human
***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 National nutrition programs in Bangladesh have included prenatal food supplementation to reduce maternal and child malnutrition . The knowledge base is weak regarding the effect of prenatal food supplementation on the birth weight ( BW ) of infants in population s in whom low BW is prevalent and regarding any variation in effect based on maternal nutritional status . OBJECTIVE We examined whether observational data support an effect of daily prenatal food supplementation on BW by considering the duration of supplementation and whether the effect is modified by maternal postpartum weight ( a proxy of prepregnancy weight ) groups . DESIGN A cohort of undernourished pregnant women ( n = 777 ) who received prenatal food supplementation ( 608 kcal/d ) was followed . The association between the uptake of food supplements and BW was analyzed after adjustment for potential confounders ( n = 619 with complete information ) . Differential effects in lower and higher maternal postpartum weight groups were examined . RESULTS The average BW was 2521 g. On average , the women received daily supplements for 4 mo , which result ed in an increase in BW of 118 g ( 1.0 g/d ) . The strongest effect was found for births occurring in January and February . There was a linear dose-response relation between duration of supplementation and BW for women with higher postpartum weights ( > or = 42 kg , above the median ) . In women with lower weights ( < 42 kg , below median ) , a shorter duration of supplementation ( < 4 mo ) had no such dose-response relation with BW , but there was a linear dose-response relation for longer duration s of supplementation . CONCLUSIONS The association between duration of prenatal food supplementation and BW varies with maternal postpartum weight . A large effect was observed after the season with food insecurity ( mid-August to mid-November ) The effect of prenatal energy supplementation on  maternal anthropometry was assessed in a controlled , r and omized trial in Madura , East Java . At 26 - 28 wk of gestation women were either given 465 kcal/d ( HE group ) or 52 kcal/d ( LE group ) . Two hundred seventy-six women were enrolled in the HE group and 266 women , in the LE group .  Supplement intake was variable . Testing of effect by treatment and compliance was thus done by subcategories ( HE 1 - 3 and LE 1 - 3 , corresponding to less than 45 , 45 - 89 , and greater than or equal to 90 packets of supplement consumed ) . Analysis of variance did not show significant differences among the six subcategories in third-trimester weight gain , sum of skinfold thicknesses , 4-wk postpartum weight , or body mass index . In this population energy supplementation for the short duration of the last 90 - 110 d of pregnancy was not sufficient to improve maternal nutrition as judged by anthropometry To evaluate the effect of a nutritional supplement on change in  women 's weight during a reproductive cycle and on the difference in birth weight between one infant and the previous one , we analyzed data on 176 complete reproductive cycles from an experiment that was conducted in rural Guatemala . Women with an initial weight < 50 kg were classified as marginally nourished or malnourished . Women whose intake of the supplement was in the top 2 tertiles were distinguished from those whose intake was in the lowest tertile . Linear regression modeling was used to estimate the effect of supplementation on these outcomes and to control for confounding factors . Malnourished women gained weight during the reproductive cycle , but their second ( study ) infant tended to weigh less at birth than their prior-born infant . Higher intakes of supplement were associated with a less negative difference in birth weight . Marginally nourished women lost weight during the reproductive cycle and their second ( study ) infant tended to weigh more at birth than their prior-born infant . Higher intakes of supplement were associated with a less negative weight [ corrected ] trend for the women themselves . Well-nourished women and their infants did not show any of these benefits from supplementation . These findings help explain past contradictory findings on maternal depletion as well as on the benefits of nutritional supplementation for mothers and their infants To improve maternal nutritional status and to ameliorate protein-energy malnutrition in pregnant women and infants , supplementary foods for rural pregnant women were formulated and evaluated . Six formulas with protein and energy contents of 16 - 22 g and 350 - 500 kcal/100 g food , respectively , were developed from locally available raw material s. A field evaluation of formulas I and V was conducted at the regional MCH Center at Rajchaburi , about 120 km from Bangkok .  Formulas providing 13 g protein and 350 kcal per day were given to two groups of mothers in the first or second pregnancy , starting at 28 + /- 2 wk of gestation . A third group , unsupplemented , served as controls .  Maternal weight gain and left mid-arm circumference were measured every 2 wk . Birth weight , length , head and chest circumferences of newborns , and placental weight were significantly higher in both supplemented groups . These findings suggest that among undernourished mothers , supplementation of as little as 13 g protein and 350 kcal daily during the last trimester can significantly improve maternal weight gain and birth weight of newborns In a double blind controlled intervention , two groups of nutritionally at-risk rural Taiwanese women were given a nutrient-rich dietary supplement ( group A , n = 114 ) or a placebo ( group B , n = 111 ) beginning after the birth of one child and continuing through the lactation period for a subsequent child . Outcome variables assessed include infant birth measurements postnatal physical growth , motor , mental , and dental development , morbidity , and maternal weight and skinfold changes during pregnancy and lactation . While few A-B differences in mean values of outcome variables were found , there were significant responses in subgroups of the sample . Comparisons of infants born after a nutrient-supplemented pregnancy ( A2 ) versus an unsupplemented pregnancy ( A1 ) showed that A2 male infants weighed more than A1 males at birth , and A1-A2 sibling correlations in birth measurements , especially Rohrer 's index ( wt/l3 ) were significantly reduced . Important mediators of supplement effects included sex of the offspring , season of birth , maternal body size , and birth of a previous infant characterized by dysmorphic prenatal growth . The limited effects of supplementation on the population as a whole may reflect the operation of long term adaptations which allow women to maintain reproductive success despite their apparent marginal nutritional status Colombian women at risk of malnutrition were enrolled in a health care program and r and omly assigned to supplementation and control groups at the beginning of the third trimester of pregnancy . The net dietary intake increments result ing from supplementation amounted to 155 cal and 20 g of protein per day . Supplementation had a significant effect on the mean birth weight of male infants , but not that of female infants ; the mechanisms responsible for the sex differences remain to be eluci date d. The r and omized trial design of the experiment and the documented similarity between the experimental and control groups at the onset permit the conclusion that the observed differences were caused by the food supplementation program . The effect of  supplementation  on maternal weight gain and the association of the latter with birth weight strongly suggest that improved maternal nutrition mediated the effect on birth weight This study is a r and omized controlled double-blind trial on the effects of nutrition supplement of pregnant and lactating women on their offspring . The study was conducted by the late Dr. Bacon Chow in 14 villages in Sui-Lin township , a farming area about 180 miles from Taipei , Taiwan . Two hundred ninety-four women were r and omly assigned to one of two treatment groups . The daily supplement for one group provided 800 kcal and 40 g of protein/day ; for the other group it only provided 80 kcal/day . Supplementation began after 3 wk of the delivery of a first study infant , continued throughout lactation , and through the pregnancy and lactation of a second study infant . Between group comparisons on the birth weight , number of low birth weight infants , or incidence of fetal deaths showed no statistically significant findings . However , the birth weight of the second study infant was statistically different and higher than that of the first study infant in the high supplement group . Moreover , in the low supplement group there was a correlation of 0.22 ( p = 0.06 ) between the change scores for birth weight from the first to the second study infant and the quantity of supplements consumed during the last trimester of pregnancy . There was also in this same group a significant slope in a linear regression of birth weight on total daily caloric intake during the 3rd trimester of pregnancy for the male second study infants . These findings are partly in agreement with findings from three other large supplementation studies in Colombia , Guatemala , and New York . In this study the findings indicate that caloric supplementation does result in a small yet statistically meaningful increment in birth weight within a population which is not nutritionally at risk BACKGROUND Few data exist for the effects of multiple micronutrient ( MM ) or food supplementation to undernourished pregnant women on their offsprings ' development . OBJECTIVE We aim ed to compare the effects on infant development of early ( 8 - 10 wk gestation ) or usual ( approximately 17 wk gestation ) supplementation with food and MM , 30 mg Fe + 400 microg folate , or 60 mg Fe + 400 microg folate . DESIGN A large , r and omized , controlled trial of pregnancy supplementation was conducted in Bangladesh . A sub sample of infants ( n = 2853 ) were assessed on 2 problem-solving tests ( support and cover tests ) , the motor index of the Bayley Scales of Infant Development , and Wolke 's behavior ratings at 7 mo of age . RESULTS There were no significant effects of any intervention in the group as a whole . However , infants of undernourished mothers [ body mass index ( BMI ; in kg/m2 ) < 18.5 ] who received early food supplementation performed slightly but significantly ( P = 0.035 ) better on the support test than did infants of mothers who received usual food supplementation ( z score : 0.17 ; 95 % CI : 0.01 , 0.33 ) . There were no benefits in infants of higher- BMI mothers ( P = 0.024 for BMI x food interaction ) . Children of low- BMI mothers who received MMs had slightly better motor scores ( z score : 0.28 ; 95 % CI : 0.08 , 0.48 ) and activity ratings ( z score : 0.24 ; 95 % CI : 0.037 , 0.45 ) than did those who received 30 mg Fe + 400 microg folate , whereas other children did not benefit ( P = 0.05 for both motor scores and BMI x micronutrients and for activity and BMI x micronutrients ) . CONCLUSIONS Small benefits from early food and MM supplementation were found in infants of low- BMI but not of high- BMI mothers . However , the benefits were of doubtful functional importance , and longer follow-up is required to determine programmatic implication The effect of  maternal supplementation during both gestation and lactation on infant growth from birth to 12 mth was investigated in the double-blind , r and omly allocated control trial conducted in Taiwan by the late Bacon F. Chow . The supplement was a milk-based formula providing 800 kcal and 40 g protein daily . The placebo provided less than 40 kcal per diem but resembled the supplement in appearance . Supplementation was limited to mothers and began after birth of one infant and continued without interruption until weaning of a second infant . Supplement effects were tested by comparing both supplement and placebo groups and first- and second-infant groups with respect to weight , length and head circumference . Both comparisons of growth curves and analyses of variance were carried out . Both strategies agreed in failing to detect differences in growth between supplement and placebo groups . However , differences were found between first and second infants in the supplement group BACKGROUND Prenatal multiple micronutrient ( MMN ) or balanced energy and protein supplementation has a limited effect on birth size of the offspring . OBJECTIVE The objective was to determine whether a prenatal MMN-fortified food supplement ( FFS ) improves anthropometric measures at birth compared with supplementation with an MMN pill alone . DESIGN We conducted a nonblinded , individually r and omized controlled trial in 1296 pregnant women in 2 villages in rural Burkina Faso . Supplements were provided on a daily basis , and compliance was closely verified by using a community-based network of home visitors . RESULTS Anthropometric measures at birth were available for analysis for 87 % of the 1175 live singleton deliveries enrolled . After adjustment for gestational age at birth , the FFS group had a significantly higher birth length ( + 4.6 mm ; P = 0.001 ) . FFS supplementation result ed in a modestly higher birth weight ( + 31 g ; P = 0.197 ) . Subgroup analyses showed clinical ly important treatment effects on birth length ( + 12.0 mm ; P = 0.005 ) and on birth weight ( + 111 g ; P = 0.133 ) for underweight [ body mass index ( in kg/m(2 ) ) < 18.5 ] pregnant women . Women with early pregnancy anemia who received FFS gave birth to longer newborns ( + 7.3 mm ; P = 0.002 ) than did those who received MMN supplementation . CONCLUSIONS The provision of FFS to pregnant women result ed in higher birth length than did MMN supplementation . For women with a suboptimal prepregnancy nutritional status , MMN supplementation 
    Output:
    
agent
***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 National nutrition programs in Bangladesh have included prenatal food supplementation to reduce maternal and child malnutrition . The knowledge base is weak regarding the effect of prenatal food supplementation on the birth weight ( BW ) of infants in population s in whom low BW is prevalent and regarding any variation in effect based on maternal nutritional status . OBJECTIVE We examined whether observational data support an effect of daily prenatal food supplementation on BW by considering the duration of supplementation and whether the effect is modified by maternal postpartum weight ( a proxy of prepregnancy weight ) groups . DESIGN A cohort of undernourished pregnant women ( n = 777 ) who received prenatal food supplementation ( 608 kcal/d ) was followed . The association between the uptake of food supplements and BW was analyzed after adjustment for potential confounders ( n = 619 with complete information ) . Differential effects in lower and higher maternal postpartum weight groups were examined . RESULTS The average BW was 2521 g. On average , the women received daily supplements for 4 mo , which result ed in an increase in BW of 118 g ( 1.0 g/d ) . The strongest effect was found for births occurring in January and February . There was a linear dose-response relation between duration of supplementation and BW for women with higher postpartum weights ( > or = 42 kg , above the median ) . In women with lower weights ( < 42 kg , below median ) , a shorter duration of supplementation ( < 4 mo ) had no such dose-response relation with BW , but there was a linear dose-response relation for longer duration s of supplementation . CONCLUSIONS The association between duration of prenatal food supplementation and BW varies with maternal postpartum weight . A large effect was observed after the season with food insecurity ( mid-August to mid-November ) The effect of prenatal energy supplementation on  maternal anthropometry was assessed in a controlled , r and omized trial in Madura , East Java . At 26 - 28 wk of gestation women were either given 465 kcal/d ( HE group ) or 52 kcal/d ( LE group ) . Two hundred seventy-six women were enrolled in the HE group and 266 women , in the LE group .  Supplement intake was variable . Testing of effect by treatment and compliance was thus done by subcategories ( HE 1 - 3 and LE 1 - 3 , corresponding to less than 45 , 45 - 89 , and greater than or equal to 90 packets of supplement consumed ) . Analysis of variance did not show significant differences among the six subcategories in third-trimester weight gain , sum of skinfold thicknesses , 4-wk postpartum weight , or body mass index . In this population energy supplementation for the short duration of the last 90 - 110 d of pregnancy was not sufficient to improve maternal nutrition as judged by anthropometry To evaluate the effect of a nutritional supplement on change in  women 's weight during a reproductive cycle and on the difference in birth weight between one infant and the previous one , we analyzed data on 176 complete reproductive cycles from an experiment that was conducted in rural Guatemala . Women with an initial weight < 50 kg were classified as marginally nourished or malnourished . Women whose intake of the supplement was in the top 2 tertiles were distinguished from those whose intake was in the lowest tertile . Linear regression modeling was used to estimate the effect of supplementation on these outcomes and to control for confounding factors . Malnourished women gained weight during the reproductive cycle , but their second ( study ) infant tended to weigh less at birth than their prior-born infant . Higher intakes of supplement were associated with a less negative difference in birth weight . Marginally nourished women lost weight during the reproductive cycle and their second ( study ) infant tended to weigh more at birth than their prior-born infant . Higher intakes of supplement were associated with a less negative weight [ corrected ] trend for the women themselves . Well-nourished women and their infants did not show any of these benefits from supplementation . These findings help explain past contradictory findings on maternal depletion as well as on the benefits of nutritional supplementation for mothers and their infants To improve maternal nutritional status and to ameliorate protein-energy malnutrition in pregnant women and infants , supplementary foods for rural pregnant women were formulated and evaluated . Six formulas with protein and energy contents of 16 - 22 g and 350 - 500 kcal/100 g food , respectively , were developed from locally available raw material s. A field evaluation of formulas I and V was conducted at the regional MCH Center at Rajchaburi , about 120 km from Bangkok .  Formulas providing 13 g protein and 350 kcal per day were given to two groups of mothers in the first or second pregnancy , starting at 28 + /- 2 wk of gestation . A third group , unsupplemented , served as controls .  Maternal weight gain and left mid-arm circumference were measured every 2 wk . Birth weight , length , head and chest circumferences of newborns , and placental weight were significantly higher in both supplemented groups . These findings suggest that among undernourished mothers , supplementation of as little as 13 g protein and 350 kcal daily during the last trimester can significantly improve maternal weight gain and birth weight of newborns In a double blind controlled intervention , two groups of nutritionally at-risk rural Taiwanese women were given a nutrient-rich dietary supplement ( group A , n = 114 ) or a placebo ( group B , n = 111 ) beginning after the birth of one child and continuing through the lactation period for a subsequent child . Outcome variables assessed include infant birth measurements postnatal physical growth , motor , mental , and dental development , morbidity , and maternal weight and skinfold changes during pregnancy and lactation . While few A-B differences in mean values of outcome variables were found , there were significant responses in subgroups of the sample . Comparisons of infants born after a nutrient-supplemented pregnancy ( A2 ) versus an unsupplemented pregnancy ( A1 ) showed that A2 male infants weighed more than A1 males at birth , and A1-A2 sibling correlations in birth measurements , especially Rohrer 's index ( wt/l3 ) were significantly reduced . Important mediators of supplement effects included sex of the offspring , season of birth , maternal body size , and birth of a previous infant characterized by dysmorphic prenatal growth . The limited effects of supplementation on the population as a whole may reflect the operation of long term adaptations which allow women to maintain reproductive success despite their apparent marginal nutritional status Colombian women at risk of malnutrition were enrolled in a health care program and r and omly assigned to supplementation and control groups at the beginning of the third trimester of pregnancy . The net dietary intake increments result ing from supplementation amounted to 155 cal and 20 g of protein per day . Supplementation had a significant effect on the mean birth weight of male infants , but not that of female infants ; the mechanisms responsible for the sex differences remain to be eluci date d. The r and omized trial design of the experiment and the documented similarity between the experimental and control groups at the onset permit the conclusion that the observed differences were caused by the food supplementation program . The effect of  supplementation  on maternal weight gain and the association of the latter with birth weight strongly suggest that improved maternal nutrition mediated the effect on birth weight This study is a r and omized controlled double-blind trial on the effects of nutrition supplement of pregnant and lactating women on their offspring . The study was conducted by the late Dr. Bacon Chow in 14 villages in Sui-Lin township , a farming area about 180 miles from Taipei , Taiwan . Two hundred ninety-four women were r and omly assigned to one of two treatment groups . The daily supplement for one group provided 800 kcal and 40 g of protein/day ; for the other group it only provided 80 kcal/day . Supplementation began after 3 wk of the delivery of a first study infant , continued throughout lactation , and through the pregnancy and lactation of a second study infant . Between group comparisons on the birth weight , number of low birth weight infants , or incidence of fetal deaths showed no statistically significant findings . However , the birth weight of the second study infant was statistically different and higher than that of the first study infant in the high supplement group . Moreover , in the low supplement group there was a correlation of 0.22 ( p = 0.06 ) between the change scores for birth weight from the first to the second study infant and the quantity of supplements consumed during the last trimester of pregnancy . There was also in this same group a significant slope in a linear regression of birth weight on total daily caloric intake during the 3rd trimester of pregnancy for the male second study infants . These findings are partly in agreement with findings from three other large supplementation studies in Colombia , Guatemala , and New York . In this study the findings indicate that caloric supplementation does result in a small yet statistically meaningful increment in birth weight within a population which is not nutritionally at risk BACKGROUND Few data exist for the effects of multiple micronutrient ( MM ) or food supplementation to undernourished pregnant women on their offsprings ' development . OBJECTIVE We aim ed to compare the effects on infant development of early ( 8 - 10 wk gestation ) or usual ( approximately 17 wk gestation ) supplementation with food and MM , 30 mg Fe + 400 microg folate , or 60 mg Fe + 400 microg folate . DESIGN A large , r and omized , controlled trial of pregnancy supplementation was conducted in Bangladesh . A sub sample of infants ( n = 2853 ) were assessed on 2 problem-solving tests ( support and cover tests ) , the motor index of the Bayley Scales of Infant Development , and Wolke 's behavior ratings at 7 mo of age . RESULTS There were no significant effects of any intervention in the group as a whole . However , infants of undernourished mothers [ body mass index ( BMI ; in kg/m2 ) < 18.5 ] who received early food supplementation performed slightly but significantly ( P = 0.035 ) better on the support test than did infants of mothers who received usual food supplementation ( z score : 0.17 ; 95 % CI : 0.01 , 0.33 ) . There were no benefits in infants of higher- BMI mothers ( P = 0.024 for BMI x food interaction ) . Children of low- BMI mothers who received MMs had slightly better motor scores ( z score : 0.28 ; 95 % CI : 0.08 , 0.48 ) and activity ratings ( z score : 0.24 ; 95 % CI : 0.037 , 0.45 ) than did those who received 30 mg Fe + 400 microg folate , whereas other children did not benefit ( P = 0.05 for both motor scores and BMI x micronutrients and for activity and BMI x micronutrients ) . CONCLUSIONS Small benefits from early food and MM supplementation were found in infants of low- BMI but not of high- BMI mothers . However , the benefits were of doubtful functional importance , and longer follow-up is required to determine programmatic implication The effect of  maternal supplementation during both gestation and lactation on infant growth from birth to 12 mth was investigated in the double-blind , r and omly allocated control trial conducted in Taiwan by the late Bacon F. Chow . The supplement was a milk-based formula providing 800 kcal and 40 g protein daily . The placebo provided less than 40 kcal per diem but resembled the supplement in appearance . Supplementation was limited to mothers and began after birth of one infant and continued without interruption until weaning of a second infant . Supplement effects were tested by comparing both supplement and placebo groups and first- and second-infant groups with respect to weight , length and head circumference . Both comparisons of growth curves and analyses of variance were carried out . Both strategies agreed in failing to detect differences in growth between supplement and placebo groups . However , differences were found between first and second infants in the supplement group BACKGROUND Prenatal multiple micronutrient ( MMN ) or balanced energy and protein supplementation has a limited effect on birth size of the offspring . OBJECTIVE The objective was to determine whether a prenatal MMN-fortified food supplement ( FFS ) improves anthropometric measures at birth compared with supplementation with an MMN pill alone . DESIGN We conducted a nonblinded , individually r and omized controlled trial in 1296 pregnant women in 2 villages in rural Burkina Faso . Supplements were provided on a daily basis , and compliance was closely verified by using a community-based network of home visitors . RESULTS Anthropometric measures at birth were available for analysis for 87 % of the 1175 live singleton deliveries enrolled . After adjustment for gestational age at birth , the FFS group had a significantly higher birth length ( + 4.6 mm ; P = 0.001 ) . FFS supplementation result ed in a modestly higher birth weight ( + 31 g ; P = 0.197 ) . Subgroup analyses showed clinical ly important treatment effects on birth length ( + 12.0 mm ; P = 0.005 ) and on birth weight ( + 111 g ; P = 0.133 ) for underweight [ body mass index ( in kg/m(2 ) ) < 18.5 ] pregnant women . Women with early pregnancy anemia who received FFS gave birth to longer newborns ( + 7.3 mm ; P = 0.002 ) than did those who received MMN supplementation . CONCLUSIONS The provision of FFS to pregnant women result ed in higher birth length than did MMN supplementation . For women with a suboptimal prepregnancy nutritional status , MMN supplementation 
    Output:
    