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Suplementos nutricionales preventivos a base de lípidos administrados con alimentos complementarios a los lactantes y niños pequeños de seis a 23 meses de edad para los resultados de salud, nutrición y desarrollo

Appendices

Appendix 1. Search strategies for retracted studies

MEDLINE Ovid 1946 to February Week 4 2019

Searched 5 March 2019. 45 records were retrieved, none of which related to included studies in this review.

1 exp Lipids/
2 fatty acid$.tw,kf.
3 Docosahexaenoic acid.tw,kf.
4 Eicosapentaenoic Acid$.tw,kf.
5 PUFA$.tw,kf.
6 lipid.tw,kf.
7 (omega 3$ or omega 6$).tw,kf.
8 (soy$ or peanut or groundnut or whey or sesame or cashew or chickpea or oil$).tw,kf.
9 or/1‐8
10 Dietary Supplements/
11 Food, fortified/
12 ((diet$ or food$) adj3 (fortif$ or enrich$ or supplement$)).tw,kf.
13 (complement$ adj3 (food$ or feed$)).tw,kf.
14 "Ready to use".tw,kf.
15 (RUSF or RUTF).tw,kf.
16 "point of use".tw,kf. )
17 (home$ adj2 fortif$).tw,kf.
18 or/10‐17
19 9 and 18
20 (lipid$ adj3 nutrient$).tw,kf.
21 (lipid$ adj3 supplement$).tw,kf.
22 lipid based.tw,kf.
23 (lipid$ adj3 fortif$).tw,kf.
24 (lipid$ adj3 enrich$).tw,kf.
25 (lipid$ adj2 emuls$).tw,kf.
26 (lipid$ adj2 formulation$).tw,kf.
27 (Lipid$ adj3 powder$).tw,kf.
28 (lipid adj3 spread$).tw,kf.
29 (lipid$ adj3 paste$).tw,kf.
30 (Nutributter$ or Plumpy$).tw,kf.
31 (LBNS$ or LNS$1 or iLiNS).tw,kf.
32 or/20‐31
33 19 or 32 (43056)
34 Infant/ (753966)
35 (baby or babies or infant$ or toddler$ or child$).tw. (1425823)
36 34 or 35 (1743645)
37 33 and 36 (3151)
38 exp animals/ not humans.sh.
39 37 not 38
40 (comment or "corrected and republished article" or editorial or "expression of concern" or published erratum or retracted publication or "retraction of publication").pt.
41 (comment or corrected or correction or corrigendum or "expression of concern" or erratum or retracted or retraction).ti.
42 40 or 41
43 39 and 42

Embase Ovid 1974 to 2019 March 04

Searched 5 March 2019. records were retreived, none of which related to included studies in this review.

1 exp Lipids/
2 fatty acid$.tw,kw.
3 Docosahexaenoic acid.tw,kw.
4 Eicosapentaenoic Acid$.tw,kw.
5 PUFA$.tw,kw.
6 lipid$.tw,kw.
7 (omega 3$ or omega 6$).tw,kw.
8 (soy$ or peanut or groundnut or whey or sesame or cashew or chickpea or oil$).tw,kw.
9 or/1‐8
10 dietary supplement/
11 fortified food/
12 ((diet$ or food$) adj3 (fortif$ or enrich$ or supplement$)).tw,kw.
13 (complement$ adj3 (food$ or feed$)).tw,kw.
14 "Ready to use".tw,kw.
15 (RUSF or RUTF).tw,kw.
16 "point of use".tw,kw.
17 (home$ adj2 fortif$).tw,kw.
18 or/10‐17
19 9 and 18
20 lipid based.tw,kw.
21 (lipid$ adj3 nutrient$).tw,kw.
22 (lipid$ adj3 supplement$).tw,kw.
23 (lipid$ adj3 fortif$).tw,kw.
24 (lipid$ adj3 enrich$).tw,kw.
25 (lipid$ adj2 emuls$).tw,kw.
26 (lipid$ adj2 formulation$).tw,kw.
27 (Lipid$ adj3 powder$).tw,kw.
28 (lipid adj3 spread$).tw,kw.
29 (lipid$ adj3 paste$).tw,kw.
30 (Nutributter$ or Plumpy$).tw,kw.
31 (LBNS$ or LNS$1 or iLiNS).tw,kw.
32 or/20‐31
33 19 or 32
34 infant/
35 (baby or babies or infant$ or toddler$ or child$).tw.
36 34 or 35
37 33 and 36
38 exp animals/ or exp invertebrate/ or animal experiment/ or animal model/ or animal tissue/ or animal cell/ or nonhuman/)
39 human/ or normal human/ or human cell/
40 38 not 39
41 37 not 40
42 exp erratum/
43 erratum.pt.
44 yes.nr.
45 tombstone.pt.
46 (comment or corrected or correction or corrigendum or "expression of concern" or erratum or retracted or retraction).ti.
47 or/42‐46
48 41 and 47

Retraction Watch Database retractiondatabase.org/RetractionSearch.aspx?

Searched 5 March 2019.

We searched for retractions of all reports of included studies using PubMed ID (where a PubMed ID existed for the report), and ran separate searches for the title of each paper. When searching by title alone retrieved a large number of records, we searched by a combination of title and surname of first author.

Appendix 2. Search strategies for intervention studies

Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library

#1[mh Lipids]
#2(fatty next acid*)
#3((Docosahexaenoic or Eicosapentaenoic) next acid*)
#4(PUFA or PUFAs)
#5lipid*
#6(omega next (3* or 6*))
#7(soy* or peanut or groundnut or whey or sesame or cashew or chickpea or oil*)
#8{or #1‐#7}
#9[mh "Dietary Supplements"]
#10[mh "Food, fortified"]
#11((diet* or food*) near/3 (fortif* or enrich* or supplement*))
#12(complement* near/3 (food* or feed*))
#13"Ready to use"
#14"point of use"
#15(RUSF or RUTF)
#16(home* near/2 fortif*)
#17{or #9‐#16}
#18#8 and #17
#19(lipid next based)
#20(lipid* near/3 supplement*)
#21(lipid* near/3 nutrient*)
#22(lipid* near/3 fortif*)
#23(lipid* near/3 formulation*)
#24(lipid* near/3 enrich*)
#25(lipid* near/3 emuls*)
#26(lipid* near/3 powder*)
#27(lipid* near/3 spread*)
#28(lipid* near/3 paste*)
#29(Nutributter* or Plumpy*)
#30(LNS or iLiNS)
#31{or #19‐#30}
#32#18 or #31
#33[mh ^Infant]
#34infant* or toddler* or baby or babies or child*
#35#33 or #34
#36#32 and #35 in Trials

MEDLINE Ovid

1 exp Lipids/
2 fatty acid$.tw,kf.
3 Docosahexaenoic acid.tw,kf.
4 Eicosapentaenoic Acid$.tw,kf.
5 PUFA$.tw,kf.
6 lipid.tw,kf.
7 (omega 3$ or omega 6$).tw,kf.
8 (soy$ or peanut or groundnut or whey or sesame or cashew or chickpea or oil$).tw,kf.
9 or/1‐8
10 Dietary Supplements/
11 Food, fortified/
12 ((diet$ or food$) adj3 (fortif$ or enrich$ or supplement$)).tw,kf.
13 (complement$ adj3 (food$ or feed$)).tw,kf.
14 "Ready to use".tw,kf.
15 (RUSF or RUTF).tw,kf.
16 "point of use".tw,kf.
17 (home$ adj2 fortif$).tw,kf.
18 or/10‐17
19 9 and 18
20 (lipid$ adj3 nutrient$).tw,kf.
21 (lipid$ adj3 supplement$).tw,kf.
22 lipid based.tw,kf.
23 (lipid$ adj3 fortif$).tw,kf.
24 (lipid$ adj3 enrich$).tw,kf.
25 (lipid$ adj2 emuls$).tw,kf.
26 (lipid$ adj2 formulation$).tw,kf.
27 (lipid$ adj3 powder$).tw,kf.
28 (lipid adj3 spread$).tw,kf.
29 (lipid$ adj3 paste$).tw,kf.
30 (Nutributter$ or Plumpy$).tw,kf.
31 (LBNS$ or LNS$1 or iLiNS).tw,kf.
32 or/20‐31
33 19 or 32
34 Infant/
35 (baby or babies or infant$ or toddler$ or child$).tw.
36 34 or 35
37 33 and 36
38 exp animals/ not humans.sh.
39 37 not 38

MEDLINE In‐Process and Other Non‐Indexed Citations Ovid

1 lipid based.tw,kf.
2 (lipid$ adj3 nutrient$).tw,kf.
3 (lipid$ adj3 supplement$).tw,kf.
4 (lipid$ adj3 fortif$).tw,kf.
5 (lipid$ adj3 enrich$).tw,kf.
6 (lipid$ adj2 emuls$).tw,kf.
7 (lipid$ adj2 formulation$).tw,kf.
8 (Lipid$ adj3 powder$).tw,kf.
9 (lipid adj3 spread$).tw,kf.
10 (lipid$ adj3 paste$).tw,kf.
11 (Nutributter$ or Plumpy$).tw,kf.
12 (LBNS$ or LNS$1 or iLiNS).tw,kf.
13 or/1‐12
14 ((diet$ or food$) adj3 (fortif$ or enrich$ or supplement$)).tw,kf.
15 (complement$ adj3 (food$ or feed$)).tw,kf.
16 (RUSF or RUTF).tw,kf.
17 "point of use".tw,kf.
18 (home$ adj2 fortif$).tw,kf.
19 lipid$.tw,kf.
20 fatty acid$.tw,kf.
21 Docosahexaenoic acid$.tw,kf.
22 Eicosapentaenoic Acid$.tw,kf.
23 PUFA$.tw,kf.
24 (omega 3$ or omega 6$).tw,kf.
25 (soy$ or peanut or groundnut or whey or sesame or cashew or chickpea or oil$).tw,kf.
26 or/14‐18
27 or/19‐25
28 26 and 27
29 13 or 28
30 (baby or babies or infant$ or toddler$ or child$).tw.
31 29 and 30

MEDLINE E‐pub ahead of print Ovid

1 lipid based.tw,kf.
2 (lipid$ adj3 nutrient$).tw,kf.
3 (lipid$ adj3 supplement$).tw,kf.
4 (lipid$ adj3 fortif$).tw,kf.
5 (lipid$ adj3 enrich$).tw,kf.
6 (lipid$ adj2 emuls$).tw,kf.
7 (lipid$ adj2 formulation$).tw,kf.
8 (Lipid$ adj3 powder$).tw,kf.
9 (lipid adj3 spread$).tw,kf.
10 (lipid$ adj3 paste$).tw,kf.
11 (Nutributter$ or Plumpy$).tw,kf.
12 (LBNS$ or LNS$1 or iLiNS).tw,kf.
13 or/1‐12
14 ((diet$ or food$) adj3 (fortif$ or enrich$ or supplement$)).tw,kf.
15 (complement$ adj3 (food$ or feed$)).tw,kf.
16 (RUSF or RUTF).tw,kf.
17 "point of use".tw,kf.
18 (home$ adj2 fortif$).tw,kf.
19 lipid$.tw,kf.
20 fatty acid$.tw,kf.
21 Docosahexaenoic acid$.tw,kf.
22 Eicosapentaenoic Acid$.tw,kf.
23 PUFA$.tw,kf.
24 (omega 3$ or omega 6$).tw,kf.
25 (soy$ or peanut or groundnut or whey or sesame or cashew or chickpea or oil$).tw,kf.
26 or/14‐18
27 or/19‐25
28 26 and 27
29 13 or 28
30 (baby or babies or infant$ or toddler$ or child$).tw.
31 29 and 30

Embase Ovid

1 exp Lipids/
2 fatty acid$.tw,kw.
3 Docosahexaenoic acid.tw,kw.
4 Eicosapentaenoic Acid$.tw,kw.
5 PUFA$.tw,kw.
6 lipid$.tw,kw.
7 (omega 3$ or omega 6$).tw,kw.
8 (soy$ or peanut or groundnut or whey or sesame or cashew or chickpea or oil$).tw,kw.
9 or/1‐8
10 dietary supplement/
11 fortified food/
12 ((diet$ or food$) adj3 (fortif$ or enrich$ or supplement$)).tw,kw.
13 (complement$ adj3 (food$ or feed$)).tw,kw.
14 "Ready to use".tw,kw.
15 (RUSF or RUTF).tw,kw.
16 "point of use".tw,kw.
17 (home$ adj2 fortif$).tw,kw.
18 or/10‐17
19 9 and 18
20 lipid based.tw,kw.
21 (lipid$ adj3 nutrient$).tw,kw.
22 (lipid$ adj3 supplement$).tw,kw.
23 (lipid$ adj3 fortif$).tw,kw.
24 (lipid$ adj3 enrich$).tw,kw.
25 (lipid$ adj2 emuls$).tw,kw.
26 (lipid$ adj2 formulation$).tw,kw.
27 (Lipid$ adj3 powder$).tw,kw.
28 (lipid adj3 spread$).tw,kw.
29 (lipid$ adj3 paste$).tw,kw.
30 (Nutributter$ or Plumpy$).tw,kw.
31 (LBNS$ or LNS$1 or iLiNS).tw,kw.
32 or/20‐31
33 19 or 32
34 infant/
35 (baby or babies or infant$ or toddler$ or child$).tw.
36 34 or 35
37 33 and 36
38 exp animals/ or exp invertebrate/ or animal experiment/ or animal model/ or animal tissue/ or animal cell/ or nonhuman/
39 human/ or normal human/ or human cell/
40 38 not 39
41 37 not 40

CINAHL Plus EBSCOhost (Cumulative Index to Nursing and Allied Health Literature

S1(MH "Lipids+")
S2TI (lipid*) or AB (lipid*)
S3TI(Docosahexaenoic acid*) OR AB(Docosahexaenoic acid*)
S4TI( Eicosapentaenoic acid*) OR AB( Eicosapentaenoic acid*)
S5TI(PUFA*) OR AB(PUFA* )
S6TI(omega 3* or omega 6*) OR AB(omega 3* or omega 6* )
S7TI (soy* or peanut or groundnut or whey or sesame or cashew or chickpea or oil*) or AB(soy* or peanut or groundnut or whey or sesame or cashew or chickpea or oil*)
S8TI(fatty acid*) OR AB(fatty acid* )
S9S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S8
S10(MH "Dietary Supplements")
S11(MH "Dietary Supplementation")
S12(MH "Food, Fortified")
S13TI ((diet* or food*) n3 (fortif* or enrich* or supplement*)) OR AB((diet* or food*) n3 (fortif* or enrich* or supplement*))
S14TI (complement* N3 (food* or feed*)) or AB (complement* N3 (food* or feed*))
S15"Ready to use"
S16(RUSF or RUTF)
S17"point of use"
S18TI (home* N2 fortif*) OR AB(home* N2 fortif*)
S19S10 OR S11 OR S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18
S20S9 AND S19
S21TI (lipid based) or AB (lipid based)
S22TI(lipid* N3 supplement*) OR AB( lipid* N3 supplement*)
S23TI(lipid* N3 nutrient*) OR AB(lipid* N3 nutrient*)
S24TI(lipid* N3 fortif*) OR AB (lipid* N3 fortif*)
S25TI(lipid* N3 formulation*) OR AB(lipid* N3 formulation*)
S26TI(lipid* N3 enrich*) OR AB(lipid* N3 enrich* )
S27TI(lipid* N3 emuls*) OR AB(lipid* N3 emuls*)
S28TI(lipid* N3 powder*) OR AB(lipid* N3 powder*)
S29TI(lipid N3 spread*) OR AB(lipid N3 spread*)
S30TI(lipid* N3 paste*) OR AB(lipid* N3 paste*)
S31Nutributter*
S32 Plumpy*
S33TI(LNS*1 or iLiNS) OR AB( LNS*1 or iLiNS)
S34S21 OR S22 OR S23 OR S24 OR S25 OR S26 OR S27 OR S28 OR S29 OR S30 OR S31 OR S32 OR S33
S35S20 OR S34
S36(MH "Infant")
S37TI(baby or babies or infant* or toddler* or child*) OR AB (baby or babies or infant* or toddler* or child*)
S38S36 OR S37
S39S35 AND S38

Science Citation Index (SCI) and Social Sciences Citation Index (SSCI) Web of Science

#5 #4 AND #3
#4 TS=(infant* OR child* OR toddler* or baby or babies)
#3 #2 OR #1
#2 TS=(Nutributter* OR Plumpy* OR LNS OR iLiNS OR "lipid based" )
#1 TS=(( "fatty acid*" OR PUFA OR PUFAs OR "omega 3*" OR "omega 6*" OR soy* OR peanut* OR groundnut* OR whey* OR sesame* OR cashew* OR chickpea* OR oil* ) Near/3 ( FORTIF* OR ENRICH OR SUPPLEMENT* OR "READY TO USE" OR "POINT OF USE" OR RUSF OR RUTF OR PASTE* OR SPREAD* OR FORMULAT* OR EMULS* OR NUTRIENT* OR POWDER*))

Conference Proceedings Citation Index ‐ Science (CPCI‐S) and Conference Proceedings Citation Index ‐ Social Science & Humanities (CPCI‐SS&H) Web of Science

#5 #4 AND #3
DocType=All document types; Language=All languages;
#4 TS=(infant* OR child* OR toddler* or baby or babies)
DocType=All document types; Language=All languages;
#3 #2 OR #1
DocType=All document types; Language=All languages;
#2 TS=(Nutributter* OR Plumpy* OR LNS OR iLiNS OR "lipid based" )
DocType=All document types; Language=All languages;
#1 TS=(( "fatty acid*" OR PUFA OR PUFAs OR "omega 3*" OR "omega 6*" OR soy* OR peanut* OR groundnut* OR whey* OR sesame* OR cashew* OR chickpea* OR oil* ) Near/3 ( FORTIF* OR ENRICH OR SUPPLEMENT* OR "READY TO USE" OR "POINT OF USE" OR RUSF OR RUTF OR PASTE* OR SPREAD* OR FORMULAT* OR EMULS* OR NUTRIENT* OR POWDER*))
DocType=All document types; Language=All languages;

Cochrane Database of Systematic Reviews (CDSR), part of the Cochrane Library

#1[mh Lipids]
#3((Docosahexaenoic or Eicosapentaenoic) next acid*):ti,ab
#4(PUFA or PUFAs):ti,ab
#5lipid*:ti,ab 23529
#6(omega next (3* or 6*)):ti,ab
#7(soy* or peanut or groundnut or whey or sesame or cashew or chickpea or oil*):ti,ab
#8{or #1‐#7}
#9[mh "Dietary Supplements"]
#10[mh "Food, fortified"]
#11((diet* or food*) near/3 (fortif* or enrich* or supplement*)):ti,ab
#12(complement* near/3 (food* or feed*)):ti,ab
#13"Ready to use":ti,ab
#14"point of use":ti,ab
#15(RUSF or RUTF):ti,ab
#16(home* near/2 fortif*):ti,ab
#17{or #9‐#16}
#18#8 and #17
#19(lipid next based):ti,ab
#20(lipid* near/3 supplement*):ti,ab
#21(lipid* near/3 nutrient*):ti,ab
#22(lipid* near/3 fortif*):ti,ab
#23(lipid* near/3 formulation*):ti,ab
#24(lipid* near/3 enrich*):ti,ab
#25(lipid* near/3 emuls*):ti,ab
#26(lipid* near/3 powder*):ti,ab
#27(lipid* near/3 spread*):ti,ab
#28(lipid* near/3 paste*):ti,ab
#29(Nutributter* or Plumpy*):ti,ab
#30(LNS*1 or iLiNS):ti,ab
#31{or #19‐#30}
#32#18 or #31
#33[mh ^Infant]
#34infant* or toddler* or baby or babies or child*:ti,ab
#35#33 or #34
#36#32 and #35 in Cochrane Reviews (Reviews and Protocols)

Database of Abstracts of Reviews of Effect (DARE), part of the Cochrane Library

#1[mh Lipids]
#3((Docosahexaenoic or Eicosapentaenoic) next acid*):ti,ab
#4(PUFA or PUFAs):ti,ab
#5lipid*:ti,ab 23529
#6(omega next (3* or 6*)):ti,ab
#7(soy* or peanut or groundnut or whey or sesame or cashew or chickpea or oil*):ti,ab
#8{or #1‐#7}
#9[mh "Dietary Supplements"]
#10[mh "Food, fortified"]
#11((diet* or food*) near/3 (fortif* or enrich* or supplement*)):ti,ab
#12(complement* near/3 (food* or feed*)):ti,ab
#13"Ready to use":ti,ab
#14"point of use":ti,ab
#15(RUSF or RUTF):ti,ab
#16(home* near/2 fortif*):ti,ab
#17{or #9‐#16}
#18#8 and #17
#19(lipid next based):ti,ab
#20(lipid* near/3 supplement*):ti,ab
#21(lipid* near/3 nutrient*):ti,ab
#22(lipid* near/3 fortif*):ti,ab
#23(lipid* near/3 formulation*):ti,ab
#24(lipid* near/3 enrich*):ti,ab
#25(lipid* near/3 emuls*):ti,ab
#26(lipid* near/3 powder*):ti,ab
#27(lipid* near/3 spread*):ti,ab
#28(lipid* near/3 paste*):ti,ab
#29(Nutributter* or Plumpy*):ti,ab
#30(LNS*1 or iLiNS):ti,ab
#31{or #19‐#30}
#32#18 or #31
#33[mh ^Infant]
#34infant* or toddler* or baby or babies or child*:ti,ab
#35#33 or #34
#36#32 and #35 in Other Reviews

Epistemonikos (epistemonikos.org)

(title:(LIPID* OR FATTY ACID* OR OMEGA OR Docosahexaenoic OR Eicosapentaenoic OR soy* OR peanut OR groundnut OR whey OR sesame OR cashew OR chickpea OR oil*) OR abstract:(LIPID* OR FATTY ACID* OR OMEGA OR Docosahexaenoic OR Eicosapentaenoic OR soy* OR peanut OR groundnut OR whey OR sesame OR cashew OR chickpea OR oil*)) AND (title:(fortif* OR enrich* OR supplement* OR "Ready to use" OR "point of use" OR RUSF OR RUTF) OR abstract:(fortif* OR enrich* OR supplement* OR "Ready to use" OR "point of use" OR RUSF OR RUTF)) AND title:(babies OR children OR infant*)

LIMITED TO

PUBLICATION TYPE: SYSTEMATIC REVIEW
SYSTEMATIC REVIEW QUESTION : INTERVENTIONS

POPLINE (www.popline.org)

((ALL FIELDS(lipid* OR "fatty acid*" OR PUFA OR PUFAs OR "omega 3*" OR "omega 6*" OR soy* OR peanut* OR groundnut* OR whey* OR sesame* OR cashew* OR chickpea* OR oil*) AND ALL FIELDS (FORTIF* OR ENRICH OR SUPPLEMENT* OR "READY TO USE" OR "POINT OF USE" OR RUSF OR RUTF OR PASTE* OR SPREAD* OR FORMULAT* OR EMULS* OR NUTRIENT* OR POWDER*)) OR (Nutributter* OR Plumpy* OR LNS OR iLiNS)) AND ALL FIELDS (infan* OR child* OR baby OR babies OR toddler*)

ClinicalTrials.gov (clinicaltrials.gov)

Interventional Studies | LIPID‐BASED OR LNS OR iLiNS OR "NUTRIENT SUPPLEMENT" OR PASTE OR SPREAD OR BLEND OR NUTRIBUTTER OR Plumpy OR PLUMPYNUT | Child

World Health Organization International Clinical Trials Registry Platform (WHO ICTRP; who.int/trialsearch)

(LIPID BASED OR LNS OR iLiNS OR NUTRIENT SUPPLEMENT OR SPREAD OR paste OR BLEND OR NUTRIBUTTER OR Plumpy OR PLUMPYNUT) NOT (teeth OR oral heath OR dentistry)

IBECS (Índice Bibliográfico Español en Ciencias de la Salud; ibecs.isciii.es)

WORD| "lipid based" OR LNS OR iLiNS OR "nutrient supplement" OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut

AND

WORD| infan* OR child* OR baby OR babies OR toddler*

SciELO (Scientific Electronic Library Online; www.scielo.br)

"lipid based" OR LNS OR iLiNS OR "nutrient supplement" OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut [All indexes]

AND

infan* OR child* OR baby OR babies OR toddler* [All indexes]

AIM (Africa Index Medicus; search.bvsalud.org/ghl/?lang=en&submit=Search&where=REGIONAL)

(lipid based OR LNS OR iLiNS OR nutrient supplement OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut) AND (infan OR child OR baby OR babies OR toddler)

IMEMR (Index Medicus for the Eastern Mediterranean Region; search.bvsalud.org/ghl/?lang=en&submit=Search&where=REGIONAL)

(lipid based OR LNS OR iLiNS OR nutrient supplement OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut) [Title]

AND

(infan OR child OR baby OR babies OR toddler) [Title]

LILACS (Latin American and Caribbean Health Sciences Literature; lilacs.bvsalud.org/en)

(tw:("lipid based" OR LNS OR iLiNS OR "nutrient supplement" OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut) AND (tw:(infan* OR child* OR baby OR babies OR toddler*)

PAHO/WHO Institutional Repository for Information Sharing (iris.paho.org/xmlui)

("lipid based" OR LNS OR iLiNS OR "nutrient supplement" OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut) AND (infan* OR child* OR baby OR babies OR toddler*)

WHOLIS (WHO Library Database; search.bvsalud.org/ghl/?lang=en&submit=Search&where=REGIONAL)

words or phrase "lipid based" OR LNS OR iLiNS OR "nutrient supplement" OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut AND words or phrase infan* OR child* OR baby OR babies OR toddler*

WPRIM (Western Pacific Index Medicus; search.bvsalud.org/ghl/?lang=en&submit=Search&where=REGIONAL)

("lipid based" OR LNS OR iLiNS OR "nutrient supplement" OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut) AND (infan* OR child* OR baby OR babies OR toddler*)

IMSEAR (Index Medicus for the South‐East Asian Region; search.bvsalud.org/ghl/?lang=en&submit=Search&where=REGIONAL)

("lipid based" OR LNS OR iLiNS OR "nutrient supplement" OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut) [Title] AND (infan* OR child* OR baby OR babies OR toddler*) [Title]

IndMED (indmed.nic.in/indmed.html)

(lipid based OR LNS OR iLiNS OR nutrient supplement OR paste OR spread OR blend OR nutributter OR Plumpy OR plumpynut) AND (infan OR child OR baby OR babies OR toddler)

Native Health Research Database (hscssl.unm.edu/nhd)

Keywords: (Supplement AND child)

Appendix 3. Extraction sheet

Author:

Year of publication:

Journal:

Study funded by:

Country:

Study design:

Setting (Hospital/Outpatient/Community):

Setting (Stable/Emergency):

Target population:

Baseline Indicators

Anemia:

BMI:

MUAC:

Other:

Intervention/Comparison Groups

Intervention/Comparison:

Supplementary food composition/Nutrient density:

Produced by:

Dose/Frequency:

Duration of intervention:

Period of intervention:

Intervention given through:

Composition of LNS/Nutrient density:

Duration of follow‐up:

Number of participants:

Risk of Bias

Randomization/Sequence generation

Author judgment for risk of bias: Low, High or Unclear

Quote from the paper:

Allocation concealment

Author judgment for risk of bias: Low, High or Unclear

Quote from the paper:

Assessment blinding ‐ Outcome

Author judgment for risk of bias: Low, High or Unclear

Quote from the paper:

Blinding of participants/personnel

Author judgment for risk of bias: Low, High or Unclear

Quote from the paper:

Selective reporting

Author judgment for risk of bias: Low, High or Unclear

Quote from the paper:

Attribution/ Loss to follow up

Author judgment for risk of bias: Low, High or Unclear

Quote from the paper:

Other bias

Author judgment for risk of bias: Low, High or Unclear

Quote from the paper:

Outcomes

Primary/Secondary:

Outcome definition:

Units:

Numbers (for all groups)

Limitations:

Comments:

Footnotes

BMI: Body mass index.
LNS: Lipid‐based nutrient supplements.
MUAC: Mid‐upper arm circumference.

Appendix 4. Criteria for assessing risk of bias in RCTs

Random sequence generation (checking for possible selection bias)

We assessed whether the method used to generate the allocation sequence was described in sufficient detail to allow an assessment of whether it produced comparable groups.

  1. Low risk of bias: any truly random process (for example, random number table, computer random number generator)

  2. High risk of bias: any non‐random process (for example, odd or even date of birth, hospital or clinic record number)

  3. Unclear risk of bias: insufficient information provided to permit judgement of high or low risk of bias

Allocation concealment (checking for possible selection bias)

We assessed whether the method used to conceal the allocation sequence was described in sufficient detail to determine whether intervention allocations could have been foreseen in advance of, or during, enrolment.

  1. Low risk of bias: telephone or central randomisation; consecutively numbered, sealed, opaque envelopes

  2. High risk of bias: open random allocation, unsealed or non‐opaque envelopes

  3. Unclear risk of bias: insufficient information provided to permit judgement of high or low risk of bias

Blinding of participants and personnel (checking for possible performance bias)

We described all measures used, if any, to blind study participants and personnel from knowledge of which intervention a participant received.

We assessed the risk of performance bias associated with blinding of participants and personnel as follows.

  1. Low risk of bias: blinding of participants and personnel and unlikely that the blinding could have been broken, or no blinding or incomplete blinding but outcome unlikely to have been influenced

  2. High risk of bias: participants and personnel not blinded, incomplete or broken blinding and outcome likely to have been influenced

  3. Unclear risk of bias: insufficient information provided to permit judgement of high or low risk of bias

Whilst assessed separately, we combined the results into a single evaluation of risk of bias associated with blinding (Higgins 2011a).

Blinding of outcome assessment (checking for possible detection bias)

We described all measures used, if any, to blind outcome assessors from knowledge of which intervention a participant received.

  1. Low risk of bias: blinding of outcome assessment and unlikely that the blinding could have been broken, or no blinding but measurement unlikely to have been influenced

  2. High risk of bias: no blinding of outcome assessment, measurement likely to have been influenced by lack of blinding, or blinding could have been broken

  3. Unclear risk of bias: insufficient information provided to permit judgement of high or low risk of bias

Incomplete outcome data (checking for possible attrition bias through withdrawals, dropouts, protocol deviations)

We assessed the outcomes in each included study as follows.

  1. Low risk of bias: no missing outcome data or missing outcome data were unlikely to bias the results based on the following considerations; study authors provided transparent documentation of participant flow throughout the study, the proportion of missing data was similar in the intervention and control groups, the reasons for missing data were provided and balanced across intervention and control groups, or the reasons for missing data were not likely to bias the results (for example, moving house)

  2. High risk of bias: missing outcome data were likely to bias the result, 'as‐treated (per protocol)' analysis was performed with substantial differences between the intervention received and that assigned at randomisation, or potentially inappropriate methods for imputation were used

  3. Unclear risk of bias: insufficient information provided to permit judgement of high or low risk of bias

Selective outcome reporting (checking for possible reporting bias)

Selective reporting can lead to reporting bias. We compared the methods to the results and looked for outcomes that were measured (or likely to have been measured) but not reported.

  1. Low risk of bias: all of the study’s pre‐specified outcomes and expected outcomes of interest to the review were reported

  2. High risk of bias: not all of the study’s pre‐specified outcomes were reported, one or more reported primary outcomes were not pre‐specified, outcomes of interest were reported incompletely and so could not be used, or the study failed to include the results of a key outcome that was expected to be reported

  3. Unclear risk of bias: insufficient information provided to permit judgement of high or low risk of bias

Other sources of bias (checking for other possible sources of bias not covered by the domains above)

We assessed if the study was free of other potential bias as follows.

  1. Low risk of bias: similarity between outcome measures at baseline, similarity between potential confounding variables at baseline, or adequate protection of study arms against contamination

  2. High risk of bias: no similarity between outcome measures at baseline, no similarity between potential confounding variables at baseline, or inadequate protection of study arms against contamination

  3. Unclear risk of bias: insufficient information provided to permit judgement of high or low risk of bias

Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 2

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 3

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Forest plot of comparison: 1 LNS versus no intervention, outcome: 1.1 Moderate stunting.
Figuras y tablas -
Figure 4

Forest plot of comparison: 1 LNS versus no intervention, outcome: 1.1 Moderate stunting.

Forest plot of comparison: 1 LNS versus no intervention, outcome: 1.5 Moderate wasting.
Figuras y tablas -
Figure 5

Forest plot of comparison: 1 LNS versus no intervention, outcome: 1.5 Moderate wasting.

Comparison 1 LNS versus no intervention, Outcome 1 Moderate stunting.
Figuras y tablas -
Analysis 1.1

Comparison 1 LNS versus no intervention, Outcome 1 Moderate stunting.

Comparison 1 LNS versus no intervention, Outcome 2 Severe stunting.
Figuras y tablas -
Analysis 1.2

Comparison 1 LNS versus no intervention, Outcome 2 Severe stunting.

Comparison 1 LNS versus no intervention, Outcome 3 Moderate stunting: Sensitivity analysis.
Figuras y tablas -
Analysis 1.3

Comparison 1 LNS versus no intervention, Outcome 3 Moderate stunting: Sensitivity analysis.

Comparison 1 LNS versus no intervention, Outcome 4 Severe stunting: Sensitivity analysis.
Figuras y tablas -
Analysis 1.4

Comparison 1 LNS versus no intervention, Outcome 4 Severe stunting: Sensitivity analysis.

Comparison 1 LNS versus no intervention, Outcome 5 Moderate wasting.
Figuras y tablas -
Analysis 1.5

Comparison 1 LNS versus no intervention, Outcome 5 Moderate wasting.

Comparison 1 LNS versus no intervention, Outcome 6 Severe wasting.
Figuras y tablas -
Analysis 1.6

Comparison 1 LNS versus no intervention, Outcome 6 Severe wasting.

Comparison 1 LNS versus no intervention, Outcome 7 Moderate wasting: Sensitivity analysis.
Figuras y tablas -
Analysis 1.7

Comparison 1 LNS versus no intervention, Outcome 7 Moderate wasting: Sensitivity analysis.

Comparison 1 LNS versus no intervention, Outcome 8 Severe wasting: Sensitivity analysis.
Figuras y tablas -
Analysis 1.8

Comparison 1 LNS versus no intervention, Outcome 8 Severe wasting: Sensitivity analysis.

Comparison 1 LNS versus no intervention, Outcome 9 Moderate underweight.
Figuras y tablas -
Analysis 1.9

Comparison 1 LNS versus no intervention, Outcome 9 Moderate underweight.

Comparison 1 LNS versus no intervention, Outcome 10 Severe underweight.
Figuras y tablas -
Analysis 1.10

Comparison 1 LNS versus no intervention, Outcome 10 Severe underweight.

Comparison 1 LNS versus no intervention, Outcome 11 Moderate underweight: Sensitivity analysis.
Figuras y tablas -
Analysis 1.11

Comparison 1 LNS versus no intervention, Outcome 11 Moderate underweight: Sensitivity analysis.

Comparison 1 LNS versus no intervention, Outcome 12 Severe underweight: Sensitivity analysis.
Figuras y tablas -
Analysis 1.12

Comparison 1 LNS versus no intervention, Outcome 12 Severe underweight: Sensitivity analysis.

Comparison 1 LNS versus no intervention, Outcome 13 Anaemia.
Figuras y tablas -
Analysis 1.13

Comparison 1 LNS versus no intervention, Outcome 13 Anaemia.

Comparison 1 LNS versus no intervention, Outcome 14 Adverse effects.
Figuras y tablas -
Analysis 1.14

Comparison 1 LNS versus no intervention, Outcome 14 Adverse effects.

Comparison 1 LNS versus no intervention, Outcome 15 Adverse effects: Sensitivity analysis.
Figuras y tablas -
Analysis 1.15

Comparison 1 LNS versus no intervention, Outcome 15 Adverse effects: Sensitivity analysis.

Comparison 1 LNS versus no intervention, Outcome 16 Mid‐upper arm circumference (MUAC).
Figuras y tablas -
Analysis 1.16

Comparison 1 LNS versus no intervention, Outcome 16 Mid‐upper arm circumference (MUAC).

Comparison 1 LNS versus no intervention, Outcome 17 Serum haemoglobin (g/L).
Figuras y tablas -
Analysis 1.17

Comparison 1 LNS versus no intervention, Outcome 17 Serum haemoglobin (g/L).

Comparison 1 LNS versus no intervention, Outcome 18 Mortality.
Figuras y tablas -
Analysis 1.18

Comparison 1 LNS versus no intervention, Outcome 18 Mortality.

Comparison 1 LNS versus no intervention, Outcome 19 HAZ.
Figuras y tablas -
Analysis 1.19

Comparison 1 LNS versus no intervention, Outcome 19 HAZ.

Comparison 1 LNS versus no intervention, Outcome 20 WAZ.
Figuras y tablas -
Analysis 1.20

Comparison 1 LNS versus no intervention, Outcome 20 WAZ.

Comparison 1 LNS versus no intervention, Outcome 21 WHZ.
Figuras y tablas -
Analysis 1.21

Comparison 1 LNS versus no intervention, Outcome 21 WHZ.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 1 Severe stunting.
Figuras y tablas -
Analysis 2.1

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 1 Severe stunting.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 2 Moderate stunting.
Figuras y tablas -
Analysis 2.2

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 2 Moderate stunting.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 3 Moderate wasting.
Figuras y tablas -
Analysis 2.3

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 3 Moderate wasting.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 4 Severe wasting.
Figuras y tablas -
Analysis 2.4

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 4 Severe wasting.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 5 Moderate underweight.
Figuras y tablas -
Analysis 2.5

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 5 Moderate underweight.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 6 Severe underweight.
Figuras y tablas -
Analysis 2.6

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 6 Severe underweight.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 7 Anaemia.
Figuras y tablas -
Analysis 2.7

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 7 Anaemia.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 8 Adverse effects.
Figuras y tablas -
Analysis 2.8

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 8 Adverse effects.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 9 Mid‐upper arm circumference (MUAC).
Figuras y tablas -
Analysis 2.9

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 9 Mid‐upper arm circumference (MUAC).

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 10 Serum haemoglobin (g/L).
Figuras y tablas -
Analysis 2.10

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 10 Serum haemoglobin (g/L).

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 11 Mortality.
Figuras y tablas -
Analysis 2.11

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 11 Mortality.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 12 HAZ.
Figuras y tablas -
Analysis 2.12

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 12 HAZ.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 13 WHZ.
Figuras y tablas -
Analysis 2.13

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 13 WHZ.

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 14 WAZ.
Figuras y tablas -
Analysis 2.14

Comparison 2 LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided, Outcome 14 WAZ.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 1 Moderate stunting.
Figuras y tablas -
Analysis 3.1

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 1 Moderate stunting.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 2 Severe stunting.
Figuras y tablas -
Analysis 3.2

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 2 Severe stunting.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 3 Moderate wasting.
Figuras y tablas -
Analysis 3.3

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 3 Moderate wasting.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 4 Severe wasting: 6 to 12 months.
Figuras y tablas -
Analysis 3.4

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 4 Severe wasting: 6 to 12 months.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 5 Moderate underweight.
Figuras y tablas -
Analysis 3.5

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 5 Moderate underweight.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 6 Severe underweight: 6 to 12 months.
Figuras y tablas -
Analysis 3.6

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 6 Severe underweight: 6 to 12 months.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 7 Anaemia.
Figuras y tablas -
Analysis 3.7

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 7 Anaemia.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 8 Adverse effects.
Figuras y tablas -
Analysis 3.8

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 8 Adverse effects.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 9 Mid‐upper arm circumference (MUAC).
Figuras y tablas -
Analysis 3.9

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 9 Mid‐upper arm circumference (MUAC).

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 10 Serum haemoglobin (g/L).
Figuras y tablas -
Analysis 3.10

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 10 Serum haemoglobin (g/L).

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 11 Mortality.
Figuras y tablas -
Analysis 3.11

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 11 Mortality.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 12 HAZ.
Figuras y tablas -
Analysis 3.12

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 12 HAZ.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 13 WAZ.
Figuras y tablas -
Analysis 3.13

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 13 WAZ.

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 14 WHZ.
Figuras y tablas -
Analysis 3.14

Comparison 3 LNS versus no intervention: Subgroup analysis by duration of intervention, Outcome 14 WHZ.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 1 Moderate stunting.
Figuras y tablas -
Analysis 4.1

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 1 Moderate stunting.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 2 Severe stunting.
Figuras y tablas -
Analysis 4.2

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 2 Severe stunting.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 3 Moderate wasting.
Figuras y tablas -
Analysis 4.3

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 3 Moderate wasting.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 4 Severe wasting.
Figuras y tablas -
Analysis 4.4

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 4 Severe wasting.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 5 Moderate underweight.
Figuras y tablas -
Analysis 4.5

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 5 Moderate underweight.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 6 Severe underweight: at 18 months.
Figuras y tablas -
Analysis 4.6

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 6 Severe underweight: at 18 months.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 7 Anaemia.
Figuras y tablas -
Analysis 4.7

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 7 Anaemia.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 8 Adverse effects: At 18 months.
Figuras y tablas -
Analysis 4.8

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 8 Adverse effects: At 18 months.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 9 Mid‐upper arm circumference (MUAC).
Figuras y tablas -
Analysis 4.9

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 9 Mid‐upper arm circumference (MUAC).

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 10 Serum haemoglobin (g/L).
Figuras y tablas -
Analysis 4.10

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 10 Serum haemoglobin (g/L).

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 11 Mortality.
Figuras y tablas -
Analysis 4.11

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 11 Mortality.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 12 HAZ.
Figuras y tablas -
Analysis 4.12

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 12 HAZ.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 13 WAZ.
Figuras y tablas -
Analysis 4.13

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 13 WAZ.

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 14 WHZ.
Figuras y tablas -
Analysis 4.14

Comparison 4 LNS versus no intervention: Subgroup analysis by age at follow‐up, Outcome 14 WHZ.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 1 Moderate stunting.
Figuras y tablas -
Analysis 5.1

Comparison 5 LNS versus fortified blended food (FBF), Outcome 1 Moderate stunting.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 2 Severe stunting.
Figuras y tablas -
Analysis 5.2

Comparison 5 LNS versus fortified blended food (FBF), Outcome 2 Severe stunting.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 3 Moderate wasting.
Figuras y tablas -
Analysis 5.3

Comparison 5 LNS versus fortified blended food (FBF), Outcome 3 Moderate wasting.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 4 Severe wasting.
Figuras y tablas -
Analysis 5.4

Comparison 5 LNS versus fortified blended food (FBF), Outcome 4 Severe wasting.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 5 Moderate underweight.
Figuras y tablas -
Analysis 5.5

Comparison 5 LNS versus fortified blended food (FBF), Outcome 5 Moderate underweight.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 6 Severe underweight.
Figuras y tablas -
Analysis 5.6

Comparison 5 LNS versus fortified blended food (FBF), Outcome 6 Severe underweight.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 7 MUAC.
Figuras y tablas -
Analysis 5.7

Comparison 5 LNS versus fortified blended food (FBF), Outcome 7 MUAC.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 8 Haemoglobin (g/L).
Figuras y tablas -
Analysis 5.8

Comparison 5 LNS versus fortified blended food (FBF), Outcome 8 Haemoglobin (g/L).

Comparison 5 LNS versus fortified blended food (FBF), Outcome 9 HAZ.
Figuras y tablas -
Analysis 5.9

Comparison 5 LNS versus fortified blended food (FBF), Outcome 9 HAZ.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 10 WAZ.
Figuras y tablas -
Analysis 5.10

Comparison 5 LNS versus fortified blended food (FBF), Outcome 10 WAZ.

Comparison 5 LNS versus fortified blended food (FBF), Outcome 11 WHZ.
Figuras y tablas -
Analysis 5.11

Comparison 5 LNS versus fortified blended food (FBF), Outcome 11 WHZ.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 1 Moderate stunting.
Figuras y tablas -
Analysis 6.1

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 1 Moderate stunting.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 2 Moderate wasting.
Figuras y tablas -
Analysis 6.2

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 2 Moderate wasting.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 3 Moderate underweight.
Figuras y tablas -
Analysis 6.3

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 3 Moderate underweight.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 4 Anaemia.
Figuras y tablas -
Analysis 6.4

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 4 Anaemia.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 5 Anaemia: Sensitivity analysis.
Figuras y tablas -
Analysis 6.5

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 5 Anaemia: Sensitivity analysis.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 6 Serum haemoglobin (g/L).
Figuras y tablas -
Analysis 6.6

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 6 Serum haemoglobin (g/L).

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 7 Serum haemoglobin (g/L): Sensitivity analysis.
Figuras y tablas -
Analysis 6.7

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 7 Serum haemoglobin (g/L): Sensitivity analysis.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 8 HAZ.
Figuras y tablas -
Analysis 6.8

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 8 HAZ.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 9 HAZ: Sensitivity analysis.
Figuras y tablas -
Analysis 6.9

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 9 HAZ: Sensitivity analysis.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 10 WAZ.
Figuras y tablas -
Analysis 6.10

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 10 WAZ.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 11 WAZ: Sensitivity analysis.
Figuras y tablas -
Analysis 6.11

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 11 WAZ: Sensitivity analysis.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 12 WHZ.
Figuras y tablas -
Analysis 6.12

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 12 WHZ.

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 13 WHZ: Sensitivity analysis.
Figuras y tablas -
Analysis 6.13

Comparison 6 LNS versus micronutrient powders (MNP), Outcome 13 WHZ: Sensitivity analysis.

LNS plus complementary feeding compared with no intervention

Patient or population: children aged 6 to 23 months

Settings: community

Intervention: LNS plus complementary feeding

Comparison: no intervention

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

No intervention

LNS plus complementary feeding

Stunting

Moderate stunting

Measured as height‐for‐age z score < −2 SD

Measured at 12, 18 and 24 months of age

2618/7137

2353/7060

RR 0.93 (0.88 to 0.98)

13,372
(9 studies)

⊕⊕⊕⊝
Moderatea

2 studies, Kumwenda 2014 and Mangani 2015, contributed data to multiple comparisons; total number of comparisons = 13

Severe stunting

Measured as height‐for‐age z score < −3 SD

Measured at 12, 18 and 24 months of age

471/4188

290/2868

RR 0.85 (0.74 to 0.98)

6151

(5 studies)

⊕⊕⊕⊝
Moderatea

2 studies, Kumwenda 2014 and Mangani 2015, contributed data to multiple comparisons; total number of comparisons = 9

Wasting

Moderate wasting

Measured as weight‐for‐height z score < −2 SD

Measured at 12, 18 and 24 months of age

695/6213

624/6959

RR 0.82 (0.74 to 0.91)

13,172

(8 studies)

⊕⊕⊕⊝
Moderatea

1 study, Kumwenda 2014, contributed data to 2 comparisons; total number of comparisons = 11

Severe wasting

Measured as weight‐for‐height z score < −3 SD

Measured at 12 and 18 months of age

18/1636

21/1663

RR 1.27 (0.66 to 2.46)

2329

(3 studies)

⊕⊕⊕⊕
Moderateb

1 study, Kumwenda 2014, contributed data to 4 comparisons; total number of comparisons = 6

Underweight

Moderate underweight

Measured as weight‐for‐age z score < −2 SD

Measured at 12, 18 and 24 months of age

1723/7013

1525/6861

RR 0.85 (0.80 to 0.91)

13,073

(8 studies)

⊕⊕⊕⊝
Moderatea

1 study, Kumwenda 2014, contributed data to 4 comparisons; total number of comparisons = 11

Severe underweight

Measured as weight‐for‐age z score < −3 SD

Measured at 12 and 18 months of age

62/1224

50/1258

RR 0.78 (0.54 to 1.13)

1729

(2 studies)

⊕⊕⊕⊕
Moderateb

1 study, Kumwenda 2014, contributed data to 4 comparisons; total number of comparisons = 5

Anaemia

Measured as haemoglobin < 10 g/dL

Measured at 12, 18 and 24 months of age

697/1359

558/973

RR 0.79 (0.69 to 0.90)

2332

(5 studies)

⊕⊕⊝⊝
Lowa,c

Adverse effects

Defined as deaths, hospitalisations, congenital abnormalities and life‐threatening conditions requiring an immediate hospital visit

Assessed at 12 and 18 months of age

314/1369

401/2333

RR 0.86 (0.74 to 1.01)

3382

(3 studies)

⊕⊕⊕⊝
Moderatea

1 study, Kumwenda 2014, contributed data to 2 comparisons; total number of comparisons = 4

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence interval; LNS: lipid‐based nutrient supplement; RR: risk ratio; SD: standard deviation

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

aDowngraded one level due to study limitations: high risk of selection bias (inadequate sequence generation process) in one study (Adu‐Afarwuah 2007); high risk of performance bias in seven studies (Adu‐Afarwuah 2016; Ashorn 2015; Christian 2015; Dewey 2017; Hess 2015; Luby 2018; Null 2018); and high risk of detection bias in one study (Christian 2015).
bDowngraded one level due to inconsistency (I2 = 88%).
cDowngraded one level due to imprecision.

Figuras y tablas -

LNS plus complementary feeding compared with fortified blended food (FBF)

Patient or population: children aged 6 to 23 months

Settings: community

Intervention: LNS plus complementary feeding

Comparison: FBF

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

FBF

LNS plus complementary feeding

Stunting

Moderate stunting

Measured as height‐for‐age z score < −2 SD

Measured at 12 months and 18 months of age

461/1048

735/1829

RR 0.89 (0.82 to 0.97)

2828
(3 studies)

⊕⊕⊕⊝
Moderatea

1 study, Phuka 2008, contributed data to 2 comparisons; total number of comparisons = 4

Severe stunting

Measured as height‐for‐age z score < −3 SD

Measured at 12 months and 18 months of age

43/292

53/493

RR 0.41 (0.12 to 1.42)

729

(2 studies)

⊕⊕⊕⊝
Lowa,b

1 study, Phuka 2008, contributed data to 2 comparisons; total number of comparisons = 3

Wasting

Moderate wasting

Measured as weight‐for‐height z score < −2 SD

Measured at 12 months and 18 months of age

145/886

195/1462

RR 0.79 (0.65 to 0.97)

2290

(2 studies)

⊕⊕⊕⊝
Moderatea

1 study, Phuka 2008, contributed data to 2 comparisons; total number of comparisons = 3

Severe wasting

Measured as weight‐for‐height z score < −3 SD

Measured at 12 months and 18 months of age

5/296

5/497

RR 0.64 (0.19 to 2.18)

735

(2 studies)

⊕⊕⊕⊝
Moderatea

1 study, Phuka 2008, contributed data to 2 comparisons; total number of comparisons = 3

Underweight

Moderate underweight

Measured as weight‐for‐age z score < −2 SD

Measured at 12 months and 18 months of age

355/876

478/1457

RR 0.81 (0.73 to 0.91)

2280

(2 studies)

⊕⊕⊕⊝
Moderatea

1 study, Phuka 2008, contributed data to 2 comparisons; total number of comparisons = 3

Severe underweight

Measured as weight‐for‐age z score < −3 SD

Measured at 12 months of age

34/722

60/1505

RR 1.23 (0.67 to 2.25)

173

(1 study)

⊕⊕⊝⊝
Lowa,c

1 study, Phuka 2008, contributed data to 2 arms to this analysis; total number of comparisons = 2

Anaemia

None of the included studies reported this outcome

Adverse effects

None of the included studies reported this outcome

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; LNS: lipid‐based nutrient supplements; RR: Risk Ratio; SD: Standard deviation.

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate
Very low quality: we are very uncertain about the estimate

aDowngraded one level due to study limitations: high risk of performance bias in two studies (Christian 2015; Phuka 2008).
bDowngraded one level due to imprecision (high heterogeneity; I2 = 57%).
cDowngraded one level due to small sample size.

Figuras y tablas -

LNS plus complementary feeding compared with micronutrient powders (MNP)

Patient or population: children aged 6 to 23 months

Settings: community

Intervention: LNS plus complementary feeding

Comparison: MNP

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

MNP

LNS plus complementary feeding

Moderate stunting

Measured as height‐for‐age z score < −2 SD

Measured at 12 months and 24 months of age

421/1059

336/945

RR 0.92 (0.82 to 1.02)

2365
(3 studies)

⊕⊕⊕⊝
Moderatea

Moderate wasting

Measured as weight‐for‐height z score < −2 SD

Measured at 12 months and 24 months of age

133/1059

115/945

RR 0.97 (0.77 to 1.23)

2004
(2 studies)

⊕⊕⊕⊝
Moderatea

Moderate underweight

Measured as weight‐for‐age z score < −2 SD

Measured at 12 months and 24 months of age

376/1059

292/945

RR 0.88 (0.78 to 0.99)

2004
(2 studies)

⊕⊕⊕⊝
Moderatea

Anaemia

Measured as haemoglobin < 10 g/dL

Measured at 12 months of age

18/98

10/98

RR 0.38 (0.21 to 0.68)

557
(2 studies)

⊕⊕⊝⊝
Lowa,b

Adverse effects

None of the included studies reported this outcome

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; LNS: Lipid‐based nutrient supplements; RR: Risk ratio; SD: Standard deviation.

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate
Very low quality: we are very uncertain about the estimate

aDowngraded one level due to study limitations: high risk of performance bias in two studies (Adu‐Afarwuah 2016; Dewey 2017).
bDowngraded one level due to small sample size.

Figuras y tablas -
Table 1. Unused methods

Method

Approach

Measures of treatment effects

Rates

If rates represent events that could occur more than once per participant, we will report the rate difference using the methodologies described in Deeks 2011.

Unit of analysis issues

Cluster‐randomised trials

We will follow the methods described in theCochrane Handbook for Systematic Reviews of Interventions (Higgins 2011b), and adjust the sample sizes or standard errors of cluster‐randomised trials by using an estimate of the intra‐cluster correlation co‐efficient (ICC) derived from the study (if possible), from a similar trial or from a study of a similar population. If we use ICCs from other sources, we will report this in the results section, and conduct sensitivity analyses to investigate the effect of variation in the ICC.

We will acknowledge heterogeneity in the randomisation unit and perform a sensitivity analysis to investigate the effects of the randomisation unit in the future updates of the review, if applicable.

Dealing with missing data

If we find studies with high levels of missing data, we will explore the effect in the overall assessment of treatment effect by removing such studies and conducting a sensitivity analysis.

Assessment of reporting bias

If we include 10 or more studies in a meta‐analysis, we will investigate reporting biases (such as publication bias) using funnel plots. We will assess funnel plot asymmetry visually, and use formal tests for funnel plot asymmetry. For continuous outcomes, we will use the test proposed by Egger 1997. For dichotomous outcomes, we will use the test proposed by Harbord 2006. If asymmetry is detected in any of these tests or is suggested by a visual assessment, we will perform exploratory analyses to investigate it.

Subgroup analysis and investigation of heterogeneity

We will conduct exploratory subgroup analyses on the primary outcomes, irrespective of heterogeneity, when there are more than three studies contributing data. We will conduct the following analyses.

  1. Breastfeeding practices (breastfed versus not breastfed)

  2. Frequency of intervention (daily versus weekly versus flexible)

  3. Living in an emergency‐affected country (Wisner 2002), or in a refugee or internally displaced persons' camp (yes verus no)

  4. Anaemic status of participants at start of intervention (anaemic (defined as haemoglobin values < 110 g/L) versus non‐anaemic or unknown status).

Sensitivity analysis

We will carry out a sensitivity analysis to examine:

  1. the effect of removing non‐randomised studies from the analysis; and

  2. the effects of different ICCs, and the randomisation unit, for cluster trials (if these are included).

ICC: Intra‐class correlation coefficient; WHO: World Health Organization.

Figuras y tablas -
Table 1. Unused methods
Table 2. Composition of LNS

Study

Total energy

Lipid content

Protein Content

Micronutrients

Adu‐Afarwuah 2007

108 kcal

(20 g/day)

linoleic acid (1.29 g); linolenic acid (0.29 g)

Not specified

Carotene (400 μg RE); vitamin C (30 mg); folic acid (80 g); thiamine (0.3 mg); riboflavin (0.4 mg); vitamin B3 (4 mg); pantothenic acid (1.8 mg); vitamin B6 (0.3 mg); vitamin B12 (0.5 g); iron sulphate (9 mg); zinc sulphate (4 mg); calcium phosphate (100 mg); potassium (152 mg); copper sulphate (0.2 mg); sodium selenite (10 ug); potassium iodate (90 ug); phosphate (82 mg); magnesium (16 mg); manganese (0.08 mg); phytate (82 mg)

Adu‐Afarwuah 2016

118 kcal (20 g/day)

9.6 g

2.6 g

Linoleic acid (4.46 g); α‐linolenic acid (0.58 g); vitamin A (400 mg retinol equivalents); thiamine (0.3 mg); riboflavin (0.4 mg); niacin (4 mg); vitamin B6 (0.3 mg); vitamin B12 (0.5 mg); vitamin C (30 mg); vitamin D (5 mg); vitamin E (6 mg); vitamin K (30 mg); folic acid (80 mg); pantothenic acid (1.8 mg); iron (6 mg); zinc (8 mg); copper (0.34 mg); calcium (280 mg); phosphorus (190 mg); potassium (200 mg); magnesium (40 mg); selenium (20 mg); iodine (90 mg); manganese (1.2 mg)

Ashorn 2015

118 kcal (20 g/day)

9.6 g

2.6 g

Linoleic acid (4.46 g); a‐linolenic acid (0.58 g); vitamin A (400 mg RE); vitamin C (30 mg); vitamin B1 (0.3 mg); vitamin B2 (0.4 mg); niacin (4 mg); folic acid (80 mg); pantothenic acid (1.8 mg); vitamin B6 (0.3 mg); vitamin B12 (0.5 mg); vitamin D (5 mg); vitamin E (6 mg); vitamin K (30 mg); iron (6 mg); zinc (8 mg); copper (0.34 mg); calcium (280 mg); phosphorus (190 mg); potassium (200 mg); magnesium (40 mg); selenium (20 mg); iodine (90 mg); manganese (1.2 mg)

Bisimwa 2012

275 kcal (50 g/day)

Not specified

Not specified

Vitamin A (412 IU); vitamin D (307 IU); vitamin C (75 mg); thiamine (0.7 mg); riboflavin (1.0 mg); vitamin B12 (1.0 μg); pyridoxine (0.24 mg); niacin (10.3 mg); pantothenic acid (3.8 mg); folic acid (0.07 mg); vitamin K (0.01 mg); calcium (514 mg); phosphorus (265 mg); iron (9.5 mg); zinc (8.3 mg); copper (0.3 mg); iodine (0.07 mg); selenium (0.003 mg); magnesium (23.4 mg); phytic acid (0.425 mg2); phytic acid:iron molar ratio2 (2.1); phytic acid:zinc molar ratio2 (1.9)

Christian 2015

250 kcal (46 g/day)

Not specified

Not specified

Not specified

Dewey 2017

118 kcal (20 g/day)

9.6 g

2.6 g

Linoleic acid (4.46 g); α‐linolenic acid (0.58 g); vitamin A (400 mg RE); thiamine (0.5 mg); riboflavin (0.5 mg); niacin (6 mg); folic acid (150 mg); pantothenic acid (2 mg); vitamin B6 (0.5 mg); vitamin B12 (0.9 mg); vitamin C (30 mg); vitamin D (5 mg); vitamin E (6 mg); vitamin K (30 mg); calcium (280 mg); copper (0.34 mg); iodine (90 mg); iron (9 mg); magnesium (40 mg); manganese (1.2 mg); phosphorus (190 mg); potassium (200 mg); selenium (20 mg); zinc (8 mg)

Hess 2015

118 kcal (20 g/day)

9.6 g

2.6 g

Linoleic acid (4.46 g); α‐Linolenic acid (0.58 g); vitamin A (400 mg); thiamine (0.3 mg); riboflavin (0.4 mg); niacin (4 mg); pantothenic acid (1.8 mg); vitamin B6 (0.3 mg); vitamin B12 (0.5 mg); folic acid (80 mg); vitamin C (30 mg); vitamin D (5 mg); vitamin E (6 mg); vitamin K (30 mg); calcium (280 mg); copper (0.34 mg); iodine (90 mg); iron (6 mg); magnesium (40 mg); manganese (1.2 mg); phosphorus (190 mg); potassium (200 mg); selenium (20 μg); zinc (0 mg)

Huybregts 2012

247 kcal (46 g/day)

16 g

5.9 g

Linoleic acid (2 g); α‐linolenic acid (0.3 g); vitamin A (400 mg); vitamin E (6 mg); thiamine (0.5 mg); niacin (6 mg); pantothenic acid (2 mg); vitamin B6 (0.5 mg); folic acid (160 mg); vitamin B12 (0.9 mg); vitamin C (30 mg); magnesium (60 mg); zinc (4 mg); iron (9 mg); copper (0.3 mg); potassium (310 mg); calcium (387 mg); phosphorus (275 mg); selenium (17 mg); manganese (0.17 mg); iodine (90 mg)

Iannotti 2014

108 kcal (20 g/day)

7.08 g

2.56 g

Linoleic acid (1.29 g); α‐linoleic acid (0.29 g); vitamin A (400 mg); thiamine (0.3 mg); riboflavin (0.4 mg); niacin (4 mg); pantothenic acid (1.8 mg); vitamin B6 (0.3 mg); vitamin B12 (0.5 mg); folic acid (80 mg); vitamin C (30 mg); calcium (100 mg); copper (0.2 mg); iodine (90 mg); iron (9 mg); magnesium (16 mg); manganese (0.08 mg); phosphorus (82.2 mg); potassium (152 mg); selenium (10 mg); zinc (4 mg)

Kumwenda 2014

55 kcal (10 g/day)

4.7 g

1.3 g

Linoleic acid (2.22 g); α‐linolenic acid (0.29 g); vitamin A (400 μg RE); vitamin C (30 mg); vitamin B1 (0.3 mg); vitamin B2 (0.4 mg); niacin (4 mg); folic acid (80 μg); pantothenic acid (1.8 mg); vitamin B6 (0.3 mg); vitamin B12 (0.5 μg); vitamin D (200 IU); vitamin E (6 6 mg); vitamin K (30 μg); iron (6 mg); zinc (8 mg); copper (0.34 mg); calcium (240 mg); phosphorus (208 mg); potassium (265 mg); magnesium (50 mg); selenium (20 μg); iodine (90 μg); manganese (1.2 mg); phytate (28 mg)

17 kcal (20 g/day)

9.5 g

2.5 g

Linoleic acid (4.44 g); α‐linolenic acid (0.58 g); vitamin A (400 μg RE); vitamin C (30 mg); vitamin B1 (0.3 mg); vitamin B2 (0.4 mg); niacin (4 mg); folic acid (80 μg); pantothenic acid (1.8 mg); vitamin B6 (0.3 mg); vitamin B12 (0.5 μg); vitamin D (200 IU); vitamin E (6 6 mg); vitamin K (30 μg); iron (6 mg); zinc (8 mg); copper (0.34 mg); calcium (240 mg); phosphorus (208 mg); potassium (265 mg); magnesium (50 mg); selenium (20 μg); iodine (90 μg); manganese (1.2 mg); phytate (56 mg)

241 kcal (40 g/day)

18.9 g

5 g

Linoleic acid (8.88 g); α‐linolenic acid (1.16 g); vitamin A (400 μg RE); vitamin C (30 mg); vitamin B1 (0.3 mg); vitamin B2 (0.4 mg); niacin (4 mg); folic acid (80 μg); pantothenic acid (1.8 mg); vitamin B6 (0.3 mg); vitamin B12 (0.5 μg); vitamin D (200 IU); vitamin E (6 6 mg); vitamin K (30 μg); iron (6 mg); zinc (8 mg); copper (0.34 mg); calcium (240 mg); phosphorus (208 mg); potassium (265 mg); magnesium (50 mg); selenium (20 μg); iodine (90 μg); manganese (1.2 mg); phytate (112 mg)

Luby 2018

118 kcal (20 g/day)

9.6 g

2.6 g

Linoleic acid (4.46 g); Alpha‐linolenic acid (0.58 g); Vitamin A (400 μg); Vitamin D (5 μg); Vitamin E (6 mg); Vitamin K (30 μg); Vitamin C (30 mg) Folic acid (150 μg); Thiamine (B1) (0.5 mg); Riboflavin (B2) (0.5 mg); Niacin (6 mg); Pantothenic acid (B5) (2 mg); Vitamin B6 (0.5 mg); Vitamin B12 (0.9 μg); Calcium (280 mg); Copper (0.34 mg); Iodine (90 μg); Iron (9 mg); Magnesium (40 mg); Manganese (1.2 mg); Phosphorous (190 mg); Potassium (200 mg); Selenium (20 μg); Zinc (8 mg)

Mangani 2015

Milk‐LNS

284.8 kcal (54 g/day)

17.9 g

8.2 g

Retinol (400 μg RE); folate (160 μg); niacin (6 mg); pantothenic acid (2 mg); riboflavin (0.5 mg); thiamine (0.5 mg); vitamin B6 (0.5 mg); vitamin B12 (0.9 μg); vitamin C (30 mg); vitamin D (5 μg); calcium (366 mg); copper (0.4 mg); iodine (90 μg); iron (6 mg); magnesium (78.5 mg); selenium (20 μg); zinc (6.0 mg); phosphorus (185.6 mg); potassium (318.6 mg); manganese (0.60 mg)

Soy‐LNS

276.1 kcal (54 g/day)

18.5 g

7.5 g

Retinol (400 μg RE); folate (160 μg); niacin (6 mg); pantothenic acid (2 mg); riboflavin (0.5 mg); thiamine (0.5 mg); vitamin B6 (0.5 mg); vitamin B12 (0.9 μg); vitamin C (30 mg); vitamin D (5 μg); calcium (366 mg); copper (0.4 mg); iodine (90 μg); iron (6 mg); magnesium (78.5 mg); selenium (20 μg); zinc (6.0 mg); phosphorus (185.6 mg); potassium (307.3 mg); manganese (0.60 mg)

Matias 2017

110 kcal (20 g/day)

7 g

2.6 g

Linoleic acid (1.29 g); α‐linolenic acid (0.29 g); folic acid (80 μg); niacin (4 mg); pantothenic acid (1.8 mg); riboflavin (0.4 mg); thiamine (0.3 mg); vitamin A (400 μg); vitamin B12 (0.5 μg); vitamin B6 (0.3 mg); vitamin C (30 mg); calcium (100 mg); copper (0.2 mg); iodine (90 μg); iron (9 mg); magnesium (16 mg); manganese (0,08 mg); phosphorous (82 mg); potassium (152 mg); selenium (10 μg); zinc (4 mg)

Null 2018

118 kcal (20 g/day)

9.6 g

2.6 g

Linoleic acid (4.46 g); Alpha‐linolenic acid (0.58 g); Vitamin A (400 μg); Vitamin D (5 μg); Vitamin E (6 mg); Vitamin K (30 μg); Vitamin C (30 mg) Folic acid (150 μg); Thiamine (B1) (0.5 mg); Riboflavin (B2) (0.5 mg); Niacin (6 mg); Pantothenic acid (B5) (2 mg); Vitamin B6 (0.5 mg); Vitamin B12 (0.9 μg); Calcium (280 mg); Copper (0.34 mg); Iodine (90 μg); Iron (9 mg); Magnesium (40 mg); Manganese (1.2 mg); Phosphorous (190 mg); Potassium (200 mg); Selenium (20 μg); Zinc (8 mg)

Olney 2018

118 kcal (20 g/day)

9.6 g

2.6 g

Linoleic acid (4.5 g); α‐linolenic acid (0.6 g); vitamin A (400 μg); vitamin C (30 mg); vitamin D (5 mg); vitamin E (6 mg); vitamin K (30 mg); thiamine (0.5 mg); riboflavin (0.5 mg); niacin (6 mg); pantothenic acid (2 mg); vitamin B6 (0.5 mg); folic acid (150 μg); vitamin B12 (0.9 μg); iron (9 mg); zinc (8 mg); copper (0.3 mg); selenium (20 μg); iodine (90 μg); calcium (280 mg); magnesium (40 mg); manganese (1.2 mg); phosphorus (190 mg); potassium (200 mg)

Phuka 2008

130 kcal (25 g/day)

8.3 g

3.8 g

Retinol (400 mg RE); folate (160 mg); niacin (6 mg); pantothenic acid (2 mg); riboflavin (0.5 mg); thiamine (0.5 mg); vitamin B 6 (0.5 mg); vitamin B12 (0.9 mg); vitamin C (30 mg); vitamin D (5 mg); calcium (283 mg); copper (0.5 mg); iodine (90 mg); iron (8 mg); magnesium (60 mg); selenium (17 mg); zinc (8.4 mg)

264 kcal (50 g/day)

16.5 g

7.6 g

Retinol (400 mg RE); folate (160 mg); niacin (6 mg); pantothenic acid (2 mg); riboflavin (0.5 mg); thiamine (0.5 mg); vitamin B6 (0.5 mg); vitamin B12 (0.9 mg); vitamin C (30 mg); vitamin D (5 mg); calcium (366 mg); copper (0.4 mg); iodine (90 mg); iron (8 mg); magnesium (60 mg); selenium (17 mg); zinc (8.4 mg)

Siega‐Riz 2014

247 kcal (46.4 g/day)

16 g

5.9 g

Vitamin A (400 μg); vitamin B12 (0.9 μg); iron (9 mg); zinc (9 mg)

g: gram;
LNS: lipid‐based nutrient supplements
mg: milligram

Figuras y tablas -
Table 2. Composition of LNS
Comparison 1. LNS versus no intervention

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Moderate stunting Show forest plot

9

13372

Risk Ratio (Random, 95% CI)

0.93 [0.88, 0.98]

2 Severe stunting Show forest plot

5

6151

Risk Ratio (Random, 95% CI)

0.85 [0.74, 0.98]

3 Moderate stunting: Sensitivity analysis Show forest plot

7

Risk Ratio (Random, 95% CI)

0.92 [0.88, 0.96]

4 Severe stunting: Sensitivity analysis Show forest plot

4

Risk Ratio (Random, 95% CI)

0.84 [0.73, 0.97]

5 Moderate wasting Show forest plot

8

13172

Risk Ratio (Random, 95% CI)

0.82 [0.74, 0.91]

6 Severe wasting Show forest plot

3

2329

Risk Ratio (Random, 95% CI)

1.27 [0.66, 2.46]

7 Moderate wasting: Sensitivity analysis Show forest plot

6

Risk Ratio (Random, 95% CI)

0.81 [0.73, 0.90]

8 Severe wasting: Sensitivity analysis Show forest plot

2

Risk Ratio (Random, 95% CI)

1.24 [0.61, 2.51]

9 Moderate underweight Show forest plot

8

13073

Risk Ratio (Random, 95% CI)

0.85 [0.80, 0.91]

10 Severe underweight Show forest plot

2

1729

Risk Ratio (Random, 95% CI)

0.78 [0.54, 1.13]

11 Moderate underweight: Sensitivity analysis Show forest plot

6

Risk Ratio (Random, 95% CI)

0.85 [0.80, 0.90]

12 Severe underweight: Sensitivity analysis Show forest plot

1

Risk Ratio (Random, 95% CI)

0.79 [0.54, 1.16]

13 Anaemia Show forest plot

5

2332

Risk Ratio (Random, 95% CI)

0.79 [0.69, 0.90]

14 Adverse effects Show forest plot

3

3382

Risk Ratio (Random, 95% CI)

0.86 [0.74, 1.01]

15 Adverse effects: Sensitivity analysis Show forest plot

1

1932

Risk Ratio (Random, 95% CI)

0.76 [0.60, 0.95]

16 Mid‐upper arm circumference (MUAC) Show forest plot

6

8187

Std. Mean Difference (Random, 95% CI)

0.13 [0.05, 0.22]

17 Serum haemoglobin (g/L) Show forest plot

4

4518

Mean Difference (Random, 95% CI)

5.78 [2.27, 9.30]

18 Mortality Show forest plot

3

3321

Risk Ratio (Random, 95% CI)

0.93 [0.63, 1.37]

19 HAZ Show forest plot

12

15795

Std. Mean Difference (Random, 95% CI)

0.11 [0.05, 0.16]

20 WAZ Show forest plot

10

12188

Std. Mean Difference (Random, 95% CI)

0.09 [0.02, 0.16]

21 WHZ Show forest plot

10

12894

Std. Mean Difference (Random, 95% CI)

0.08 [0.04, 0.13]

Figuras y tablas -
Comparison 1. LNS versus no intervention
Comparison 2. LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Severe stunting Show forest plot

5

6151

Risk Ratio (Random, 95% CI)

0.85 [0.74, 0.98]

1.1 SQ LNS

4

4956

Risk Ratio (Random, 95% CI)

0.83 [0.70, 0.99]

1.2 MQ LNS

2

1195

Risk Ratio (Random, 95% CI)

0.88 [0.69, 1.12]

2 Moderate stunting Show forest plot

9

13372

Risk Ratio (Random, 95% CI)

0.93 [0.88, 0.98]

2.1 SQ LNS

7

9710

Risk Ratio (Random, 95% CI)

0.92 [0.84, 1.00]

2.2 MQ LNS

3

3662

Risk Ratio (Random, 95% CI)

0.94 [0.88, 1.02]

3 Moderate wasting Show forest plot

8

13172

Risk Ratio (Random, 95% CI)

0.82 [0.74, 0.91]

3.1 SQ LNS

7

9903

Risk Ratio (Random, 95% CI)

0.83 [0.73, 0.95]

3.2 MQ LNS

2

3269

Risk Ratio (Random, 95% CI)

0.78 [0.63, 0.96]

4 Severe wasting Show forest plot

3

2329

Risk Ratio (Random, 95% CI)

1.27 [0.66, 2.46]

4.1 SQ LNS

2

1106

Risk Ratio (Random, 95% CI)

1.74 [0.73, 4.15]

4.2 MQ LNS

2

1223

Risk Ratio (Random, 95% CI)

0.84 [0.31, 2.30]

5 Moderate underweight Show forest plot

8

13073

Risk Ratio (Random, 95% CI)

0.85 [0.80, 0.91]

5.1 SQ LNS

7

9880

Risk Ratio (Random, 95% CI)

0.88 [0.80, 0.96]

5.2 MQ LNS

2

3193

Risk Ratio (Random, 95% CI)

0.83 [0.76, 0.92]

6 Severe underweight Show forest plot

2

1729

Risk Ratio (Random, 95% CI)

0.78 [0.54, 1.13]

6.1 SQ LNS

2

1083

Risk Ratio (Random, 95% CI)

0.84 [0.52, 1.37]

6.2 MQ LNS

1

646

Risk Ratio (Random, 95% CI)

0.71 [0.41, 1.24]

7 Anaemia Show forest plot

5

2332

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.69, 0.90]

7.1 SQ LNS

3

1107

Risk Ratio (M‐H, Random, 95% CI)

0.63 [0.43, 0.93]

7.2 MQ LNS

2

1225

Risk Ratio (M‐H, Random, 95% CI)

0.86 [0.78, 0.94]

8 Adverse effects Show forest plot

3

3382

Risk Ratio (Random, 95% CI)

0.86 [0.74, 1.01]

8.1 SQ LNS

3

2576

Risk Ratio (Random, 95% CI)

0.86 [0.69, 1.06]

8.2 MQ LNS

1

806

Risk Ratio (Random, 95% CI)

0.85 [0.63, 1.15]

9 Mid‐upper arm circumference (MUAC) Show forest plot

6

8187

Std. Mean Difference (Random, 95% CI)

0.13 [0.05, 0.22]

9.1 SQ LNS

5

6546

Std. Mean Difference (Random, 95% CI)

0.12 [‐0.00, 0.24]

9.2 MQ LNS

2

1641

Std. Mean Difference (Random, 95% CI)

0.17 [0.08, 0.26]

10 Serum haemoglobin (g/L) Show forest plot

4

4518

Mean Difference (IV, Random, 95% CI)

5.78 [2.27, 9.30]

10.1 SQ LNS

2

3293

Mean Difference (IV, Random, 95% CI)

8.95 [7.66, 10.23]

10.2 MQ LNS

2

1225

Mean Difference (IV, Random, 95% CI)

3.01 [2.73, 3.28]

11 Mortality Show forest plot

3

3321

Risk Ratio (Random, 95% CI)

0.93 [0.63, 1.37]

11.1 SQ LNS

3

2195

Risk Ratio (Random, 95% CI)

0.88 [0.49, 1.60]

11.2 MQ LNS

1

1126

Risk Ratio (Random, 95% CI)

1.06 [0.58, 1.92]

12 HAZ Show forest plot

12

15795

Std. Mean Difference (Random, 95% CI)

0.11 [0.05, 0.16]

12.1 SQ LNS

9

10919

Std. Mean Difference (Random, 95% CI)

0.12 [0.04, 0.20]

12.2 MQ LNS

4

4876

Std. Mean Difference (Random, 95% CI)

0.08 [0.01, 0.15]

13 WHZ Show forest plot

10

12894

Std. Mean Difference (Random, 95% CI)

0.08 [0.04, 0.13]

13.1 SQ LNS

8

10631

Std. Mean Difference (Random, 95% CI)

0.08 [0.02, 0.15]

13.2 MQ LNS

3

2263

Std. Mean Difference (Random, 95% CI)

0.07 [0.00, 0.14]

14 WAZ Show forest plot

10

12188

Std. Mean Difference (Random, 95% CI)

0.09 [0.02, 0.16]

14.1 SQ LNS

9

10959

Std. Mean Difference (Random, 95% CI)

0.11 [0.02, 0.19]

14.2 MQ LNS

2

1229

Std. Mean Difference (Random, 95% CI)

0.05 [‐0.04, 0.14]

Figuras y tablas -
Comparison 2. LNS versus no intervention: Subgroup analysis by energy content/formulation of product provided
Comparison 3. LNS versus no intervention: Subgroup analysis by duration of intervention

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Moderate stunting Show forest plot

9

13372

Risk Ratio (Random, 95% CI)

0.93 [0.88, 0.98]

1.1 6 to 12 months

6

7871

Risk Ratio (Random, 95% CI)

0.96 [0.89, 1.03]

1.2 More than 12 months

3

5501

Risk Ratio (Random, 95% CI)

0.89 [0.81, 0.97]

2 Severe stunting Show forest plot

5

6151

Risk Ratio (Random, 95% CI)

0.85 [0.74, 0.98]

2.1 6 to 12 months

3

2251

Risk Ratio (Random, 95% CI)

0.89 [0.74, 1.07]

2.2 More than 12 months

2

3900

Risk Ratio (Random, 95% CI)

0.80 [0.64, 0.99]

3 Moderate wasting Show forest plot

8

13172

Risk Ratio (Random, 95% CI)

0.82 [0.74, 0.91]

3.1 6 to 12 months

5

7669

Risk Ratio (Random, 95% CI)

0.81 [0.72, 0.92]

3.2 More than 12 months

3

5503

Risk Ratio (Random, 95% CI)

0.83 [0.69, 0.99]

4 Severe wasting: 6 to 12 months Show forest plot

3

2329

Risk Ratio (Random, 95% CI)

1.27 [0.66, 2.46]

5 Moderate underweight Show forest plot

8

13073

Risk Ratio (Random, 95% CI)

0.85 [0.80, 0.91]

5.1 6 to 12 months

5

7532

Risk Ratio (Random, 95% CI)

0.87 [0.78, 0.97]

5.2 More than 12 months

3

5541

Risk Ratio (Random, 95% CI)

0.87 [0.79, 0.95]

6 Severe underweight: 6 to 12 months Show forest plot

2

1729

Risk Ratio (Random, 95% CI)

0.78 [0.54, 1.13]

7 Anaemia Show forest plot

5

2332

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.69, 0.90]

7.1 Upto 6 months

2

1176

Risk Ratio (M‐H, Random, 95% CI)

0.55 [0.20, 1.47]

7.2 6 to 12 months

2

627

Risk Ratio (M‐H, Random, 95% CI)

0.84 [0.71, 1.00]

7.3 More than 12 months

1

529

Risk Ratio (M‐H, Random, 95% CI)

0.70 [0.55, 0.88]

8 Adverse effects Show forest plot

3

3382

Risk Ratio (Random, 95% CI)

0.86 [0.74, 1.01]

9 Mid‐upper arm circumference (MUAC) Show forest plot

6

8187

Std. Mean Difference (Random, 95% CI)

0.13 [0.05, 0.22]

9.1 Upto 6 months

2

1472

Std. Mean Difference (Random, 95% CI)

0.06 [‐0.23, 0.35]

9.2 6 to 12 months

3

5114

Std. Mean Difference (Random, 95% CI)

0.18 [0.10, 0.26]

9.3 More than 12 months

1

1601

Std. Mean Difference (Random, 95% CI)

0.04 [‐0.04, 0.12]

10 Serum haemoglobin (g/L) Show forest plot

4

4518

Mean Difference (IV, Random, 95% CI)

5.78 [2.27, 9.30]

10.1 Upto 6 months

2

1176

Mean Difference (IV, Random, 95% CI)

5.58 [0.52, 10.64]

10.2 6 to 12 months

2

3342

Mean Difference (IV, Random, 95% CI)

5.96 [0.08, 11.84]

11 Mortality Show forest plot

3

3321

Risk Ratio (Random, 95% CI)

0.93 [0.63, 1.37]

11.1 6 to 12 months

3

3321

Risk Ratio (Random, 95% CI)

0.93 [0.63, 1.37]

12 HAZ Show forest plot

12

15795

Std. Mean Difference (Random, 95% CI)

0.11 [0.05, 0.16]

12.1 Upto 6 months

3

1510

Std. Mean Difference (Random, 95% CI)

0.19 [0.01, 0.36]

12.2 6 to 12 months

6

8784

Std. Mean Difference (Random, 95% CI)

0.08 [0.00, 0.15]

12.3 More than 12 months

3

5501

Std. Mean Difference (Random, 95% CI)

0.14 [0.03, 0.25]

13 WAZ Show forest plot

10

12188

Std. Mean Difference (Random, 95% CI)

0.09 [0.02, 0.16]

13.1 Upto 6 months

3

1103

Std. Mean Difference (Random, 95% CI)

0.09 [‐0.00, 0.19]

13.2 6 to 12 months

4

5544

Std. Mean Difference (Random, 95% CI)

0.03 [‐0.12, 0.18]

13.3 More than 12 months

3

5541

Std. Mean Difference (Random, 95% CI)

0.13 [0.03, 0.24]

14 WHZ Show forest plot

10

12894

Std. Mean Difference (Random, 95% CI)

0.08 [0.04, 0.13]

14.1 Upto 6 months

2

1216

Std. Mean Difference (Random, 95% CI)

0.13 [‐0.12, 0.38]

14.2 6 to 12 months

5

6175

Std. Mean Difference (Random, 95% CI)

0.07 [0.00, 0.14]

14.3 More than 12 months

3

5503

Std. Mean Difference (Random, 95% CI)

0.09 [0.01, 0.17]

Figuras y tablas -
Comparison 3. LNS versus no intervention: Subgroup analysis by duration of intervention
Comparison 4. LNS versus no intervention: Subgroup analysis by age at follow‐up

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Moderate stunting Show forest plot

9

13492

Risk Ratio (Random, 95% CI)

0.93 [0.88, 0.98]

1.1 At 12 months

1

564

Risk Ratio (Random, 95% CI)

1.01 [0.86, 1.19]

1.2 At 18 months

6

7427

Risk Ratio (Random, 95% CI)

0.95 [0.88, 1.02]

1.3 At 24 months

3

5501

Risk Ratio (Random, 95% CI)

0.89 [0.81, 0.97]

2 Severe stunting Show forest plot

5

6151

Risk Ratio (Random, 95% CI)

0.85 [0.74, 0.98]

2.1 At 12 months

1

564

Risk Ratio (Random, 95% CI)

0.96 [0.67, 1.38]

2.2 At 18 months

2

1687

Risk Ratio (Random, 95% CI)

0.86 [0.70, 1.07]

2.3 At 24 months

2

3900

Risk Ratio (Random, 95% CI)

0.80 [0.64, 0.99]

3 Moderate wasting Show forest plot

8

13172

Risk Ratio (Random, 95% CI)

0.80 [0.73, 0.88]

3.1 At 18 months

6

7669

Risk Ratio (Random, 95% CI)

0.79 [0.71, 0.89]

3.2 At 24 months

3

5503

Risk Ratio (Random, 95% CI)

0.83 [0.69, 0.99]

4 Severe wasting Show forest plot

3

2329

Risk Ratio (Random, 95% CI)

1.27 [0.66, 2.46]

4.1 At 12 months

1

563

Risk Ratio (Random, 95% CI)

0.78 [0.12, 4.93]

4.2 At 18 months

2

1766

Risk Ratio (Random, 95% CI)

1.39 [0.67, 2.87]

5 Moderate underweight Show forest plot

8

13073

Risk Ratio (Random, 95% CI)

0.85 [0.81, 0.90]

5.1 At 18 months

6

7532

Risk Ratio (Random, 95% CI)

0.85 [0.78, 0.92]

5.2 At 24 months

3

5541

Risk Ratio (Random, 95% CI)

0.87 [0.79, 0.95]

6 Severe underweight: at 18 months Show forest plot

2

1729

Risk Ratio (Random, 95% CI)

0.78 [0.54, 1.13]

7 Anaemia Show forest plot

5

2332

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.69, 0.90]

7.1 At 12 months

2

1176

Risk Ratio (M‐H, Random, 95% CI)

0.55 [0.20, 1.47]

7.2 At 18 months

3

1156

Risk Ratio (M‐H, Random, 95% CI)

0.80 [0.71, 0.91]

7.3 At 36 months

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 Adverse effects: At 18 months Show forest plot

3

3382

Risk Ratio (Random, 95% CI)

0.86 [0.74, 1.01]

9 Mid‐upper arm circumference (MUAC) Show forest plot

6

8187

Std. Mean Difference (Random, 95% CI)

0.13 [0.05, 0.22]

9.1 At 12 months

1

1193

Std. Mean Difference (Random, 95% CI)

0.15 [0.06, 0.24]

9.2 At 18 months

3

4355

Std. Mean Difference (Random, 95% CI)

0.12 [‐0.11, 0.34]

9.3 At 24 months

1

1601

Std. Mean Difference (Random, 95% CI)

0.04 [‐0.04, 0.12]

9.4 At 36 months

1

1038

Std. Mean Difference (Random, 95% CI)

0.2 [0.06, 0.34]

10 Serum haemoglobin (g/L) Show forest plot

4

4518

Mean Difference (IV, Random, 95% CI)

5.78 [2.27, 9.30]

10.1 At 12 months

1

194

Mean Difference (IV, Random, 95% CI)

8.5 [4.46, 12.54]

10.2 At 18 months

2

3342

Mean Difference (IV, Random, 95% CI)

5.96 [0.08, 11.84]

10.3 At 36 months

1

982

Mean Difference (IV, Random, 95% CI)

3.30 [1.42, 5.18]

11 Mortality Show forest plot

3

3321

Risk Ratio (Random, 95% CI)

0.93 [0.63, 1.37]

11.1 At 12 months

1

1932

Risk Ratio (Random, 95% CI)

0.85 [0.56, 1.30]

11.2 At 18 months

2

1389

Risk Ratio (Random, 95% CI)

1.10 [0.42, 2.89]

12 HAZ Show forest plot

12

15795

Std. Mean Difference (Random, 95% CI)

0.10 [0.05, 0.15]

12.1 At 12 to 15 months

3

1103

Std. Mean Difference (Random, 95% CI)

0.07 [‐0.02, 0.15]

12.2 At 18 months

6

8153

Std. Mean Difference (Random, 95% CI)

0.08 [0.00, 0.16]

12.3 At 24 months

3

5501

Std. Mean Difference (Random, 95% CI)

0.14 [0.03, 0.25]

12.4 At 36 months

1

1038

Std. Mean Difference (Random, 95% CI)

0.27 [0.10, 0.44]

13 WAZ Show forest plot

10

12188

Std. Mean Difference (Random, 95% CI)

0.10 [0.04, 0.16]

13.1 At 12 to 15 months

3

1103

Std. Mean Difference (Random, 95% CI)

0.09 [‐0.00, 0.19]

13.2 At 18 months

5

5544

Std. Mean Difference (Random, 95% CI)

0.05 [‐0.06, 0.17]

13.3 At 24 months

3

5541

Std. Mean Difference (Random, 95% CI)

0.13 [0.03, 0.23]

14 WHZ Show forest plot

10

12894

Std. Mean Difference (Random, 95% CI)

0.12 [0.02, 0.22]

14.1 At 12 to 15 months

2

809

Std. Mean Difference (Random, 95% CI)

0.10 [‐0.02, 0.22]

14.2 At 18 months

5

5544

Std. Mean Difference (Random, 95% CI)

0.13 [‐0.05, 0.31]

14.3 At 24 months

3

5503

Std. Mean Difference (Random, 95% CI)

0.09 [0.01, 0.17]

14.4 At 36 months

1

1038

Std. Mean Difference (Random, 95% CI)

0.04 [‐0.08, 0.16]

Figuras y tablas -
Comparison 4. LNS versus no intervention: Subgroup analysis by age at follow‐up
Comparison 5. LNS versus fortified blended food (FBF)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Moderate stunting Show forest plot

3

2828

Risk Ratio (Random, 95% CI)

0.89 [0.82, 0.97]

2 Severe stunting Show forest plot

2

729

Risk Ratio (Random, 95% CI)

0.41 [0.12, 1.42]

3 Moderate wasting Show forest plot

2

2290

Risk Ratio (Random, 95% CI)

0.79 [0.65, 0.97]

4 Severe wasting Show forest plot

2

735

Risk Ratio (Random, 95% CI)

0.64 [0.19, 2.18]

5 Moderate underweight Show forest plot

2

2280

Risk Ratio (Random, 95% CI)

0.81 [0.73, 0.91]

6 Severe underweight Show forest plot

1

Risk Ratio (Random, 95% CI)

Totals not selected

7 MUAC Show forest plot

2

1512

Std. Mean Difference (IV, Random, 95% CI)

0.02 [‐0.08, 0.12]

8 Haemoglobin (g/L) Show forest plot

1

182

Mean Difference (IV, Random, 95% CI)

0.29 [‐6.00, 6.59]

9 HAZ Show forest plot

4

4047

Std. Mean Difference (IV, Random, 95% CI)

0.06 [0.00, 0.13]

10 WAZ Show forest plot

3

1933

Mean Difference (IV, Random, 95% CI)

0.05 [‐0.04, 0.14]

11 WHZ Show forest plot

3

1933

Std. Mean Difference (IV, Random, 95% CI)

0.07 [‐0.02, 0.16]

Figuras y tablas -
Comparison 5. LNS versus fortified blended food (FBF)
Comparison 6. LNS versus micronutrient powders (MNP)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Moderate stunting Show forest plot

3

2365

Risk Ratio (Random, 95% CI)

0.92 [0.82, 1.02]

2 Moderate wasting Show forest plot

2

2004

Risk Ratio (Random, 95% CI)

0.97 [0.77, 1.23]

3 Moderate underweight Show forest plot

2

2004

Risk Ratio (Random, 95% CI)

0.88 [0.78, 0.99]

4 Anaemia Show forest plot

2

557

Risk Ratio (Random, 95% CI)

0.38 [0.21, 0.68]

5 Anaemia: Sensitivity analysis Show forest plot

1

Risk Ratio (Random, 95% CI)

0.56 [0.27, 1.14]

6 Serum haemoglobin (g/L) Show forest plot

2

557

Mean Difference (Random, 95% CI)

5.13 [2.00, 8.26]

7 Serum haemoglobin (g/L): Sensitivity analysis Show forest plot

1

Mean Difference (Random, 95% CI)

3.6 [‐0.13, 7.33]

8 HAZ Show forest plot

3

2362

Std. Mean Difference (IV, Random, 95% CI)

0.10 [‐0.08, 0.27]

9 HAZ: Sensitivity analysis Show forest plot

2

2001

Std. Mean Difference (IV, Random, 95% CI)

0.16 [0.03, 0.28]

10 WAZ Show forest plot

3

2362

Std. Mean Difference (IV, Random, 95% CI)

0.12 [0.02, 0.21]

11 WAZ: Sensitivity analysis Show forest plot

2

2001

Std. Mean Difference (IV, Random, 95% CI)

0.14 [0.05, 0.23]

12 WHZ Show forest plot

3

2362

Std. Mean Difference (IV, Random, 95% CI)

0.05 [‐0.06, 0.17]

13 WHZ: Sensitivity analysis Show forest plot

2

2001

Std. Mean Difference (IV, Random, 95% CI)

0.10 [0.01, 0.18]

Figuras y tablas -
Comparison 6. LNS versus micronutrient powders (MNP)