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102. Supplementation during pregnancy with small‐quantity lipid‐based nutrient supplements or multiple micronutrients, compared with iron and folic acid, increases women's urinary iodine concentration in semiurban Ghana: A randomized controlled trial

Author

Adu‐Afarwuah, Seth, primary, Young, Rebecca T., additional, Lartey, Anna, additional, Okronipa, Harriet, additional, Ashorn, Per, additional, Ashorn, Ulla, additional, Zeilani, Mamane, additional, and Dewey, Kathryn G., additional

Published
2017
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104. Small-quantity, lipid-based nutrient supplements provided to women during pregnancy and 6 mo postpartum and to their infants from 6 mo of age increase the mean attained length of 18-mo-old children in semi-urban Ghana: a randomized controlled trial

Author

Adu-Afarwuah, Seth, Lartey, Anna, Okronipa, Harriet, Ashorn, Per, Peerson, Janet M, Arimond, Mary, Ashorn, Ulla, Zeilani, Mamane, Vosti, Stephen, and Dewey, Kathryn G

Subjects
Risk, Adult, Male, multiple micronutrients, lipid-based nutrient supplements, Ghana, Medical and Health Sciences, Suburban Health, Fetal Development, Child Development, Engineering, Double-Blind Method, Pregnancy, Prevalence, Humans, Lactation, Micronutrients, Infant Nutritional Physiological Phenomena, First, Growth Disorders, home fortification, Fetal Growth Retardation, Nutrition & Dietetics, Infant, Maternal Nutritional Physiological Phenomena, Newborn, Dietary Fats, Infant Nutrition Disorders, Body Height, child growth, Dietary Supplements, supplementation, Female, Pregnancy Trimester
Abstract

BackgroundChildhood stunting usually begins in utero and continues after birth; therefore, its reduction must involve actions across different stages of early life.ObjectiveWe evaluated the efficacy of small-quantity, lipid-based nutrient supplements (SQ-LNSs) provided during pregnancy, lactation, and infancy on attained size by 18 mo of age.DesignIn this partially double-blind, individually randomized trial, 1320 women at ≤20 wk of gestation received standard iron and folic acid (IFA group), multiple micronutrients (MMN group), or SQ-LNS (LNS group) daily until delivery, and then placebo, MMNs, or SQ-LNS, respectively, for 6 mo postpartum; infants in the LNS group received SQ-LNS formulated for infants from 6 to 18 mo of age (endline). The primary outcome was child length by 18 mo of age.ResultsAt endline, data were available for 85% of 1228 infants enrolled; overall mean length and length-for-age z score (LAZ) were 79.3 cm and -0.83, respectively, and 12% of the children were stunted (LAZ

Published
2016

105. Impact of small‐quantity lipid‐based nutrient supplement on hemoglobin, iron status and biomarkers of inflammation in pregnant Ghanaian women

Author

Adu‐Afarwuah, Seth, Lartey, Anna, Okronipa, Harriet, Ashorn, Per, Zeilani, Mamane, Baldiviez, Lacey M., Oaks, Brietta M., Vosti, Stephen, and Dewey, Kathryn G.

Subjects
Adult, Inflammation, Anemia, Iron-Deficiency, Iron, Nutritional Status, Protoporphyrins, Original Articles, Maternal Nutritional Physiological Phenomena, Ghana, Hemoglobins, Young Adult, C-Reactive Protein, Folic Acid, Double-Blind Method, Pregnancy, Dietary Supplements, Receptors, Transferrin, Prevalence, Humans, Female, Micronutrients, Biomarkers
Abstract

We examined hemoglobin (Hb, g/L), iron status (zinc protoporphyrin, ZPP, µmol/mol heme, and transferrin receptor, TfR, mg/L) and inflammation (C‐reactive protein, CRP and alpha‐1 glycoprotein, AGP) in pregnant Ghanaian women who participated in a randomized controlled trial. Women (n = 1320) received either 60 mg Fe + 400‐µg folic acid (IFA); 18 micronutrients including 20‐mg Fe (MMN) or small‐quantity lipid‐based nutrient supplements (SQ‐LNS, 118 kcal/d) with the same micronutrient levels as in MMN, plus four additional minerals (LNS) daily during pregnancy. Intention‐to‐treat analysis included 349, 354 and 354 women in the IFA, MMN and LNS groups, respectively, with overall baseline mean Hb and anemia (Hb 60) [9.4% vs. 18.6% and 19.2%; P = 0.003] and elevated TfR (>6.0) [9.0% vs. 19.2% and 15.1%; P = 0.004]. CRP and AGP concentrations did not differ among groups. We conclude that among pregnant women in a semi‐urban setting in Ghana, supplementation with SQ‐LNS or MMN containing 20 mg iron resulted in lower Hb and iron status but had no impact on inflammation, when compared with iron (60 mg) plus folic acid (400 µg). The amount of iron in such supplements that is most effective for improving both maternal Hb/iron status and birth outcomes requires further evaluation. This trial was registered at http://ClinicalTrials.gov as: NCT00970866.

Published
2016

106. A mixed method study exploring adherence to and acceptability of small quantity lipid-based nutrient supplements (SQ-LNS) among pregnant and lactating women in Ghana and Malawi

Author

Klevor, Moses K., Adu-Afarwuah, Seth, Ashorn, Per, Arimond, Mary, Dewey, Kathryn G., Lartey, Anna, Maleta, Kenneth, Phiri, Nozgechi, Pyykkö, Juha, Zeilani, Mamane, Ashorn, Ulla, Lääketieteen yksikkö - School of Medicine, and University of Tampere

Subjects
Adult, Malawi, Time Factors, Kansanterveystiede, ympäristö ja työterveys - Public health care science, environmental and occupational health, Clinical Trials and Supportive Activities, Reproductive health and childbirth, Nursing, Ghana, Paediatrics and Reproductive Medicine, Young Adult, Acceptability, Clinical Research, Pregnancy, Obstetrics and Gynaecology, parasitic diseases, Lactation, Humans, Small-quantity lipid-based nutrient supplements, Women, Micronutrients, Obstetrics & Reproductive Medicine, Nutrition, Pediatric, integumentary system, Naisten- ja lastentaudit - Gynaecology and paediatrics, Lipids, Adherence, Dietary Supplements, Public Health and Health Services, Patient Compliance, Female, Pregnant Women, Research Article
Abstract

Background Supplementing pregnant and lactating mothers with small quantity lipid-based nutrient supplements (SQ-LNS) has resulted in improvements in birth outcomes in some low-income settings. In order to be effective, SQ-LNS must be consumed regularly over sustained periods. Methods The objective was to assess and compare acceptability of and adherence to SQ-LNS consumption among pregnant and lactating women in Ghana and Malawi throughout 12 months of supplementation. We enrolled women before 20 gestation weeks into randomized trials in Ghana (n = 1320) and Malawi (n = 869). In the SQ-LNS group participants received a 20 g sachet of supplement per day during pregnancy and the first 6 months of lactation. In the control groups participants received multiple micronutrients (MMN) during pregnancy and lactation or iron and folic acid (IFA) during pregnancy and calcium during lactation. We used questionnaires to collect data on self-reported adherence to daily use of supplements and conducted in-depth interviews with women in the SQ-LNS group to examine acceptability. Results The mean self-reported adherence during the supplementation period was lower in Ghana (79.9 %) than in Malawi (91.7 %) for all supplements (difference 11.8 %, P

Published
2016

108. Effects of a lipid-based nutrient supplement during pregnancy and lactation on maternal plasma fatty acid status and lipid profile: Results of two randomized controlled trials

Author

Oaks, Brietta M., primary, Young, Rebecca R., additional, Adu-Afarwuah, Seth, additional, Ashorn, Ulla, additional, Jackson, Kristina H., additional, Lartey, Anna, additional, Maleta, Kenneth, additional, Okronipa, Harriet, additional, Sadalaki, John, additional, Baldiviez, Lacey M., additional, Shahab-Ferdows, Setti, additional, Ashorn, Per, additional, and Dewey, Kathryn G., additional

Published
2017
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111. Impact of small quantity lipid-based nutrient supplements on infant and young child feeding practices at 18 months of age: results from four randomized controlled trials in Africa

Author

Arimond, Mary, primary, Abbeddou, Souheila, additional, Kumwenda, Chiza, additional, Okronipa, Harriet, additional, Hemsworth, Jaimie, additional, Jimenez, Elizabeth Yakes, additional, Ocansey, Eugenia, additional, Lartey, Anna, additional, Ashorn, Ulla, additional, Adu-Afarwuah, Seth, additional, Vosti, Stephen A., additional, Hess, Sonja Y., additional, and Dewey, Kathryn G., additional

Published
2016
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113. Influence of childcare practices on nutritional status of Ghanaian children: a regression analysis of the Ghana Demographic and Health Surveys

Author

Amugsi, Dickson Abanimi, Mittelmark, Maurice B., Lartey, Anna, Matanda, Dennis Juma, and Urke, Helga Bjørnøy

Subjects
musculoskeletal diseases
Abstract

Objectives: Guided by the UNICEF framework for childcare, this study examined the association of childcare practices (CCP) with infant and young children’s growth (height-for-age Z-scores, HAZ), and investigated whether care practices are more important to growth in some sociodemographic subgroups of children. Design: Cross-sectional survey. Setting: Urban and rural Ghana. Participants: The study sample comprised 1187 dyads of mothers aged 15–49 years and their youngest child (aged 6–36 months). Results: The results showed that CCP was a significant predictor of HAZ, after controlling for covariates/confounders at child, maternal and household levels. Children with higher CCP scores had higher HAZ. A 1-unit increase in the CCP score was associated with a 0.17-unit increase in HAZ. Child’s and mother’s age, number of children under 5 years, place of residence, maternal weight and wealth index were also significantly associated with HAZ. Statistical interaction analyses revealed no subgroup differences in the CCP/HAZ relationship. Conclusions: This study found a significant, positive association between CCP and child growth, after accounting for other important determinants of child growth at maternal and household levels. This calls for research into the effects on growth of various CCP components, with longitudinal cohort study designs that can disentangle causal relationships. publishedVersion

Published
2014

114. Influence of childcare practices on nutritional status of Ghanaian children: a regression analysis of the Ghana Demographic and Health Surveys

Author

Amugsi, Dickson A, Mittelmark, Maurice B, Lartey, Anna, Matanda, Dennis J, and Urke, Helga B

Subjects
musculoskeletal diseases, Male, Epidemiology, Research, Infant, Nutritional Status, Ghana, Health Surveys, Cross-Sectional Studies, Child, Preschool, Humans, Regression Analysis, Female, Child Care
Abstract

Objectives Guided by the UNICEF framework for childcare, this study examined the association of childcare practices (CCP) with infant and young children's growth (height-for-age Z-scores, HAZ), and investigated whether care practices are more important to growth in some sociodemographic subgroups of children. Design Cross-sectional survey. Setting Urban and rural Ghana. Participants The study sample comprised 1187 dyads of mothers aged 15–49 years and their youngest child (aged 6–36 months). Results The results showed that CCP was a significant predictor of HAZ, after controlling for covariates/confounders at child, maternal and household levels. Children with higher CCP scores had higher HAZ. A 1-unit increase in the CCP score was associated with a 0.17-unit increase in HAZ. Child's and mother's age, number of children under 5 years, place of residence, maternal weight and wealth index were also significantly associated with HAZ. Statistical interaction analyses revealed no subgroup differences in the CCP/HAZ relationship. Conclusions This study found a significant, positive association between CCP and child growth, after accounting for other important determinants of child growth at maternal and household levels. This calls for research into the effects on growth of various CCP components, with longitudinal cohort study designs that can disentangle causal relationships.

Published
2014

116. Linear Growth and Child Development in Burkina Faso, Ghana, and Malawi

Author

Prado, Elizabeth L., primary, Abbeddou, Souheila, additional, Adu-Afarwuah, Seth, additional, Arimond, Mary, additional, Ashorn, Per, additional, Ashorn, Ulla, additional, Brown, Kenneth H., additional, Hess, Sonja Y., additional, Lartey, Anna, additional, Maleta, Kenneth, additional, Ocansey, Eugenia, additional, Ouédraogo, Jean-Bosco, additional, Phuka, John, additional, Somé, Jérôme W., additional, Vosti, Steve A., additional, Yakes Jimenez, Elizabeth, additional, and Dewey, Kathryn G., additional

Published
2016
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127. Dietary patterns in Liberian refugees in Buduburam, Ghana.

Author

Ross, Wilhelmenia L., Gallego‐Pérez, Daniel F., Lartey, Anna, Sandow, Adam, Pérez‐Escamilla, Rafael, and Hromi‐Fiedler, Amber

Subjects
ACCULTURATION, COMPARATIVE studies, DIET, FACTOR analysis, HEALTH behavior, MOTHERS, MULTIVARIATE analysis, NUTRITIONAL assessment, PROBABILITY theory, QUESTIONNAIRES, REFUGEES, RESEARCH funding, SELF-evaluation, CROSS-sectional method, DATA analysis software, DESCRIPTIVE statistics
Abstract

Previous research suggests that acculturation (i.e., exposure and assimilation to local culture) is associated with changes in dietary patterns among immigrants. This study investigates this association in a refugee population using time in refugee settlement as a proxy for acculturation. A cross-sectional survey was conducted among a systematic sample to (a) identify dietary patterns in Liberian refugees and Ghanaians living in or near a refugee settlement, (b) compare adherence to these dietary patterns between groups, and (c) investigate the association between acculturation and dietary patterns in Liberian refugees. Participants were Liberian and Ghanaian women with young children living in the Buduburam refugee settlement or Awutu in Ghana ( n = 480; 50% Liberian; mean age 28, SD 6.3, range 16-48 years). Time in settlement was assessed by self-report; food consumption was assessed by food frequency questionnaire. Principal component analysis was used to identify dietary patterns; a generalized linear model was used to test the association of interest. Three distinct dietary patterns emerged: Healthy, Sweets, and Fats. Ghanaians were more adherent to the Healthy pattern than Liberians ( p < 0.05). Liberians were more adherent to the Sweets and Fats patterns than Ghanaians ( p < 0.05). There were no significant differences in dietary pattern adherence among the Liberians based on time in settlement. Ghanaians living in Awutu were more adherent to the Healthy pattern than Ghanaians who lived in settlement ( p < 0.05). Differences in dietary patterns were observed between Liberian refugees and Ghanaians. These differences were not associated with acculturation and may be related to the food environment in the settlement. [ABSTRACT FROM AUTHOR]

Published
2017
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128. Food in the Anthropocene: the EAT–LancetCommission on healthy diets from sustainable food systems

Author

Willett, Walter, Rockström, Johan, Loken, Brent, Springmann, Marco, Lang, Tim, Vermeulen, Sonja, Garnett, Tara, Tilman, David, DeClerck, Fabrice, Wood, Amanda, Jonell, Malin, Clark, Michael, Gordon, Line J, Fanzo, Jessica, Hawkes, Corinna, Zurayk, Rami, Rivera, Juan A, De Vries, Wim, Majele Sibanda, Lindiwe, Afshin, Ashkan, Chaudhary, Abhishek, Herrero, Mario, Agustina, Rina, Branca, Francesco, Lartey, Anna, Fan, Shenggen, Crona, Beatrice, Fox, Elizabeth, Bignet, Victoria, Troell, Max, Lindahl, Therese, Singh, Sudhvir, Cornell, Sarah E, Srinath Reddy, K, Narain, Sunita, Nishtar, Sania, and Murray, Christopher J L

Published
2019
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140. Willingness-to-Pay for LNS Products: Evidence from the iLiNS Studies

Author

Vosti, Stephen, primary, Adams, Katherine, additional, Ayifah, Emmanuel, additional, Guissou, Rosemonde, additional, Phiri, Thokozani, additional, Ashorn, Per, additional, Lartey, Anna, additional, Maleta, Ken, additional, Ouedraogo, Jean, additional, Dewey, Kathryn, additional, and Lybbert, Travis, additional

Published
2015
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141. Impact of Small-quantity Lipid-based Nutrient Supplements on Infant and Young Child Feeding Practices

Author

Arimond, Mary, primary, Abbeddou, Souheila, additional, Adu-Afarwuah, Seth, additional, Ashorn, Ulla, additional, Brown, Kenneth, additional, Hemsworth, Jaimie, additional, Hess, Sonja, additional, Jimenez, Elizabeth, additional, Kumwenda, Chiza, additional, Lartey, Anna, additional, Okronipa, Harriet, additional, Ouedraogo, Jean-Bosco, additional, Vosti, Stephen, additional, and Dewey, Kathryn, additional

Published
2015
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142. A randomized, community-based trial of the effects of improved, centrally processed complementary foods on growth and micronutrient status of Ghanaian infants from 6 to 12 mo of age

Author

Lartey, Anna, Manu, Alhassan, Brown, Kenneth H, Peerson, Janet M, and Dewey, Kathryn G

Subjects
Infants -- Food and nutrition, Cereal products -- Health aspects, Enriched cereal products -- Evaluation, Food/cooking/nutrition, Health
Abstract

Background: Koko, a fermented maize porridge used as the primary complementary food in Ghana, has been implicated in the high prevalence of child malnutrition. Weanimix, a cereal-legume blend developed by the United Nations Children's Fund and the Ghanaian government, has been promoted as an alternative. Objective: We evaluated the effect of feeding Weanimix and 3 other locally formulated, centrally processed complementary foods on the nutritional status of 208 breast-fed infants. Design: Infants were randomly assigned to receive 1 of 4 foods from 6 to 12 mo of age: Weanimix (W), Weanimix plus vitamins and minerals (WM), Weanimix plus fish powder (WF), and koko plus fish powder (KF). Dietary and anthropometric data were collected regularly. Blood was collected at 6 and 12 mo of age to assess iron, zinc, vitamin A, and riboflavin status. Before and after the intervention, cross-sectional data on the anthropometric status of infants not included in the intervention (NI; n = 464) were collected. Results: There were no significant differences between intervention groups in weight or length gain or in hemoglobin, hematocrit, transferrin saturation, plasma zinc, or erythrocyte riboflavin values between 6 and 12 mo of age. From 9 to 12 mo of age, z scores were lower in NI infants than in the combined intervention groups [at 12 mo: -1.71 [+ or -] 0.90 compared with -1.19 [+ or -] 0.93 for weight and -1.27 [+ or -] 1.02 compared with -0.63 [+ or -] 0.84 for length (P [is less than] 0.001 for both), respectively]. The percentage of infants with low ferritin values increased significantly between 6 and 12 mo of age in groups W, WF, and KF but not in group WM. Change in plasma retinol between 6 and 12 mo of age was significantly greater in group WM than in the other 3 groups combined (0.14 [+ or -] 0.3 compared with -0.04 [+ or -] 0.3 [micro]mol/L, P = 0.003). Conclusions: All 4 foods improved growth relative to the NI group. Infants fed WM had better iron stores and vitamin A status than those fed nonfortified foods. Am J Clin Nutr 1999;70:391-404. KEY WORDS Complementary feeding, breast-feeding, infant growth, micronutrient status, iron, zinc, vitamin A, riboflavin, Ghana, energy density, Weanimix, koko, fermented maize porridge

Published
1999

143. The impact of lipid-based nutrient supplement provision to pregnant women on newborn size in rural Malawi: a randomized controlled trial

Author

Ashorn, Per, primary, Alho, Lotta, additional, Ashorn, Ulla, additional, Cheung, Yin Bun, additional, Dewey, Kathryn G, additional, Harjunmaa, Ulla, additional, Lartey, Anna, additional, Nkhoma, Minyanga, additional, Phiri, Nozgechi, additional, Phuka, John, additional, Vosti, Stephen A, additional, Zeilani, Mamane, additional, and Maleta, Kenneth, additional

Published
2014
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150. Maternal and child nutrition: building momentum for impact

Author

Black, Robert E, primary, Alderman, Harold, additional, Bhutta, Zulfiqar A, additional, Gillespie, Stuart, additional, Haddad, Lawrence, additional, Horton, Susan, additional, Lartey, Anna, additional, Mannar, Venkatesh, additional, Ruel, Marie, additional, Victora, Cesar G, additional, Walker, Susan P, additional, and Webb, Patrick, additional

Published
2013
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