Agriculture Reference
In-Depth Information
randomized to (1) supplementation, (2) psychosocial stimulation with weekly home
visits, (3) supplement and stimulation, or (4) control. Interventions were provided
for 2 years. Stimulation and supplementation benefited the children's developmental
levels (Grantham-McGregor et al. 1991) and had additive but not interactive effects.
There were no benefits of supplementation to child exploration or affect assessed
after 6 months of intervention (Meeks Gardner et al. 1999). Children were reassessed
at 7 to 8 years, and small benefits of supplementation on a range of educational and
cognitive tests were seen but no significant differences on any one test (Grantham-
McGregor et al. 1997). No benefits from supplementation were detected at 11 or 17
years to cognitive functioning or behavior (Chang et al. 2002, Walker et al. 2005,
2006).
supplementation trials to Prevent undernutrition in high-Risk Populations
Guatemala
Four villages in Guatemala were randomized to high-energy and protein supplement
(atole) or low-energy supplement. Supplements were provided ad libitum twice daily
at centers for pregnant and lactating women and children up to age 7 years. Atole
benefited motor but not mental development at 24 months and perceptual organiza-
tion and verbal skills at age 4 and 5 years but not 3 and 6 years (Pollitt et al. 1993).
Children of lower socioeconomic status benefited the most. Children of participants
supplemented with atole in pregnancy who were supplemented through at least age
2 years performed significantly better on 4 of 6 psychoeducational tests and on 2of 7
information processing tests at age 13-19 years (Pollitt et al. 1993). In a subsample
of children at age 6 to 8 years, those who received higher levels of supplementation
from birth to 2 years were more socially involved, happier and more angry, and less
anxious (Barrett et al. 1982).
Colombia
High-risk families in Bogota, Columbia, were randomized to receive supplementa-
tion for varying periods: from pregnancy to infants aged 6 months (n = 57), infants
aged 6 to 36 months (n = 60), from pregnancy to infants aged 36 months (n = 57),
or control (n = 54). At 4 and 8 months, supplemented infants showed less apathy.
At 36 months, supplement benefited developmental levels in those supplemented
from pregnancy through 36 months (Waber et al. 1981). Benefits for the two groups
supplemented for shorter periods were inconsistent. At follow-up at age 5 to 8
years, supplementation benefited scores on reading readiness but not arithmetic or
basic knowledge; however, these results have only been reported in a conference
abstract.
These studies provide consistent evidence that food-based supplements that pro-
vide additional energy and protein (and varying amounts of micronutrients) have
concurrent benefits for child development. Limited or no benefits were found after
supplementation ended in two studies in which supplementation was given to under-
nourished children. The most substantial benefits to later development have been
found in the study conducted in Guatemala among participants whose mothers were
supplemented in pregnancy and who were supplemented at least until age 2 years.
