Efficacy of long-term oral nutritional supplementation with dietary counseling on growth, body composition and bone mineralization in children with or at risk for undernutrition: a randomized controlled trial
Abstract Background Impaired growth, accompanied by low lean mass and poor bone mineralization in undernourished children, is linked to adverse short- and long-term health outcomes. Oral nutritional supplements (ONS) promote catch-up growth, but their efficacy in improving lean mass and bone mineral...
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2025-07-01
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| Series: | Nutrition Journal |
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| Online Access: | https://doi.org/10.1186/s12937-025-01133-5 |
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| author | Mandy Y. L. Ow Nga Thuy Tran Yatin Berde Tu Song Nguyen Van Khanh Tran Morgan J. Jablonka Geraldine E. Baggs Dieu T. T. Huynh |
| author_facet | Mandy Y. L. Ow Nga Thuy Tran Yatin Berde Tu Song Nguyen Van Khanh Tran Morgan J. Jablonka Geraldine E. Baggs Dieu T. T. Huynh |
| author_sort | Mandy Y. L. Ow |
| collection | DOAJ |
| description | Abstract Background Impaired growth, accompanied by low lean mass and poor bone mineralization in undernourished children, is linked to adverse short- and long-term health outcomes. Oral nutritional supplements (ONS) promote catch-up growth, but their efficacy in improving lean mass and bone mineralization remains uninvestigated. This study aims to compare the efficacy of long-term ONS with dietary counseling (DC) versus DC alone on growth, body composition, bone mineralization, and health outcomes in children with or at risk of undernutrition. Methods Children (n = 330) aged 24–60 months with WHO Growth Standard z-scores of weight-for-age < − 1, height-for-age < − 1, and weight-for-height < 0 were randomized in a multisite controlled trial to receive two servings of a complete and balanced ONS formula with DC, or DC-only, for 240 days. Anthropometric measurements, dietary intake, and parent-reported measures of illness-related and other health outcomes were assessed at baseline and days 30, 120, and 240. Dual X-ray absorptiometry–assessed body composition and bone mineralization, and nutritional blood biomarkers were measured at baseline and day 240. Results ONS supplementation augmented growth in height and weight through day 240, with increasing between-group differences over visits (P < 0.01 for treatment-by-visit interaction in height, weight, height-for-age and weight-for-age z-scores). Energy and protein intake levels were 26% and 22% higher, respectively, in the ONS + DC compared to the DC-group at day 240 (both P < 0.001). The ONS + DC group also had a higher lean mass index of 11.06 (0.05) versus 10.92 (0.05) kg/m2 (P = 0.048) and total body less head bone mineral density of 0.407 (0.003) versus 0.399 (0.003) g/cm2 (P = 0.03) at day 240, with no differences in fat mass index compared to DC. The ONS + DC group also had better serum vitamin D and K status, fewer sick and missed school days, better parent-reported sleep habits, appetite, energy, and physical activity levels versus DC-group (all P < 0.05). Conclusion Adding ONS to DC for 8 months improved linear catch-up growth and supported quality growth, as evidenced by greater lean mass and bone mineral accretion. These findings, alongside parent-reported improvements in child health, suggest that improved nutrient intake with ONS improves multiple domains of child health and well-being. Trial registration This clinical trial was registered on ClinicalTrials.gov (registration number: NCT05239208) on 14 February 2022. Video Abstract |
| format | Article |
| id | doaj-art-873bfb7986894e9f9cd1a2193bb4f204 |
| institution | Kabale University |
| issn | 1475-2891 |
| language | English |
| publishDate | 2025-07-01 |
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| series | Nutrition Journal |
| spelling | doaj-art-873bfb7986894e9f9cd1a2193bb4f2042025-08-20T03:42:44ZengBMCNutrition Journal1475-28912025-07-0124111410.1186/s12937-025-01133-5Efficacy of long-term oral nutritional supplementation with dietary counseling on growth, body composition and bone mineralization in children with or at risk for undernutrition: a randomized controlled trialMandy Y. L. Ow0Nga Thuy Tran1Yatin Berde2Tu Song Nguyen3Van Khanh Tran4Morgan J. Jablonka5Geraldine E. Baggs6Dieu T. T. Huynh7Abbott Nutrition R&D Asia-Pacific Center, Abbott Laboratories, Abbott Manufacturing Singapore Pte LtdDepartment of Micronutrients, National Institute of NutritionMars Group Inc.Department of General Planning, National Institute of NutritionDepartment of Micronutrients, National Institute of NutritionAbbott Nutrition R&D, Abbott LaboratoriesAbbott Nutrition R&D, Abbott LaboratoriesAbbott Nutrition R&D Asia-Pacific Center, Abbott Laboratories, Abbott Manufacturing Singapore Pte LtdAbstract Background Impaired growth, accompanied by low lean mass and poor bone mineralization in undernourished children, is linked to adverse short- and long-term health outcomes. Oral nutritional supplements (ONS) promote catch-up growth, but their efficacy in improving lean mass and bone mineralization remains uninvestigated. This study aims to compare the efficacy of long-term ONS with dietary counseling (DC) versus DC alone on growth, body composition, bone mineralization, and health outcomes in children with or at risk of undernutrition. Methods Children (n = 330) aged 24–60 months with WHO Growth Standard z-scores of weight-for-age < − 1, height-for-age < − 1, and weight-for-height < 0 were randomized in a multisite controlled trial to receive two servings of a complete and balanced ONS formula with DC, or DC-only, for 240 days. Anthropometric measurements, dietary intake, and parent-reported measures of illness-related and other health outcomes were assessed at baseline and days 30, 120, and 240. Dual X-ray absorptiometry–assessed body composition and bone mineralization, and nutritional blood biomarkers were measured at baseline and day 240. Results ONS supplementation augmented growth in height and weight through day 240, with increasing between-group differences over visits (P < 0.01 for treatment-by-visit interaction in height, weight, height-for-age and weight-for-age z-scores). Energy and protein intake levels were 26% and 22% higher, respectively, in the ONS + DC compared to the DC-group at day 240 (both P < 0.001). The ONS + DC group also had a higher lean mass index of 11.06 (0.05) versus 10.92 (0.05) kg/m2 (P = 0.048) and total body less head bone mineral density of 0.407 (0.003) versus 0.399 (0.003) g/cm2 (P = 0.03) at day 240, with no differences in fat mass index compared to DC. The ONS + DC group also had better serum vitamin D and K status, fewer sick and missed school days, better parent-reported sleep habits, appetite, energy, and physical activity levels versus DC-group (all P < 0.05). Conclusion Adding ONS to DC for 8 months improved linear catch-up growth and supported quality growth, as evidenced by greater lean mass and bone mineral accretion. These findings, alongside parent-reported improvements in child health, suggest that improved nutrient intake with ONS improves multiple domains of child health and well-being. Trial registration This clinical trial was registered on ClinicalTrials.gov (registration number: NCT05239208) on 14 February 2022. Video Abstracthttps://doi.org/10.1186/s12937-025-01133-5Catch-up growthStuntingUnderweightWastingLean massFat mass |
| spellingShingle | Mandy Y. L. Ow Nga Thuy Tran Yatin Berde Tu Song Nguyen Van Khanh Tran Morgan J. Jablonka Geraldine E. Baggs Dieu T. T. Huynh Efficacy of long-term oral nutritional supplementation with dietary counseling on growth, body composition and bone mineralization in children with or at risk for undernutrition: a randomized controlled trial Nutrition Journal Catch-up growth Stunting Underweight Wasting Lean mass Fat mass |
| title | Efficacy of long-term oral nutritional supplementation with dietary counseling on growth, body composition and bone mineralization in children with or at risk for undernutrition: a randomized controlled trial |
| title_full | Efficacy of long-term oral nutritional supplementation with dietary counseling on growth, body composition and bone mineralization in children with or at risk for undernutrition: a randomized controlled trial |
| title_fullStr | Efficacy of long-term oral nutritional supplementation with dietary counseling on growth, body composition and bone mineralization in children with or at risk for undernutrition: a randomized controlled trial |
| title_full_unstemmed | Efficacy of long-term oral nutritional supplementation with dietary counseling on growth, body composition and bone mineralization in children with or at risk for undernutrition: a randomized controlled trial |
| title_short | Efficacy of long-term oral nutritional supplementation with dietary counseling on growth, body composition and bone mineralization in children with or at risk for undernutrition: a randomized controlled trial |
| title_sort | efficacy of long term oral nutritional supplementation with dietary counseling on growth body composition and bone mineralization in children with or at risk for undernutrition a randomized controlled trial |
| topic | Catch-up growth Stunting Underweight Wasting Lean mass Fat mass |
| url | https://doi.org/10.1186/s12937-025-01133-5 |
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