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Micronutrient supplementation is widely used to prevent stunting in children under 5 years in low‐ and middle‐income countries (LMIC), but the impact of treatment has been disappointing, possibly due to non‐compliance. Our aim was to deliver long‐term micronutrient supplementation via a novel, culturally acceptable liquid food to improve linear growth in a high stunting prevalence region. In a randomised control trial, 971 children aged 6–72 months received either 'Chispuditos®' (n = 681), a hot drink (atole) fortified with micronutrients (atole + MN) (9 mg/zinc, 12.5 mg/iron), or lactose‐free milk (n = 290) for 18 months. Primary outcomes were changes in length/height‐for‐age (HAZ) score and the prevalence of stunting at 18‐month follow‐up. Adherence was monitored monthly, and 73% children in atole + MN group consumed at least half their daily zinc and iron requirement. At 18 months, there was no difference between the treatments in growth [mean change in HAZ −0.02 (95% CI −0.12, 0.08)] or stunting [atole + MN 41%, milk 41%; RR 0.99 (95% CI 0.84, 1.19)]. There were no differences in haemoglobin (HB), ferritin or zinc. No children had iron deficiency anaemia (IDA) at outcome, but zinc deficiency remained equally prevalent in both groups: atole + MN 35%, milk 35% [RR 1.02 (95% CI 0.83, 1.24)]. There was no difference in morbidity between the groups, and micronutrient status was unrelated to HAZ. Long‐term micronutrient supplementation via a culturally acceptable food had no impact on stunting or morbidity, raising the question of whether large‐scale micronutrient supplementation is worthwhile. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to describe the prevalence of undernutrition in hospitalised infants aged under 6 months and test the utility of simple index measures to detect undernutrition.Design: Diagnostic accuracy study: weight, length, mid-upper arm circumference (MUAC), triceps and subscapular skinfolds were measured in infants aged 2 weeks to 6 months admitted to a Teaching Hospital in Enugu, Nigeria. Index criteria : low (<-2SD) weight-for-age Z-scores (WAZ), weight-for-length Z-scores (WLZ); MUAC <11 cm. Reference definition: weight faltering (conditional weight gain below fifth percentile for healthy Nigerian infants) or sum of skinfolds (SSF) <10 mm.Results: Of 125 hospitalised infants, only 5% (6) were admitted specifically for undernutrition, but low SSF were found in 33% (41) and, 24% (25) with known birth weight had weight faltering, giving an undernutrition prevalence of 36%. Low WAZ was the most discriminating predictor of undernutrition (sensitivity 69%, positive predictive value 86%, likelihood ratio 5.5; area under receiver operator curves 0.90) followed by MUAC (73%, 73%, 4.9; 0.86), while WLZ performed least well (49%, 67%, 2.9; 0.84). Where both MUAC and WAZ were low, there was sensitivity 90%, positive predictive value 82% and likelihood ratio 8.7.Conclusions: Infants aged under 6 months admitted to hospital in Nigeria had a high prevalence of undernutrition. In young, high-risk population, a low WAZ alone was a valuable screening criterion, while combining weight with MUAC gave even higher discrimination. Measurement of length to calculate WLZ was a less useful predictor in this population. [ABSTRACT FROM AUTHOR]

Fruits and vegetables (F&V) are often featured in names of commercial baby foods (CBFs). We aimed to survey all available CBFs in the UK market with F&V included in the food name in order to describe the amount and types of F&V used in CBF and their contribution to total sugar content. Food labels were used to identify F&V and total sugar content. Fruits were more common than vegetables in names of the 329 CBFs identified. The six most common F&V in the names were all relatively sweet: apple, banana, tomato, mango, carrot and sweet potato. The percentage of F&V in the foods ranged from a median of 94% for sweet-spoonable to 13% for dry-savoury products. Fruit content of sweet foods (n = 177) was higher than vegetable content of savoury foods (n = 152) with a median (IQR) of 64.0 g/100 g (33.0-100.0) vs. 46.0 g/100 g (33-56.7). Fruit juice was added to 18% of products. The proportion of F&V in CBF correlated significantly with sugar content for all the food types except dry-savoury food (sweet-spoonable r = 0.24, P = 0.006; savoury-spoonable r = 0.65, P < 0.001; sweet-dry r = 0.81, P < 0.001; savoury-dry r = 0.51, P = 0.06) and explained up to two-thirds of the variation in sugar content. The F&V content of CBFs mainly consists of fruits and relatively sweet vegetables which are unlikely to encourage preferences for bitter-tasting vegetables or other non-sweet foods. F&V contribute significantly to the total sugar content, particularly of savoury foods., (© 2015 John Wiley & Sons Ltd.)