(P02-060-25) Effect of Cooking With Liquefied Petroleum Gas Versus Biomass on Wasting Among Infants at 12 Months of Age in India

Objectives: Acute undernutrition, or wasting, in children is associated with an increased risk of mortality. India has the second-highest global prevalence of wasting at 18.7%, with little improvement since the 1990s. We aimed to evaluate whether a cleaner cooking intervention, which was previously shown to reduce food insecurity and increase child dietary diversity, affected child wasting in rural Tamil Nadu, India.

Methods: Data were from a randomized controlled trial that enrolled 799 pregnant women from Tamil Nadu, India. Participants in the intervention group received a free liquefied petroleum gas (LPG) cookstove and LPG fuel for 18 months, while the control group continued to rely primarily on biomass fuels for cooking. Infant weight and length were assessed at 6, 9, and 12 months of age. We calculated weight-for-length z-scores (WLZ) and defined wasting as WLZ below -2 standard deviations (SD) from the median. To estimate intervention effects, we conducted an intention-to-treat analysis using linear regression for continuous WLZ and log-binomial regression for the binary wasting variable. Interaction effects by wasting with child sex and study site were also assessed.

Results: Wasting prevalence in the intervention group was 6.4%, 6.9%, and 12.4% at 6, 9, and 12 months, compared to 8.3%, 10.2%, and 13.5% in the control group. At the study endline (age 12 months), mean WLZ was -0.86 (SD: 1.06) in the intervention group and -0.94 (SD: 1.12) in the control group. The analysis indicated no effect of the intervention on mean WLZ at 12 months (B: -0.08; 95% CI: -0.26, 0.09) or wasting prevalence at 12 months (relative risk [RR]: 12 months, 1.03; 95% CI: 0.95, 1.11). No significant interaction effects were observed between childhood wasting and sex or study site.

Conclusions: An intervention strategy initiated during pregnancy to mitigate household air pollution by replacing biomass fuel with LPG for cooking showed no significant effect on childhood wasting.

Funding Sources: U.S. National Institutes of Health; Bill & Melinda Gates Foundation