19. Supplementary feeding versus no supplementary feeding (control, placebo, standard care, dietary advice), outcome: growth in children, weight.
| Review | Target group | Intervention | Outcome | Corresponding risk with intervention (95% CI) | Number of participants (studies) | Certainty of evidence (GRADE)a |
| Kristjansson 2007 | School children (aged 5–19 years) | Balanced | Weight gain (kg) | MD 0.39 (0.11 to 0.67)b,c | 1462 (3) | NR |
| MD 1.42 (1.19 to 1.65)d,e | 102 (1) | NR | ||||
| Change in weight (kg) | MD 0.13 (–0.23 to 0.49)f | 520 (1) | NR | |||
| Weight gain (adjusted ICC = 0.025) (kg) | MD 0.71 (0.48 to 0.95)g,h | 984 (3) | NR | |||
| Kristjansson 2015a | Disadvantaged infants and young children (aged 3 months to 5 years) | Supplementary feedingi | Weight gain (kg) | MD 0.12 (0.05 to 0.18)j,k | 1057 (9) | Moderate |
| Supplementary feedingl | Weight gain (kg) | MD 0.24 (0.09 to 0.39)m | 1784 (7) | NR | ||
| Supplementary foodn | Weight gain (kg) | MD –0.10 (–0.52 to 0.32)o | 45 (1) | NR | ||
| Balanced | Weight gain (kg) | MD 0.95 (0.58 to 1.33)p | 116 (1) | NR | ||
| Lazzerini 2013 | Children with MAM (< 5 years of age) | Balancedq | Weight gain total (kg) | MD 0.18 (0.04 to 0.33)r | 178 (1) | Low |
| Ota 2015 | Pregnant women | Balanced | Child's birth weight (g) | MD 40.96 (4.66 to 77.26)s,t | 5385 (11) | Moderate |
| Child's weight at 1 year (g) | MD 30.43 (–139.67 to 200.53) | 623 (2) | NR | |||
| Child's weight at 11 to 17 years (kg) | MD 0.46 (–0.77 to 1.69)u | 855 (2) | NR | |||
| High protein | Child's birth weight (g) | MD –73.0 (–171.26 to 25.26) | 504 (1) | Low | ||
| Child's weight at 1 year (g) | MD 61.0 (–184.60 to 306.60) | 409 (1) | NR | |||
| Isocaloric balanced protein | Child's birth weight (g) | MD 108.25 (–220.89 to 437.4) | 184 (2) | Very low | ||
| Sguassero 2012 | Children < 5 years of age (< 24 years) | High energy, protein and balancedv | Weight at end of intervention (kg) | MD –0.03 (–0.17 to 0.12)w | 587 (3) | NR |
| Balanced | Weight gain during the intervention (kg) | MD 0.04 (–0.03 to 0.11)j,x | 795 (2) | NR | ||
| CI: confidence interval;ICC: intracluster correlation; MAM: moderate acute malnutrition; MD: mean difference; NR: not reported. | ||||||
aAs reported in 'Summary of findings' tables. bDeveloping country/low‐ and middle‐income country (LMIC) randomised controlled trials (RCTs). cChildren who were fed (milk with calcium; githeri and meat; breakfast (patty with meat, vegetables, milk or banana cake)) at school gained significantly more weight (sensitivity analyses with ICCs at 0.01, 0.05 and 0.10 made little difference) (gain of 0.25 kg/year). In subgroup analyses, findings were significant for undernourished and adequately nourished children, as well as children aged 9 to 10 years specifically. dDeveloped country/high‐income country (HIC) controlled before‐and‐after study (CBA). eChildren who received milk at school gained significantly more weight. fDeveloped country/HIC RCT. gDeveloping country/LMIC CBAs. hChildren who were fed (school lunch; green gram and palm sugar; vegetable protein mixture) at school gained significantly more weight (sensitivity analyses with ICCs at 0.01, 0.05 and 0.10 made little difference) (gain of 0.75 kg/year). In subgroup analyses, findings were significant for boys and girls, and children aged 5 to 6, 6 to 8 and 9 to 10 years specifically. iBalanced (four studies); high energy (two studies); high lipid (one study); supplementary food (two studies). jAnalyses include the same RCT: Simondon 1996 (multi‐country study). kLow‐ and middle‐income country (LMIC) RCT. lBalanced (two studies); high energy (one study); high lipid (one study); high protein (one study); supplementary food (two studies). mLMIC CBA. n113 g wet ration fruit cereal, rice cereal with apple sauce, mixed cereal with apple sauce and bananas, and oatmeal with apple sauce and bananas (Gerber Products Company). oHigh‐income country (HIC) RCT. pAboriginal children, HIC CBA. qComplementary foods (Pusti Packet). rTotal weight gain significantly higher in group receiving complementary foods (Pusti Packet) than versus standard care. sBalanced energy and protein supplement associated with significant increases in mean birth weight (liquid, chocolate‐flavoured supplement; biscuit; milk; supplement with sesame cake, jaggery, oil; fortified food supplement with peanut butter, soy flour, vegetable oil, sugar, micronutrients; supplement as dry powder providing energy, protein, fat; supplement with dried skim milk, enriched bread, vegetable oil; mixture of beans, maize and micronutrients or porridge and micronutrients; oral supplement (beverage); glucose drink; glucose drink and skim milk powder). tNo subgroup differences between undernourished and adequately nourished groups (test for subgroup differences: Chi2 = 2.35, degrees of freedom (df) = 1 (P = 0.12), I2 = 57.5%). uNo subgroup differences between boys and girls (test for subgroup differences: Chi2 = 0.22, df = 1 (P = 0.64), I2 = 0%). vComparison group: no food or low‐protein, kcal supplementation. wNo subgroup differences based on age, nutritional status (stunted/wasted versus not) of the children and duration of feeding (< 12 months versus ≥ 12 months). xNo subgroup difference based on duration of feeding but subgroup difference based on age (test for subgroup differences: Chi2 = 7.24, df = 1 (P = 0.01), I2 = 86%): children > 24 months (MD 0.22, 95% CI 0.07 to 0.37).
Additional comments
- Grobler 2013 described weight outcomes narratively for one trial: children receiving enhanced nutrition support had significantly more weight gain in the first eight weeks than children receiving standard care (P < 0.0001) (Rollins 2007).
- Kristjansson 2015a narratively reported two additional RCTs in LMIC. One 14‐month RCT (60 children) found a large and significant effect of feeding on weight gain for boys (end‐of‐study difference 3.91 kg; statistically significant) and girls (end‐of‐study difference 2.55 kg; statistically significant) (Obatolu 2003). One study found that 48 children who received supplementary feeding gained a mean of 39 g more than the 43 children in the control group (six‐month intervention: not significant) (Fauveau 1992).