Impact of Small-Quantity Lipid-Based Nutrient Supplements on Pubertal Status of 9–13-Year Olds: A Follow-Up Study of the iLiNS-DYAD-Ghana Trial

IF 3.2 Q2 NUTRITION & DIETETICS Current Developments in Nutrition Pub Date : 2024-12-01 DOI:10.1016/j.cdnut.2024.104458

Helena Nti , Seth Adu-Afarwuah , Brietta M Oaks , Elizabeth L Prado , Charles D Arnold , Paul D. Hastings , Amanda E Guyer , Kathryn G Dewey , Benjamin Amponsah , Helena J Bentil , Mavis Osipi Mensah , Ebenezer Adjetey , Xiuping Tan , Lois Maame Donkor Aryee , Fatimah Bintu Ayete Labi , Adom Manu

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Abstract

Background

Early and delayed puberty are both associated with adverse health and psychosocial outcomes.

Objectives

We assessed the impact of provision of small-quantity lipid-based nutrient supplement (SQ-LNS) to mothers during pregnancy and 6 mo postpartum and to their children aged 6–18 mo, on pubertal status.

Methods

This study was a follow-up to a partially double-blind randomized controlled trial. At ≤20 wk, 1320 females were randomly assigned to receive daily: iron and folic acid during pregnancy and placebo 0–6 mo postpartum; or multiple micronutrients during pregnancy and 0–6 mo postpartum; or SQ-LNS during pregnancy and 0–6 mo postpartum and to their children from 6 to 18 mo. We re-enrolled 966 and 919 children at 9–11 y and 11–13 y, respectively. We calculated a total pubertal status score based on the Petersen Pubertal Development Scale (PDS) to assess growth spurt, skin changes, body hair, facial hair, voice break, breast development, and menstruation. Pubertal status was regressed on child’s age to generate age-adjusted PDS z-scores (aPDSZ); we performed interaction and mediation analyses.

Results

Mean ± standard deviation aPDSZ did not differ between the SQ-LNS and non-LNS groups at 9–11 y (0.01 ± 0.95 compared with –0.01 ± 0.98; P = 0.958) but was more advanced in the SQ-LNS group at 11–13 y (0.07 ± 1.04 compared with –0.04 ± 0.98; P = 0.049) in the adjusted model. The effect of SQ-LNS varied by sex (P-interaction = 0.003) and household asset index z-score (P-interaction = 0.002): Puberty was more advanced in the SQ-LNS compared with non-LNS group among females (P = 0.007) but not males (P = 0.877), and within lower (P = 0.002) than average (P = 0.436) and higher (P = 0.332) socioeconomic households.

Conclusion

Provision of SQ-LNS during the first 1000 d of life advanced pubertal status among females.

Trial registration number

This trial was registered at clinicaltrials.gov as NCT00970866 (https://clinicaltrials.gov/ct2/show/record/NCT00970866).

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少量脂质营养补充剂对9-13岁儿童青春期状态的影响：iLiNS-DYAD-Ghana试验的随访研究

背景：青春期提前和延迟都与不良的健康和社会心理结果相关。目的：我们评估了在怀孕期间和产后6个月的母亲及其6-18个月的孩子提供少量脂质营养补充剂（SQ-LNS）对青春期状态的影响。方法：本研究为部分双盲随机对照试验的随访。在≤20周时，随机分配1320名女性在怀孕期间每天服用铁和叶酸，并在产后0-6个月服用安慰剂；或在怀孕期间和产后0-6个月补充多种微量营养素；在妊娠期和产后0-6个月以及6 - 18个月的孩子中，我们分别在9-11岁和11-13岁时重新招募了966名和919名儿童。我们根据彼得森青春期发育量表（PDS）计算了总的青春期状态评分，以评估生长发育、皮肤变化、体毛、面部毛发、声音破裂、乳房发育和月经。将青春期状态与儿童年龄进行回归，得到年龄校正PDS z-score (aPDSZ)；我们进行了交互和中介分析。结果：在9-11 y时，SQ-LNS组与非lns组aPDSZ的平均值±标准差无显著差异（0.01±0.95与-0.01±0.98）；P = 0.958)，但在11-13 y时SQ-LNS组更先进(0.07±1.04比-0.04±0.98；P = 0.049)。SQ-LNS的影响因性别（P-交互作用= 0.003）和家庭资产指数z-得分（P-交互作用= 0.002）而异：与非lns组相比，SQ-LNS组的女性（P = 0.007）青春期提前，而男性（P = 0.877）青春期提前，并且在低（P = 0.002）低于平均（P = 0.436）和高（P = 0.332）社会经济家庭中青春期提前。结论：在女性生命的前1000天提供SQ-LNS可提高其青春期状态。试验注册号：本试验在clinicaltrials.gov注册为NCT00970866 （https://clinicaltrials.gov/ct2/show/record/NCT00970866）。

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