Abstract
Evidence on whether nutritional supplementation affects physical activity (PA) during early childhood is limited. We examined the long-term effects of lipid-based nutrient supplements (LNS) on total PA, moderate-to-vigorous PA (MVPA) and sedentary behaviour (SB) of children at 4–6 years using an accelerometer for 1 week. Their mothers were enrolled in the International Lipid-based Nutrient Supplement-DYAD randomised controlled trial in Ghana, assigned to daily LNS or multiple micronutrients (MMN) during pregnancy through 6 months postpartum or Fe and folic acid (IFA) during pregnancy and placebo for 6 months postpartum. From 6 to 18 months, children in the LNS group received LNS; the other two groups received no supplements. Analysis was done with intention to treat comparing two groups: LNS v. non-LNS (MMN+ IFA). Of the sub-sample of 375 children fitted with accelerometers, 353 provided sufficient data. Median vector magnitude (VM) count was 1374 (interquartile range (IQR) 309), and percentages of time in MVPA and SB were 4·8 (IQR 2) and 31 (IQR 8) %, respectively. The LNS group (n 129) had lower VM (difference in mean −73 (95 % CI −20, −126), P = 0·007) and spent more time in SB (LNS v. non-LNS: 32·3 v. 30·5 %, P = 0·020) than the non-LNS group (n 224) but did not differ in MVPA (4·4 v. 4·7 %, P = 0·198). Contrary to expectations, provision of LNS in early life slightly reduced the total PA and increased the time in SB but did not affect time in MVPA. Given reduced social-emotional difficulties in the LNS group previously reported, including hyperactivity, one possible explanation is less restless movement in the LNS group.
Highlights
The foundations for health behaviours such as physical activity (PA) and sedentary behaviour (SB) are laid from a very young age[1] and have long-term consequences for health and development
We hypothesised that lipidbased nutrient supplements (LNS) supplementation during pregnancy, postpartum and infancy would increase PA and lower SB at 4–6 years compared with maternal Fe and folic acid (IFA) supplementation during pregnancy only, or multiple micronutrient (MMN) supplementation during pregnancy and through 6 months postpartum
TV ownership did not differ by intervention group (LNS = 86·8 %; nonLNS = 84·8 %; P = 0·607). In this follow-up study to assess the long-term effects of a randomised controlled trial of maternal and infant supplementation with small-quantity LNS on the PA and SB of children in Ghana, we found significant but relatively small differences between LNS-supplemented and non-LNS children at preschool age, in the opposite direction of what was expected
Summary
The foundations for health behaviours such as physical activity (PA) and sedentary behaviour (SB) are laid from a very young age[1] and have long-term consequences for health and development. Deficiencies in micronutrients, Fe[16,17,18] and Zn[19,20], are associated with reduced PA in early childhood; evidence for the effects of micronutrient supplementation during early life on behavioural PA in randomised trials has been mixed[19,20,21,22,23,24,25,26,27,28], and only two such studies[25,26] have used accelerometers to measure PA outcomes. We investigated the long-term effects of maternal LNS during pregnancy and 6 months postpartum and infant supplementation from 6 to 18 months of age on PA and SB at age 4–6 years measured using accelerometers. We hypothesised that LNS supplementation during pregnancy, postpartum and infancy would increase PA and lower SB at 4–6 years compared with maternal Fe and folic acid (IFA) supplementation during pregnancy only, or MMN supplementation during pregnancy and through 6 months postpartum
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