***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background As a result of inappropriate feeding , poor health and hygiene , and poor caring practice s , the nutritional status of many young infants deteriorates with advancing age . Objective To explore the effectiveness of a nutrition education package to prevent malnutrition among young children . Methods A community-based , r and omized , controlled trial was conducted among 605 normal and mildly malnourished children aged 6 to 9 months in 121 Community Nutrition Centers ( CNCs ) of the Bangladesh Integrated Nutrition Project ( BINP ) in four regions of Bangladesh from 2000 to 2002 . The intervention group received weekly nutrition education based on the nutrition triangle concept of UNICEF for 6 months , whereas the control group received regular BINP services . Both groups were observed for a further 6 months to assess the sustainability of the effects . Information on socio-economic status , feeding patterns , morbidity , and anthropometric features was collected . Results A significant increase in the frequency of complementary feeding was observed in the intervention group as compared with the control group , and the increase was sustained throughout the observation period . The intervention group had a higher weight gain than the control group after the end of the intervention ( 0.86 vs. 0.77 kg , p = 0.053 ) and after the end of the observation period ( 1.81 vs. 1.39 kg , p < .001 ) . The proportion of normal and mildly malnourished children was greater in the intervention group than in the control group after the end of the observations ( 88.9 % vs. 61.5 % , p < .001 ) . Nutrition education successfully prevented malnutrition in all the areas . Variation in the outcome of nutrition education among the regions was observed . Conclusions This culturally appropriate nutrition education package based on the nutrition triangle model effectively prevented growth faltering and malnutrition among young children OBJECTIVE : To examine the associations of duration of exclusive breastfeeding with infections in the upper respiratory ( URTI ) , lower respiratory ( LRTI ) , and gastrointestinal tracts ( GI ) in infancy . METHODS : This study was embedded in the Generation R Study , a population -based prospect i ve cohort study from fetal life onward in the Netherl and s. Rates of breastfeeding during the first 6 months ( never ; partial for < 4 months , not thereafter ; partial for 4–6 months ; exclusive for 4 months , not thereafter ; exclusive for 4 months , partial thereafter ; and exclusive for 6 months ) and doctor-attended infections in the URTI , LRTI , and GI until the age of 12 months were assessed by question naires and available for 4164 subjects . RESULTS : Compared with never-breastfed infants , those who were breastfed exclusively until the age of 4 months and partially thereafter had lower risks of infections in the URTI , LRTI , and GI until the age of 6 months ( adjusted odds ratio [ aOR ] : 0.65 [ 95 % confidence interval ( CI ) : 0.51–0.83 ] ; aOR : 0.50 [ CI : 0.32–0.79 ] ; and aOR : 0.41 [ CI : 0.26–0.64 ] , respectively ) and of LRTI infections between the ages of 7 and 12 months ( aOR : 0.46 [ CI : 0.31–0.69 ] ) . Similar tendencies were observed for infants who were exclusively breastfed for 6 months or longer . Partial breastfeeding , even for 6 months , did not result in significantly lower risks of these infections . CONCLUSIONS : Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants . Our findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months , but preferably 6 months , in industrialized countries Complementary feeding practice s are often inadequate in developing countries , result ing in a significant nutritional decline between 6 and 18 mo of age . We assessed the effectiveness of an educational intervention to promote adequate complementary feeding practice s that would be feasible to sustain with existing re sources . The study was a cluster r and omized controlled trial in communities in the state of Haryana in India . We developed the intervention through formative research . Eight communities were pair matched on their baseline characteristics ; one of each pair was r and omly assigned to receive the intervention and the other to no specific feeding intervention . Health and nutrition workers in the intervention communities were trained to counsel on locally developed feeding recommendations .  Newborns were enrolled in all of the communities ( 552 in the intervention and 473 in the control ) and followed up every 3 mo to the age of 18 mo . The main outcome measures were weights and lengths at 6 , 9 , 12 , and 18 mo and complementary feeding practice s at 9 and 18 mo . All analyses were by intent to treat . In the overall analyses , there was a small but significant effect on length gain in the intervention group ( difference in means 0.32 cm , 95 % CI , 0.03 , 0.61 ) . The effect was greater in the subgroup of male infants ( difference in mean length gain 0.51 cm , 95 % CI 0.03 , 0.98 ) . Weight gain was not affected . Energy intakes from complementary foods overall were significantly higher in the intervention group children at 9 mo ( mean + /- SD : 1556 + /- 1109 vs. 1025 + /- 866 kJ ; P < 0.001 ) and 18 mo ( 3807 + /- 1527 vs. 2577 + /- 1058 kJ ; P < 0.001 ) . Improving complementary feeding practice s through existing services is feasible but the effect on physical growth is limited . Factors that limit physical growth in such setting s must be better understood to plan more effective nutrition programs OBJECTIVE Inappropriate complementary feeding is one of the major causes of malnutrition in young children in developing countries . We developed an educational intervention , delivered by local health-care providers , aim ed at improving complementary feeding practice s and child nutrition . DESIGN Eight townships in Laishui , a rural area in China , were r and omly assigned to the educational intervention or control group . A total of 599 healthy infants were enrolled at age 2 - 4 months and followed up until 1 year of age . In the intervention group , educational messages and enhanced home-prepared recipes were disseminated to caregivers through group trainings and home visits . Question naire surveys and anthropometric measurements were taken at baseline and ages 6 , 9 and 12 months . Analysis was by intention to treat . RESULTS It was found that food diversity , meal frequency and hygiene practice s were improved in the intervention group . Infants in the intervention group gained 0.22 kg more weight ( 95 % CI 0.003 , 0.45 kg , P = 0.047 ) and gained 0.66 cm more length ( 95 % CI 0.03 , 1.29 cm , P = 0.04 ) than did controls over the study period . CONCLUSIONS Findings from the study suggest that an educational intervention delivered through local health-care providers can lead to substantial behavioural changes of caregivers and improve infant growth In order to teach suitable feeding and hygiene practice s to a group of r and omly selected Qashqa'i tribe families with 406 children aged 0 - 59 months , a culturally appropriate community-based education intervention approach was used . To assess the impact of the intervention on the study group , another group of families with 405 children were r and omly selected to serve as the controls . At the beginning of the intervention programme both groups of children had access to a similar diet , consisting of cereals , beans , oil , sugar , milk and yoghurt . Baseline data , age , gender , weight , height and mean arm circumference ( MAC ) , were obtained before the intervention . Using Hubley 's behavioural change model , the components of which deal with beliefs , attitudes , subjective norms and enabling factors , the research team studied the behaviour of the family members and tried to change their nutritional behaviour . This was achieved by design ing a suitable education programme to be carried out for 12 months . During the programme , families were instructed to follow different methods of food preparation and cooking practice s. The final data were collected 3 months after the end of the intervention programme . The results indicated that the children in the study group gained : 1.16 ( sd 1.2 ) kg body weight , 0.033 ( sd 0.05 ) m in height , 0.0067 ( sd 0.015 ) m in MAC , 0.8 ( sd 1 ) in weight-for-age Z-score , 0.97 ( sd 1.7 ) in height-for-age Z-score and 0.28 ( sd 1.8 ) in weight-for-height Z-score by the end of the study . The corresponding values for the control group were 0.42 ( sd 1.0 ) , 0.0167 ( sd 0.047 ) , 0.0017 ( sd 0.012 ) , 0.35 ( sd 1.1 ) , 0.56 ( sd 1.5 ) and 0.014 ( sd 1.6 ) respectively and the differences were statistically significant ( P<0.05 ) . These findings suggest that educational interventions involving parents and /or other family members who might play a role in the care behaviour and care re sources are important in feeding the children energy- and protein-enriched , hygienic , simple and cheap foods . Such practice s could improve child growth even under conditions of poverty BACKGROUND Malnutrition is the underlying cause of half of child mortality . Many programmes attempt to remedy this issue but there is a lack of evidence on effective ways to decrease child malnutrition . METHODS We did a cluster-r and omised trial of an educational intervention in a poor periurban area ( ie , shanty town ) of Peru . Guided by formative research , the intervention aim ed to enhance the quality and coverage of existing nutrition education and to introduce an accreditation system in six government health facilities compared with six control facilities . The primary outcome measure was growth that was measured by weight , length , and Z scores for weight-for-age and length-for-age at age 18 months . Main secondary outcomes were the percentage of children receiving recommended feeding practice s and the 24-h dietary intake of energy , iron , and zinc from complementary food at ages 6 , 9 , 12 , and 18 months . Analysis was by intention to treat . FINDINGS We enrolled a birth cohort of 187 infants from the catchment areas of intervention centres and 190 from control areas . Caregivers in intervention areas were more likely to report receiving nutrition advice from the health service than were caregivers in control health facilities ( 16 [ 52 % ] of 31 vs 9 [ 24 % ] of 37 , p=0.02 ) . At 6 months more babies in intervention areas were fed nutrient-dense thick foods at lunch ( a recommended complementary feeding practice ) than were controls ( 48 [ 31 % ] of 157 vs 29 [ 20 % ] of 147 ; difference between groups 19 [ 11 % ] , p=0.03 ) . Fewer children in intervention areas failed to meet dietary requirements for energy ( 8 months : 30 [ 18 % ] of 170 vs 45 [ 27 % ] of 167 , p=0.04 ; 12 months : 64 [ 38 % ] of 168 vs 82 [ 49 % ] of 167 , p=0.043 ) , iron ( 8 months : 155 [ 91 % ] of 170 vs 161 [ 96 % ] of 167 , 9 months : 152 [ 93 % ] of 163 vs 165 [ 99 % ] of 166 , p=0.047 ) , and zinc ( 9 months : 125 [ 77 % ] of 163 vs 145 [ 87 % ] of 166 , p=0.012 ) than did controls . Children in control areas were more likely to have stunted growth ( ie , length for age less than 2 SD below the reference population median ) at 18 months than children in intervention groups ( 26 [ 16 % ] of 165 vs 8 [ 5 % ] of 171 ; adjusted odds ratio 3.04 [ 95 % CI 1.21 - 7.64 ] ) . Adjusted mean changes in weight gain , length gain , and Z scores were all significantly better in the intervention area than in the control area . INTERPRETATION Improvement of nutrition education delivered through health services can decrease the prevalence of stunted growth in childhood in areas where access to food is not a limiting factor This prospect i ve r and omized trial was carried out to test the efficacy of a specific intervention for reducing the extent of their malnutrition and to change behaviour of mothers relating to child-feeding practice s , care-giving , and health-seeking practice s under the Bangladesh Integrated Nutrition Project ( BINP ) . The study was conducted in rural Bangladesh among 282 moderately-malnourished ( weight-for-age between 61 % and 75 % of median of the National Center for Health Statistics st and ard ) children aged 6 - 24 months . Mothers of the first intervention group received intensive nutrition education ( INE group ) twice a week for three months . The second intervention group received the same nutrition education , and their children received additional supplementary feeding ( INE+SF 
    Output:
    
RESULTS The nutritional status of children in all studies improved and this was evidence d by increases in weight , height , mid upper arm circumference and reduced morbidity .
Key messages about education were age at introduction of complementary foods , nutrition value on different types of feeds found locally and frequency of feeding the children .
However , there were varied results regarding the effects of the intervention on the nutrition status of children .
In addition to home visiting , conducting group meetings of care givers and community leaders , providing education twice a week and use of cooking demonstrations have shown that they produce highly significant findings .
The evidence from the identified studies suggests that community- based nutrition education improves the nutrition status of under-five children in developing countries