1. Background
nutritional deficits, stunting, nutritional insufficiencies, SD, infections, undernutrition, enteric dysfunction
DISEASE, INFECTIONS, UNDERNUTRITION
Our objective was to quantify the effects of yogurt supplementation and nutrition education over three months on the linear growth of infants at risk of stunting. We conducted a three-arm pilot randomized controlled trial: (1) nutrition education for mothers; (2) nutrition education plus a daily yogurt supplement (50 g) for the index child; and (3) usual care (control). Dyads of children aged 4–6 months and at risk of stunting [length-for-age z-score (LAZ) ≤ −1 SD and >−2 SD] and their mothers with ≤10 years of education were eligible for the study. Participants were recruited from five slum areas in Dhaka, Bangladesh. Intention-to-treat (N = 162) and complete-case analyses (N = 127) showed no between-group statistically significant differences in LAZ or weight-for-age (WAZ). However, the yogurt group showed greater change in linear growth compared to the control (LAZ: mean difference 0.20, 95% CI: −0.06, 0.47, Child undernutrition is a major public health concern, contributing substantially to child mortality and disease burden in low- and middle-income countries (LMICs) [While child stunting is a multifactorial condition, repeated infections and nutritional insufficiencies were identified as its immediate causes [Different approaches have been trialled to address this complex problem of child undernutrition or stunting. Generally, nutrition-specific interventions have been implemented for years to address stunting. Different systematic reviews indicated that basic nutritional education was effective at lowering undernutrition among children to a certain extent; when complementary or supplementary foods were added to nutritional education, the results improved [Impaired functionality of the small intestine, known as environmental enteric dysfunction (EED), is now believed to be the underlying aetiology of nutritional deficits in children living in unsanitary conditions like slums [A fermented food can be considered a probiotic food when it contains characterized cultures and viable microbes at the time of consumption [Commercially produced probiotics are supplements, whereas fermented foods are part of a meal. Yogurt is one of the most bioactive foods consumed by humans. The nutritional value of yogurt is high relative to its cost. In Bangladesh, yogurt is a traditional fermented dessert item produced both commercially and at the household level [To our knowledge, no study to date in Bangladesh has tested the efficacy of yogurt on infant growth as early as six months of age, when children are at increased risk of exposure to pathogens affecting their gut health [