes. Caregiver-reported preferences for sweet items also did not differ between groups (P = 0.9).ConclusionIn this setting, where child consumption of sweet foods was common, exposure to a slightly sweet LNS early in life did not increase preference for or consumption of sweet foods and beverages at preschool age. This trial was registered at clinicaltrials.gov as NCT00970866.

Highlights

The prevalence of childhood overweight and obesity worldwide remains high [1, 2]
To rule out any potential adverse effects, we tested the hypothesis that the preference for or consumption of sweet foods and beverages by children who were exposed to lipid-based nutrient supplement (LNS) early in life would not be higher than those of children who were never exposed to LNS, using a noninferiority approach
We obtained data from caregivers on child food and beverage preference and consumption for 985 children (345, LNS; 640, non-LNS), which constituted 74.6% of all women who were enrolled into the parent trial and 80.6% of participants who

Summary

Introduction

The prevalence of childhood overweight and obesity worldwide remains high [1, 2]. This is a cause for concern because childhood overweight is a risk factor for adult obesity and its consequences [3]. Objective: We tested the hypothesis that exposure to a slightly sweet lipid-based nutrient supplement (LNS) early in life would not increase preference for or consumption of sweet items at preschool age. For the photo game and reported consumption of sweet items, we examined group differences using predetermined noninferiority margins equivalent to an effect size of 0.2. Conclusion: In this setting, where child consumption of sweet foods was common, exposure to a slightly sweet LNS early in life did not increase preference for or consumption of sweet foods and beverages at preschool age. This trial was registered at clinicaltrials.gov as NCT00970866.

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Results

Conclusion