As compared to children who did not consume any supplement, the two formulas were effective in improving the weight and BMI of children at risk of malnutrition.
Findings of the 90-day multi-centre RCT were published in Nutrients.
The study took place in 10 hospitals and clinics across India, where a total of 321 children age two to four were involved.
These children were at risk of malnutrition and were described as picky eaters by their parents.
They were randomised into three groups, receiving either 1) PediaSure and dietary counselling or 2) PediaSure Advance and dietary counselling or 3) only dietary counselling.
The two PediaSure products contained similar nutrient composition, such as matching levels of protein, vitamins and minerals, and the prebiotic fibre fructo-oligosaccharide (FOS).
However, PediaSure is a milk-based powder formula while PediaSure Advance is a lactose-free formula.
Also, the milk-based formula has a higher carbohydrate energy percent than the lactose-free version, as well as a lower percentage of fat energy.
During the 90-day trial, the two groups drinking PediaSure products had at least a serving or a maximum of two servings per day.
PediaSure is a nutritional supplement brand by Abbott Healthcare, the company which funded this research.
Weight, BMI growth
Among the three groups, children taking the milk-based formula had shown the most significant and fastest increase in weight and BMI.
For those taking the milk-based supplement, significant weight improvement could be seen from day seven until the end of the study.
In contrast, the lactose-free supplement only started to produce significant improvement in weight on day 30.
Also, the milk-based supplement had consistently produced significant improvements to the BMI throughout the entire trial.
However, the lactose-free supplement only produced significant improvements on day 30 and day 90 of the trial, but not on day 60 of the trial.
Children taking either formulas had reported a greater height growth than those who did not.
However, the improvements were not statistically significant and the researchers believe that a longer intervention period might be required.
“While wasting is a measure of an acute malnutrition, stunting is an indicator of chronic malnutrition, which is a result of a slow and cumulative process caused by sustained nutrient inadequacies.
“Thus, nutritional intervention to promote catch-up growth in height takes longer as compared to catch-up weight.
“Most studies of nutritional repletion and height gain in stunted children used a time course of 6 months or longer,” the researchers explained.
Mid-upper arm circumference
On the other hand, the milk-based formula was more effective than the lactose-free formula in improving mid-upper arm circumference (MUAC).
In children who drank the milk-based formula, significant improvements in MUAC was seen from day 60 of the trial.
“Results showed that a milk-based ONS (oral nutritional supplement) and a lactose-free ONS were each more effective for promoting catch-up growth than was dietary counselling alone.
“As a limitation, the 3-month study interval was sufficient to observe catch-up growth in weight; however, the intervention interval should be longer, e.g., 6 months or more, to promote and observe catch-up growth in height.
“We therefore see room for improvement worldwide in adopting and following health policies that recommend routine nutritional screening for all children; we also encourage enhanced training of professionals for identification and treatment of malnutrition,” the researchers said.
Oral Nutritional Supplementation Improves Growth in Children at Malnutrition Risk and with Picky Eating Behaviors
Authors: Deepti Khanna et al