scholarly journals PROCOMIDA, a Food-Assisted Maternal and Child Health and Nutrition Program, Contributes to Postpartum Weight Retention in Guatemala: A Cluster-Randomized Controlled Intervention Trial

2019 ◽  
Vol 149 (12) ◽  
pp. 2219-2227 ◽  
Author(s):  
Jef L Leroy ◽  
Deanna K Olney ◽  
Marie T Ruel
Keyword(s):  
Weight Gain ◽  
Child Health ◽  
Maternal And Child Health ◽  
Child Undernutrition ◽  
Randomized Controlled ◽  
Health And Nutrition ◽  
Postpartum Weight ◽  
Cluster Randomized ◽  
Unhealthy Weight ◽  
And Child Health

ABSTRACT Background Food-assisted maternal and child health and nutrition (FA-MCHN) programs are widely used to reduce household food insecurity and maternal and child undernutrition in low- and middle-income countries. These programs, however, may unintentionally lead to excessive energy intake and unhealthy weight gain, especially in food-secure populations. Objective We evaluated the impact of an FA-MCHN program implemented in Guatemala on maternal weight from pregnancy to 24 mo postpartum. The program was earlier shown to reduce stunting. Methods We used a longitudinal, cluster-randomized controlled trial with arms varying in family ration size [full (FFR), reduced (RFR), none (NFR)] and individual maternal ration type [corn–soy blend (CSB), lipid-based nutrient supplement (LNS), micronutrient powder (MNP)]: A: FFR + CSB; B: RFR + CSB; C: NFR + CSB; D: FFR + LNS; E: FFR + MNP; F: control. Weight was measured during pregnancy and at 1, 4, 6, 9, 12, 18, and 24 mo postpartum. We used linear mixed models controlling for pregnancy weight with random cluster and mother effects. Data on 3535 women were analyzed. Results Significant (P < 0.05) or marginally significant (P < 0.10) effects of 0.50–0.65 kg were found at all time points (except 9 mo) in arm A. Similar-sized effects were found in arms B (1, 4, 6, and 12 mo) and C (1 and 12 mo). Marginally significant effects (0.51–0.66 kg) were found in arm D (1, 6, 9, and 12 mo); in arm E, marginally significant effects (0.48–0.75 kg) were found from 6 to 24 mo. Conclusions The effect on maternal postpartum weight is of concern because of the high existing prevalence of overweight. Programs need to include “double-duty” objectives and actions, to ensure that addressing child undernutrition does not exacerbate the problem of unhealthy weight gain. This trial was registered at clinicaltrials.gov as NCT01072279.

scholarly journals The Maternal and Child Health (MCH) Handbook in Mongolia: A Cluster-Randomized, Controlled Trial

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0119772 ◽  
Author(s):  
Rintaro Mori ◽  
Naohiro Yonemoto ◽  
Hisashi Noma ◽  
Tumendemberel Ochirbat ◽  
Emma Barber ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Child Health ◽  
Maternal And Child Health ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
And Child Health

scholarly journals Tubaramure, a Food-Assisted Maternal and Child Health and Nutrition Program in Burundi, Increased Household Food Security and Energy and Micronutrient Consumption, and Maternal and Child Dietary Diversity: A Cluster-Randomized Controlled Trial

2019 ◽  
Vol 150 (4) ◽  
pp. 945-957 ◽  
Author(s):  
Jef L Leroy ◽  
Deanna K Olney ◽  
Lilia Bliznashka ◽  
Marie Ruel
Keyword(s):  
Food Security ◽  
Child Health ◽  
Dietary Diversity ◽  
Household Food Security ◽  
Food Groups ◽  
Randomized Controlled ◽  
Health And Nutrition ◽  
Household Food ◽  
Cluster Randomized ◽  
And Child Health

ABSTRACT Background Food-assisted maternal and child health and nutrition programs are a widely used approach to address undernutrition. Little is known about the effects of these programs’ combined household and individual food rations on household and individual food consumption. Tubaramure in Burundi targeted women and children during the first 1000 d of life, and included: 1) food rations (corn-soy blend and micronutrient-fortified vegetable oil); 2) health services strengthening and promotion of their use; and 3) behavior change communication on nutrition, hygiene, and health practices. Objectives The objectives were: 1) to assess Tubaramure’s impact on household food consumption and food security, maternal dietary diversity, and infant and young child feeding practices; 2) to explore the role of the food rations; and 3) assess 6–8 mo impacts around 8 mo after the end of the program. Methods We used a 4-arm cluster-randomized controlled repeated cross-sectional design (11,906 observations). The treatment arms received the same food ration but differed in the ration timing and duration: 1) the first 1000 d; 2) from pregnancy through 17.9 mo of age; or 3) from birth through 23.9 mo of age. Results Tubaramure significantly (P &lt; 0.05) improved the percentage of food secure households [from 4.5 to 7.3 percentage points (pp)], and increased household energy consumption (from 17% to 20%) and micronutrient consumption. The program had a positive effect on maternal dietary diversity (+0.4 food groups, P &lt; 0.05) and increased the proportion of children aged 6–23.9 mo consuming ≥4 food groups (from 8.0 to 9.6 pp, P &lt; 0.05). The effects on many outcomes were attributable to the food rations. Postprogram effects (P &lt; 0.05) were found on household food security, maternal dietary diversity, and younger sibling's complementary feeding practices. Conclusions Programs such as Tubaramure have the potential to improve food security and household and individual energy and micronutrient consumption in severely resource-constrained populations, as seen in rural Burundi. This trial was registered at clinicaltrials.gov as NCT01072279.

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