(P07-032-25) Oral Nutritional Supplement Improves Pediatric Growth Indicators More Than Dietary Counseling Alone Over 120 Days

Objectives: Research suggests 1 in 8 children have at least one primary indicator for pediatric undernutrition in the United States. Long term effects of undernutrition and growth faltering can lead to detrimental outcomes later in life; hence, early intervention is critical. Oral nutritional supplements (ONS) are effective in helping reverse signs of pediatric undernutrition but have not recently been evaluated in the US in combination with dietary counseling (DC). The objective of this study was to assess changes in growth outcomes, primary indicators of pediatric undernutrition, in the US over 120 days with DC alone and with DC and ONS.

Methods: 279 undernourished children (3- < 9 years of age, BMI-for-age z-score [BMIAZ] or mid-upper-arm circumference z-score [MUACAZ] between -3 and -1) from 17 study centers in the US were assigned to either the DC group (2 DC sessions) or ONS+DC group (2 servings providing total 480 kcal (1.0 kcal/ml) of a commercially available ONS [PediaSure] daily and 2 DC sessions) for 120 days. Participants came in at baseline, day 30, day 60, and 120 days/exit. DC sessions were completed by a registered dietitian at approximately 30d and 60d. Outcomes were changes in weight, weight-for-age z-score (WAZ) and percentile (WAP), height, height-for-age z-score (HAZ) and percentile (HAP), BMIAZ and percentiles (BMIAP), weight-for-height z-scores (WHZ) and percentiles (WHP) over 30, 60, and 120 days compared to baseline. Outcomes were analyzed by AN(C)OVA or repeated measures ANCOVA (RM-ANCOVA) and P-values < 0.05 were considered statistically significant (SAS Version 9.4).

Results: Change in weight (kg), WAZ, WAP, WHZ, WHP, and BMIAP were significantly higher in the ONS+DC group vs. the DC group at 30, 60, and 120 days by AN(C)OVA. Change in height (cm) and HAP were significantly higher in the ONS+DC group vs DC group overall (group effects: p=0.0398 and p=0.0242, respectively) by RM-ANCOVA. Change in HAZ also trended higher in the ONS+DC group vs. DC group overall (group effect: p=0.0501) by RM-ANCOVA.

Conclusions: In summary, oral nutritional supplementation with DC significantly improves various growth measurements over 120 days compared to DC alone. ONS represents an effective addition to DC for the management of anthropometric indicators of pediatric undernutrition.

Funding Sources: This study was funded by Abbott Laboratories, Nutrition Division.