Four‐year Longitudinal Analysis of the Nutritional Status of Children Ages 6 to 84 Months that Have Received a Micronutrient Fortified Beverage

Abstract

Since 2010, six Guatemala City Municipal Nurseries were provided a 21 micronutrient fortified corn and soy beverage that contains chelated forms of zinc (9mg) and iron (12mg) to address micronutrient deficiencies among children ages 6 to 84 months that attend the daycare centers for 5 days/week. The main objective of this study was to carry out a four‐year longitudinal analysis of the nutritional status of stunted children that have attended the nurseries. A total of 491 children with stunting (height‐for‐age Z scores (HAZ) <‐2SD) at enrollment were identified. Height and weight measurements were collected at the beginning and before the end of every school year. Hemoglobin (Hb) was assessed in a subsample of individuals at the beginning and before the end of the school year for the first year, and in subsequent years only at the end of the school year; concentrations were adjusted for an elevation of 1500m. A multivariate mixed model analysis was performed to evaluate the relationship between time of intervention and HAZ, and Hb concentrations. To assess prevalence of stunting and anemia across time, a multivariate generalized linear mixed model was performed. We observed that mean HAZ score (baseline HAZ=−2.54SD) improved over time by 0.02 SD per month (F=609.56, df=1, 1159.16 p<0.001) after controlling for sex; and on average, the odds of having stunting decreased by ~11% for every month the child received the nutrition intervention, OR=0.89 95% CI (0.88–0.91), p<0.001, controlling for sex. For those stunted children with anemia at baseline, the odds of having anemia decreased on average by 11% for every month of receiving the nutritional intervention, OR: 0.89, 95% CI (0.85–0.93), p<0.001. We also observed a significant increase in mean Hb concentrations (F=81.59, df=1, 102.00, p<0.001) in anemic children at baseline (mean Hb=10.45g/dL) and the next measurement after ten months (12.30g/dL). The Hb concentrations were maintained within normal ranges (≥11.60g/dL) in all subsequent measurements. This analysis demonstrates that the nutrition program at the Guatemala City Municipal nurseries is effective in reducing the prevalence of stunting and anemia, and in improving mean HAZ and Hb concentrations in stunted children from 6 to 84 months of age.Support or Funding InformationThis research was sponsored in part by the Mathile Institute for the Advancement of Human Nutrition.