Nutrition Deficiency Due to Insufficient Food
Conditions
Brief summary
Adolescents' diets are key to breaking the intergenerational cycle of malnutrition. This study will guide policies and programs on the adequacy, acceptability, and feasibility of implementing balanced energy protein and multiple micronutrient supplementations to fill nutrient gaps in adolescent girls. Using a trial, the study will assess dietary intake and nutrient gaps, acceptability of balanced energy protein and multiple micronutrient supplementations. In addition to the trial, the study will the assess willingness to pay for the supplements and the most effective delivery platform and model to reach vulnerable adolescent girls. The most effective delivery platform and model to reach vulnerable adolescent girls cost-effectively will also be assessed through interviews with (inter)national experts, producers, and the donor community.
Detailed description
In low- and middle-income countries, it is estimated that each year, 21 million adolescent girls become mothers. Infants of adolescent mothers are at increased risk of delivering babies preterm, with low birth weight or length. Targeting nutrition interventions to improve adolescent girls' diet and nutrition is crucial to breaking the intergenerational cycle of poor growth and development. There is a specific need to assess how a balanced energy protein (BEP) and multiple micronutrient (MMN) supplement interventions can be tailored to adolescent girls and women of reproductive age. This study aims to assess the adequacy, acceptability, and feasibility of implementing nutritional supplementations to fill nutrient gaps in adolescent girls in resource-limited settings. A trial will specifically: 1. assess the short-term acceptability of BEP and MMN supplements 2. assess how nutrition supplements increase nutrient adequacy of diets adolescent girls in resources-limited settings; Using a qualitative component, the study explores the food agency of adolescents and the most effective delivery platform to reach vulnerable adolescent girls cost-effectively. The overall aim is to guide policies and programs on new formulations of nutritional supplements for adolescent girls in resource-limited settings.
Interventions
DIETARY_SUPPLEMENTBEP supplement
The BEP supplement used in Burkina Faso is a fortified medium-quantity lipid-based nutrient supplement called Plumpy'Doz. The product is a peanut and milk-based ready-to-use nutritional formulation produced by Nutriset. A peanut-based BEP formulation with a trademark Plumpy'Sup produced by Hilina Enriched Foods PLC will be used in Ethiopia.
DIETARY_SUPPLEMENTMultiple Micronutrient supplement
The MMN formulation is based on the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP). The formulation contains 15 minerals and vitamins and is administered as a tablet.
Sponsors
Addis Continental Institute of Public Health
Institut de Recherche en Sciences de la Sante, Burkina Faso
Bill and Melinda Gates Foundation
AfricSanté, Burkina Faso
University Ghent
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
200 adolescent girls will be enrolled in Ethiopia and 200 adolescent girls will be enrolled in Burkina Faso.
Eligibility
Sex/Gender
FEMALE
Age
15 Years to 19 Years
Healthy volunteers
Yes
Inclusion criteria
Eligibility criteria are all based on self-reported information Inclusion criteria: * Non-pregnant and non-lactating women * Without any known chronic illness or acute illness affecting appetite * Permanent residents of the study area
Exclusion criteria
* Being allergic to peanuts * Eating disorders or dietary restrictions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acceptability of the supplement | Day 8 (after 7 days of consumption) | Acceptability to the nutritional supplements, as measured using a 9-item scale (1 Dislike extremely up to 9 Like extremely) |
| Nutritional adequacy | Day 8 (after 7 days of consumption) | Mean nutrient adequacy ratio of adolescent diets, using 24 h recall |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Willingness to pay for the supplement | Day 8 (after 7 days of consumption) | Mean household head's willingness to pay values elicited through their bids |
| Reported consumption of the supplement | Day 8 (average of 7-day intervention) | Percent of the recommended nutritional supplement consumed during the intervention period, self-reported |
| Substitution of food and nutrient intake | Day 8 (after 7 days of consumption) | Substitution of food and nutrition intake at group level, using 24 h recall |
| Nutrient intake | Day 8 (after 7 days of consumption) | Mean energy, macronutrient and micronutrient intake between the BEP and MMN group, using 24 h recall |
Countries
Burkina Faso, Ethiopia
Outcome results
None listed