4. Discussion
MDD, weight gain, intestinal inflammation, inflammation
INTESTINAL INFLAMMATION, INFLAMMATION, MALNUTRITION
To the best of our knowledge, this is the first randomized controlled trial that tested the effects of yogurt supplementation along with nutritional education on the growth parameters of 6-month-old infants in Bangladesh. We found no significant between-group differences in mean LAZ or WAZ in either ITT or complete-case analyses. However, in both ITT and complete-case analyses, we have seen a consistent tendency to demonstrate better growth outcomes (mean length and LAZ) in favour of the yogurt-plus group compared to the control group, which was slightly greater than the education-only group. Further, in both ITT and complete-case analyses, a 24-h recall of food consumption revealed that children in both the yogurt-plus and education-only groups were more likely to meet the MDD score compared to the control, with the yogurt-plus group presenting a greater effect.Three possible explanations for the non-significant effects of the intervention can be considered: first, the study was too short to demonstrate growth benefits from yogurt consumption. To estimate growth trajectories, at least two measurements at least two months apart are required; however, longer intervals and additional measurements are desirable [Limited studies employed gut microbiota-targeted interventions to improve child growth in LMICs. The systematic reviews conducted by Heuven et al. and Donovan et al. included seven probiotic and yogurt intervention studies conducted in LMICs. These studies generally observed an impact on weight gain; however, their population was different (hospitalized, stunted, or healthy) than the present study. Two studies, one in India [For low-educated mothers to achieve better feeding practices, we choose nutrition education as a minimal intervention along with yogurt supplementation. Panjwani et al. in their systematic review presented the pooled effect of linear growth in children aged 6–23 months in LMICs from six RCTs; nutrition education regarding complementary feeding alone was able to increase LAZ by a mean difference of 0.13 (95% CI: 0.01, 0.24), exactly the effect seen in the education-only group. We saw a larger mean difference in LAZ in the yogurt-plus group, which is in-line with the findings that combined education with nutritional supplementation was better at improving growth [Our objective was to reduce gut inflammation through yogurt consumption to enhance child growth, a novel strategy to address malnutrition. A systematic review by Harper et al. considered intestinal inflammation as one of the five domains to describe the complex mechanism by which EED may contribute to stunting [