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The problem of poor nutrition with impaired growth persists in young children worldwide, including in India, where wasting occurs in 20% of urban children (&lt, 5 years). Exacerbating this problem, some children are described by their parent as a picky eater with behaviors such as eating limited food and unwillingness to try new foods. Timely intervention can help prevent nutritional decline and promote growth recovery, oral nutritional supplements (ONS) and dietary counseling (DC) are commonly used. The present study aimed to determine the effects of ONS along with DC on growth in comparison with the effects of DC only. Enrolled children (N = 321) were &gt, 24 to ≤48 months old, at malnutrition risk (weight-for-height percentile 3rd to 15th), and described as a picky eater by their parent. Enrollees were randomized to one of the three groups (N = 107 per group): ONS1 + DC, ONS2 + DC, and DC only. From day 1 to day 90, study findings showed significant increases in weight-for-height percentile for ONS1 + DC and for ONS2 + DC interventions, as compared to DC only (p = 0.0086 for both). There was no significant difference between the two ONS groups. Anthropometric measurements (weight and body mass index) also increased significantly over time for the two ONS groups (versus DC only, p &lt, 0.05), while ONS1 + DC significantly improved mid-upper-arm circumference (p &lt, 0.05 versus DC only), as well. ONS groups showed a trend toward greater height gain when compared to DC only group, but the differences were not significant within the study interval. For young Indian children with nutritional risk and picky eating behaviors, our findings showed that a 90-day nutritional intervention with either ONS1 or ONS2, along with DC, promoted catch-up growth more effectively than did DC alone.

FIGURE 1. A, Chest x-ray showing the picture mimicking tension hydropneum abdomen showing the herniation of the stomach and left lobe of the liver. D, Ch left lung. From the Department of Gastroenterology, Minimal Access Surgery, Cardiothoracic Surgery, and Radiology, Sahara Hospital, Lucknow, India. Disclosures: Authors have nothing to disclose with regard to commercial support. Received for publication Nov 19, 2009; accepted for publication Nov 26, 2009; available ahead of print Feb 22, 2010. Address for reprints: Sanjay K. Somani, MD, DM, Department of Gastroenterology, Sahara Hospital, Viraj Khand, Lucknow-226010, UP, India (E-mail: sanjayksomani@rediffmail.com). J Thorac Cardiovasc Surg 2011;141:300-1 0022-5223/$36.00 Copyright 2011 by The American Association for Thoracic Surgery doi:10.1016/j.jtcvs.2009.11.062