Objective: To assess the effectiveness of dietary counseling and complementary food supplements on anemia and stunting prevalence in children aged 6-23 months.
Design: A controlled intervention study with measurements of height and hemoglobin levels, and cross-sectional surveys in August 2012 (baseline) and 2013 and 2014 (end-line).
Setting: One intervention and control county in rural Qinghai Province, China.
Intervention: Complementary food supplements (containing protein, fat, carbohydrate, vitamin A, B1, B2, B12, D3, folic acid, iron, zinc, and calcium) and complementary feeding counseling were given in the intervention county.
Participants: Caregivers and their children aged 6-23 months.
Primary and secondary outcomes measures: The effect of the interventions on anemia (hemoglobin< 110g/L) and stunting (z-score of height-for-age< -2.0) prevalence(controlled for differences between the counties), and infant feeding practices.
Results: The surveys were conducted among 1804, 2187, and 2186 child aged 6-23 months in the intervention county in August 2012, 2013 and 2014 respectively, and 804, 680 and 790 children in the control county respectively. Between baseline and end-line, anemia prevalence decreased more in the intervention county compared to the control county (71.1% to 47.8% vs 86.3% to 75.3%, respectively; P<0.0001). There was no difference in the decrease in stunting prevalence between the counties (9.7% to 7.1% vs 17.0% to 15.0%; P=0.7954). The proportions of children given iron-rich or -fortified food, introduced (semi-) solid food at 6-8 months, and given food with minimum dietary diversity increased from 43.2% to 88.8% (P<0.0001), 81.4% to 96% (P=0.0470), and 53.0% to 59.8% (P<0.0001), respectively.
Conclusions: We found much higher anemia prevalence in poor rural areas of Qinghai Province compared to national data. Community-based complementary food supplements combined with dietary counseling can improve feeding practices and reduce anemia prevalence. Future studies should use longer follow-up to assess the effects on stunting.
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