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BACKGROUND/OBJECTIVES: This study measured the effects of dietary supplementation with lipid-based nutrient supplements (LNSs) on 18-month-old children's physical activity. SUBJECTS/METHODS: In a randomised, controlled, outcome-assessor blinded trial 1932 six-month-old children from Malawi received one of five interventions daily from 6-18 months of age: 10-g milk-LNS, 20-g milk-LNS, 20-g non-milk-LNS, 40-g milk-LNS or 40-g non-milk-LNS, or received no intervention in the same period (control). The control group received delayed intervention with corn-soy blend from 18-30 months. Physical activity was measured over 1 week by ActiGraph GT3X+ accelerometer at 18 months. Main outcome was mean vector magnitude accelerometer counts/15 s. Analyses were restricted to children with valid accelerometer data on at least 4 days with minimum 6 h of wearing time per day. RESULTS: Of the 1435 children recruited to this substudy, 1053 provided sufficient data for analysis. The mean (s.d.) vector magnitude accelerometer counts in the total sample were 307 (64). The difference (95% CI) in mean accelerometer counts, compared with the control group, was 8 (-6 to 21, P = 0.258) in 10-g milk-LNS, 3 (-11 to 17, P = 0.715) in 20-g milk-LNS, 5 (-8 to 19, P = 0.445) in 20-g non-milk-LNS, 10 (-3 to 23, P = 0.148) in 40-g milk-LNS and 2 (-12 to 16, P = 0.760) in 40-g non-milk-LNS groups. CONCLUSIONS: Provision of 10-40 g doses of LNS daily for 12 months did not increase physical activity of Malawian toddlers. European Journal of Clinical Nutrition (2015) 69, 173-178; doi:10.1038/ejcn.2014.138; published online 16 July 2014, INTRODUCTION Lipid-based nutrient supplements (LNSs) provide energy, protein, essential fatty acids and multiple micronutrients in a form that has a long shelf life, is palatable and is easy to consume. [...]