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 Moderate acute malnutrition ( MAM ) , defined as weight-for-length z score between -3 and -2 or midupper arm circumference between 11.5 and 12.5 cm , affects ∼33 million children aged < 5 y worldwide . OBJECTIVE The objective was to compare the effects of 4 dietary supplements for the treatment of MAM . DESIGN Twelve community health centers in rural Mali were r and omly assigned to provide to 1264 MAM children aged 6 - 35 mo one of 4 dietary supplements containing ∼500 kcal/d for 12 wk : 1 ) ready-to-use , lipid-based supplementary food ( RUSF ) ; 2 ) special corn-soy blend ( CSB++ ) ; 3 ) locally processed , fortified flour ( Misola ) ; or 4 ) locally milled flours plus oil , sugar , and micronutrient powder ( LMF ) . RESULTS In total , 1178 children ( 93.2 % ) completed the study . The adjusted mean ( 95 % CI ) change in weight ( kg ) from baseline was greater with RUSF than with the locally processed blends and was intermediate with CSB++ [ 1.16 ( 1.08 , 1.24 ) for RUSF , 1.04 ( 0.96 , 1.13 ) for CSB++ , 0.91 ( 0.82 , 0.99 ) for Misola , and 0.83 ( 0.74 , 0.92 ) for LMF ; P < 0.001 ] . For length change , RUSF and CSB++ differed significantly from LMF . Sustained recovery rates were higher with RUSF ( 73 % ) than with Misola ( 61 % ) and LMF ( 58 % ) , P < 0.0001 ; CSB++ recovery rates ( 68 % ) did not differ from any of the other groups . CONCLUSIONS RUSF was more effective , but more costly , than other dietary supplements for the treatment of MAM ; CSB++ yielded intermediate results . The benefits of treatment should be considered in relation to product costs and availability Objectives : Human milk ( HM ) is the optimal source of nutrition for premature infants ; however , it is unclear whether HM alone is sufficient to meet their elevated nutritional requirements early after hospital discharge . We previously reported that premature infants ( 750–1800 g birth weight ) fed HM containing extra nutrients for 12 weeks after discharge had dietary intakes closer to recommended levels and grew more rapidly than those fed HM alone . The objectives of the present article are to examine the impact of this intervention on bone mineralization , body composition , and HM  use up to 1 year . Data are also presented on general developmental level at 18-month corrected age ( CA ) . Patients and Methods : At discharge , predominantly HM-fed infants were r and omized to receive for 12 weeks either approximately half of their feedings containing a multinutrient fortifier ( intervention , n = 19 ) or all of their feedings as HM alone ( control , n = 20 ) . Results : Intervention infants remained longer ( P < 0.001 ) and had greater whole-body bone mineral content ( P = 0.02 ) until 12-month CA compared with controls . Intervention infants born less than or equal to 1250 g continued to have a larger mean head circumference throughout the first year of life ( P < 0.0001 ) .  Human milk  feeding ( mL · kg−1 · day−1 ) differed between groups at 6- ( P = 0.035 ) , but not 12-month CA . No statistically significant differences were found between groups in the mental , motor , or behavior rating scale scores of the Bayley II at 18-month CA . Conclusions : Adding a multinutrient fortifier to HM provided to predominantly HM-fed  premature infants early after discharge results in sustained differences in weight , length , and whole-body bone mineral content , and in smaller babies , head circumference for the first year of life Background and Objectives : Postdischarge formulas with extra energy and protein improve short-term growth but may also influence long-term body composition in an unwanted manner . Energy- and protein-enriched formulas with an increased protein-to-energy ratio improves gain of lean mass . The objective of the study was to investigate whether feeding a nutrient-enriched formula without extra energy after term , usually 3 to 4 weeks after discharge , would influence growth and body composition in infancy . Methods : In this r and omized controlled trial preterm infants were fed fortified human milk or preterm formula until term . At term , 102 infants were r and omized to a nutrient-enriched formula without extra energy or st and ard formula until 6 months corrected age . Twenty-six infants received unfortified human milk after term . At term and 6 months corrected age , anthropometry and a dual-energy x-ray absorptiometry ( DEXA ) scan were performed . Lean and fat mass ( FM ) were corrected for height . Results : There were no differences in growth or body size between the feeding groups . Infants fed the enriched formula gained less FM and had lower FM corrected for body size at 6 months corrected age than infants fed st and ard formula . Infants fed human milk had lower lean mass and higher FM corrected for body size at 6 months corrected age than formula-fed infants . Conclusions : Feeding nutrient-enriched formula without extra energy after term does not change quantity of growth but does influence type of weight gain and body composition of preterm infants . Infants fed the nutrient-enriched formula had lower FM corrected for body size at 6 months corrected age than infants fed st and ard formula or human milk Background : There is no consensus over best approaches to reliably prevent malnutrition in rural communities in low-income countries . Objective : We compared the effectiveness of 2 lipid-based ready-to-use supplementary foods ( RUSFs ) differing in dairy protein content to improve the nutritional status of mothers and at-risk infants and young children in rural Guinea-Bissau . Methods : A 3-month cluster-r and omized controlled pilot trial of 2 RUSFs was conducted with 692 mothers and 580 mildly or moderately malnourished infants ( 6 - 23 months ) and children ( 24 - 59 months ) from 13 villages . The RUSFs contained either 478 ( mothers , children ) or 239 kcal/d ( infants ) with 15 % or 33 % of protein from dairy and were distributed at community health centers 5 d/wk . Controls were wait-listed to receive RUSF . Primary outcomes were mid-upper arm circumference ( MUAC ) in mothers , and weight-for-age and height-for-age z-scores ( WAZ and HAZ ) in infants and children . Results : There was a significant effect of the RUSF-33 % on MUAC in mothers ( P = .03 ) . The WAZ and HAZ increased substantially , by ≈1 z-score , in infants and children ( P < .01 ) independent of group r and omization . In children , but not infants , baseline WAZ and change in maternal MUAC were associated with change in WAZ ( β = .07 , P = .02 ) . Conclusion : Ready-to-use supplementary foods with higher dairy protein content had a significant benefit in village mothers , supporting a comparable recent finding in preschool children . In addition , supplementation of children < 2 years result ed in improved growth independent of family nutritional status , whereas success in older children was associated with change in maternal nutrition , suggesting the need for community-level education about preventing malnutrition in older , as well as younger , children BACKGROUND Improved complementary feeding is cited as a critical factor for reducing stunting . Consumption of meats has been advocated , but its efficacy in low-re source setting s has not been tested . OBJECTIVE The objective was to test the hypothesis that daily intake of 30 to 45 g meat from 6 to 18 mo of age would result in greater linear growth velocity and improved micronutrient status in comparison with an equicaloric multimicronutrient-fortified cereal . DESIGN This was a cluster r and omized efficacy trial conducted in the Democratic Republic of Congo , Zambia , Guatemala , and Pakistan . Individual daily portions of study foods and education messages to enhance complementary feeding were delivered to participants . Blood tests were obtained at trial completion . RESULTS A total of 532 ( 86.1 % ) and 530 ( 85.8 % ) participants from the meat and cereal arms , respectively , completed the study .  Linear growth velocity did not differ between treatment groups : 1.00 ( 95 % CI : 0.99 , 1.02 ) and 1.02 ( 95 % CI : 1.00 , 1.04 ) cm/mo for the meat and cereal groups , respectively ( P = 0.39 ) . From baseline to 18 mo , stunting [ length-for-age z score ( LAZ ) < -2.0 ] rates increased from ~33 % to nearly 50 % . Years of maternal education and maternal height were positively associated with linear growth velocity ( P = 0.0006 and 0.003 , respectively ) ; LAZ at 6 mo was negatively associated ( P < 0.0001 ) . Anemia rates did not differ by group ; iron deficiency was significantly lower in the cereal group . CONCLUSION The high rate of stunting at baseline and the lack of effect of either the meat or multiple micronutrient-fortified cereal intervention to reverse its progression argue for multifaceted interventions beginning in the pre- and early postnatal periods OBJECTIVE To examine the effects of animal- source foods on  toddler growth .  DESIGN A 5-month comparison feeding intervention study with one of three millet-based porridges r and omized to eighteen feeding stations serving 303 children aged 11 - 40 months . Feeding stations served plain millet porridge ( Plain group ) , porridge with milk ( Milk group ) or porridge with beef ( Meat group ) .  Anthropometry , morbidity and food intake were measured at baseline and regular intervals . Longitudinal mixed models were used to analyse growth . SETTING Embu , Kenya . SUBJECTS Two hundred and seventy-four children were included in final analyses .  RESULTS Linear growth was significantly greater for the Milk group than the Meat group ( P = 0·0025 ) . Slope of growth of mid-arm muscle area of the Plain group was significantly greater than in the Meat group ( P = 0·0046 ) , while the Milk group 's mid-upper arm circumference growth rate was significantly greater than the Meat group 's ( P = 0·0418 ) . The Milk and Plain groups ' measures did not differ . CONCLUSIONS Milk and meat porridges did not have a significantly greater effect on growth  than plain porridge in this undernourished population  . Linear growth was influenced by more than energy intakes , as the Plain group 's total body weight-adjusted energy intakes were significantly greater than the Meat group 's , although linear growth did not differ . Energy intakes may be more important for growth in arm muscle . The diverse age distribution in the study makes interpretation difficult . A longer study period , larger sample size and more focused age group would improve clarity of the results Poor complementary feeding practice s are associated with stunting and growth faltering throughout the developing world . The objective was to compare the effect of using peanut-/soy-based fortified spread ( FS ) and corn porridge fortified with fish powder ( FP ) as complementary foods on growth in rural Malawian children . A total of 240 children were enrolled at the age of 6 mo and r and omized to receive FS or FP .  Both complementary foods provided 836 kJ/d from 6 to 9 mo of age and 1254 kJ/d from 9 to 18 mo of age . Children were followed monthly for anthropometry and fortnightly for the symptoms of fever , cough , or diarrhea until they were 18 mo old . Zn and Se status were assessed at 6 and 12 mo . The primary outcomes were the rates of weight and length gain from 6 - 12 mo and from 12 - 18 mo . Children who received FS gained 110 g more ( 95 % CI 220 to 10 ) from 6 - 12 mo of age than children receiving FP .  Weight gain did not differ between children receiving FS and FP between 12 and 18 mo of age , nor did statural growth from 6 to 12 mo or 12 to 18 mo . A total of 23 % of all children were Zn deficient at 6 mo of age and this increased to 37 % at 12 mo of age . Neither FS nor FP was associated with significantly improved Zn status .  FS was associated with better weight gain from 6 - 12 mo of age and may be useful in conjunction with additional interventions to improve infant growth in the developing world 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 
    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 Moderate acute malnutrition ( MAM ) , defined as weight-for-length z score between -3 and -2 or midupper arm circumference between 11.5 and 12.5 cm , affects ∼33 million children aged < 5 y worldwide . OBJECTIVE The objective was to compare the effects of 4 dietary supplements for the treatment of MAM . DESIGN Twelve community health centers in rural Mali were r and omly assigned to provide to 1264 MAM children aged 6 - 35 mo one of 4 dietary supplements containing ∼500 kcal/d for 12 wk : 1 ) ready-to-use , lipid-based supplementary food ( RUSF ) ; 2 ) special corn-soy blend ( CSB++ ) ; 3 ) locally processed , fortified flour ( Misola ) ; or 4 ) locally milled flours plus oil , sugar , and micronutrient powder ( LMF ) . RESULTS In total , 1178 children ( 93.2 % ) completed the study . The adjusted mean ( 95 % CI ) change in weight ( kg ) from baseline was greater with RUSF than with the locally processed blends and was intermediate with CSB++ [ 1.16 ( 1.08 , 1.24 ) for RUSF , 1.04 ( 0.96 , 1.13 ) for CSB++ , 0.91 ( 0.82 , 0.99 ) for Misola , and 0.83 ( 0.74 , 0.92 ) for LMF ; P < 0.001 ] . For length change , RUSF and CSB++ differed significantly from LMF . Sustained recovery rates were higher with RUSF ( 73 % ) than with Misola ( 61 % ) and LMF ( 58 % ) , P < 0.0001 ; CSB++ recovery rates ( 68 % ) did not differ from any of the other groups . CONCLUSIONS RUSF was more effective , but more costly , than other dietary supplements for the treatment of MAM ; CSB++ yielded intermediate results . The benefits of treatment should be considered in relation to product costs and availability Objectives : Human milk ( HM ) is the optimal source of nutrition for premature infants ; however , it is unclear whether HM alone is sufficient to meet their elevated nutritional requirements early after hospital discharge . We previously reported that premature infants ( 750–1800 g birth weight ) fed HM containing extra nutrients for 12 weeks after discharge had dietary intakes closer to recommended levels and grew more rapidly than those fed HM alone . The objectives of the present article are to examine the impact of this intervention on bone mineralization , body composition , and HM  use up to 1 year . Data are also presented on general developmental level at 18-month corrected age ( CA ) . Patients and Methods : At discharge , predominantly HM-fed infants were r and omized to receive for 12 weeks either approximately half of their feedings containing a multinutrient fortifier ( intervention , n = 19 ) or all of their feedings as HM alone ( control , n = 20 ) . Results : Intervention infants remained longer ( P < 0.001 ) and had greater whole-body bone mineral content ( P = 0.02 ) until 12-month CA compared with controls . Intervention infants born less than or equal to 1250 g continued to have a larger mean head circumference throughout the first year of life ( P < 0.0001 ) .  Human milk  feeding ( mL · kg−1 · day−1 ) differed between groups at 6- ( P = 0.035 ) , but not 12-month CA . No statistically significant differences were found between groups in the mental , motor , or behavior rating scale scores of the Bayley II at 18-month CA . Conclusions : Adding a multinutrient fortifier to HM provided to predominantly HM-fed  premature infants early after discharge results in sustained differences in weight , length , and whole-body bone mineral content , and in smaller babies , head circumference for the first year of life Background and Objectives : Postdischarge formulas with extra energy and protein improve short-term growth but may also influence long-term body composition in an unwanted manner . Energy- and protein-enriched formulas with an increased protein-to-energy ratio improves gain of lean mass . The objective of the study was to investigate whether feeding a nutrient-enriched formula without extra energy after term , usually 3 to 4 weeks after discharge , would influence growth and body composition in infancy . Methods : In this r and omized controlled trial preterm infants were fed fortified human milk or preterm formula until term . At term , 102 infants were r and omized to a nutrient-enriched formula without extra energy or st and ard formula until 6 months corrected age . Twenty-six infants received unfortified human milk after term . At term and 6 months corrected age , anthropometry and a dual-energy x-ray absorptiometry ( DEXA ) scan were performed . Lean and fat mass ( FM ) were corrected for height . Results : There were no differences in growth or body size between the feeding groups . Infants fed the enriched formula gained less FM and had lower FM corrected for body size at 6 months corrected age than infants fed st and ard formula . Infants fed human milk had lower lean mass and higher FM corrected for body size at 6 months corrected age than formula-fed infants . Conclusions : Feeding nutrient-enriched formula without extra energy after term does not change quantity of growth but does influence type of weight gain and body composition of preterm infants . Infants fed the nutrient-enriched formula had lower FM corrected for body size at 6 months corrected age than infants fed st and ard formula or human milk Background : There is no consensus over best approaches to reliably prevent malnutrition in rural communities in low-income countries . Objective : We compared the effectiveness of 2 lipid-based ready-to-use supplementary foods ( RUSFs ) differing in dairy protein content to improve the nutritional status of mothers and at-risk infants and young children in rural Guinea-Bissau . Methods : A 3-month cluster-r and omized controlled pilot trial of 2 RUSFs was conducted with 692 mothers and 580 mildly or moderately malnourished infants ( 6 - 23 months ) and children ( 24 - 59 months ) from 13 villages . The RUSFs contained either 478 ( mothers , children ) or 239 kcal/d ( infants ) with 15 % or 33 % of protein from dairy and were distributed at community health centers 5 d/wk . Controls were wait-listed to receive RUSF . Primary outcomes were mid-upper arm circumference ( MUAC ) in mothers , and weight-for-age and height-for-age z-scores ( WAZ and HAZ ) in infants and children . Results : There was a significant effect of the RUSF-33 % on MUAC in mothers ( P = .03 ) . The WAZ and HAZ increased substantially , by ≈1 z-score , in infants and children ( P < .01 ) independent of group r and omization . In children , but not infants , baseline WAZ and change in maternal MUAC were associated with change in WAZ ( β = .07 , P = .02 ) . Conclusion : Ready-to-use supplementary foods with higher dairy protein content had a significant benefit in village mothers , supporting a comparable recent finding in preschool children . In addition , supplementation of children < 2 years result ed in improved growth independent of family nutritional status , whereas success in older children was associated with change in maternal nutrition , suggesting the need for community-level education about preventing malnutrition in older , as well as younger , children BACKGROUND Improved complementary feeding is cited as a critical factor for reducing stunting . Consumption of meats has been advocated , but its efficacy in low-re source setting s has not been tested . OBJECTIVE The objective was to test the hypothesis that daily intake of 30 to 45 g meat from 6 to 18 mo of age would result in greater linear growth velocity and improved micronutrient status in comparison with an equicaloric multimicronutrient-fortified cereal . DESIGN This was a cluster r and omized efficacy trial conducted in the Democratic Republic of Congo , Zambia , Guatemala , and Pakistan . Individual daily portions of study foods and education messages to enhance complementary feeding were delivered to participants . Blood tests were obtained at trial completion . RESULTS A total of 532 ( 86.1 % ) and 530 ( 85.8 % ) participants from the meat and cereal arms , respectively , completed the study .  Linear growth velocity did not differ between treatment groups : 1.00 ( 95 % CI : 0.99 , 1.02 ) and 1.02 ( 95 % CI : 1.00 , 1.04 ) cm/mo for the meat and cereal groups , respectively ( P = 0.39 ) . From baseline to 18 mo , stunting [ length-for-age z score ( LAZ ) < -2.0 ] rates increased from ~33 % to nearly 50 % . Years of maternal education and maternal height were positively associated with linear growth velocity ( P = 0.0006 and 0.003 , respectively ) ; LAZ at 6 mo was negatively associated ( P < 0.0001 ) . Anemia rates did not differ by group ; iron deficiency was significantly lower in the cereal group . CONCLUSION The high rate of stunting at baseline and the lack of effect of either the meat or multiple micronutrient-fortified cereal intervention to reverse its progression argue for multifaceted interventions beginning in the pre- and early postnatal periods OBJECTIVE To examine the effects of animal- source foods on  toddler growth .  DESIGN A 5-month comparison feeding intervention study with one of three millet-based porridges r and omized to eighteen feeding stations serving 303 children aged 11 - 40 months . Feeding stations served plain millet porridge ( Plain group ) , porridge with milk ( Milk group ) or porridge with beef ( Meat group ) .  Anthropometry , morbidity and food intake were measured at baseline and regular intervals . Longitudinal mixed models were used to analyse growth . SETTING Embu , Kenya . SUBJECTS Two hundred and seventy-four children were included in final analyses .  RESULTS Linear growth was significantly greater for the Milk group than the Meat group ( P = 0·0025 ) . Slope of growth of mid-arm muscle area of the Plain group was significantly greater than in the Meat group ( P = 0·0046 ) , while the Milk group 's mid-upper arm circumference growth rate was significantly greater than the Meat group 's ( P = 0·0418 ) . The Milk and Plain groups ' measures did not differ . CONCLUSIONS Milk and meat porridges did not have a significantly greater effect on growth  than plain porridge in this undernourished population  . Linear growth was influenced by more than energy intakes , as the Plain group 's total body weight-adjusted energy intakes were significantly greater than the Meat group 's , although linear growth did not differ . Energy intakes may be more important for growth in arm muscle . The diverse age distribution in the study makes interpretation difficult . A longer study period , larger sample size and more focused age group would improve clarity of the results Poor complementary feeding practice s are associated with stunting and growth faltering throughout the developing world . The objective was to compare the effect of using peanut-/soy-based fortified spread ( FS ) and corn porridge fortified with fish powder ( FP ) as complementary foods on growth in rural Malawian children . A total of 240 children were enrolled at the age of 6 mo and r and omized to receive FS or FP .  Both complementary foods provided 836 kJ/d from 6 to 9 mo of age and 1254 kJ/d from 9 to 18 mo of age . Children were followed monthly for anthropometry and fortnightly for the symptoms of fever , cough , or diarrhea until they were 18 mo old . Zn and Se status were assessed at 6 and 12 mo . The primary outcomes were the rates of weight and length gain from 6 - 12 mo and from 12 - 18 mo . Children who received FS gained 110 g more ( 95 % CI 220 to 10 ) from 6 - 12 mo of age than children receiving FP .  Weight gain did not differ between children receiving FS and FP between 12 and 18 mo of age , nor did statural growth from 6 to 12 mo or 12 to 18 mo . A total of 23 % of all children were Zn deficient at 6 mo of age and this increased to 37 % at 12 mo of age . Neither FS nor FP was associated with significantly improved Zn status .  FS was associated with better weight gain from 6 - 12 mo of age and may be useful in conjunction with additional interventions to improve infant growth in the developing world 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 
    Output:
    