Evidence Hub

Effect of Small-Quantity Lipid-Based Nutrient Supplementation on Children's Cortisol Concentration

Nti H, Hastings PD, Adu-Afarwuah S, Adjetey E, Amponsah B, Arnold CD, Aryee LMD, Ayete Labi FB et al.

Maternal & child nutrition, 2026

680 participants

Abstract

This study investigated the role of early-life nutrition supplementation in regulating the development of hypothalamic-pituitary-adrenal (HPA) axis activity, as evidenced by hair cortisol concentration (HCC), in the iLiNS-DYAD randomized controlled trial in Ghana. Pregnant women were randomized to one of three conditions: (1) iron and folic acid (IFA) during pregnancy and placebo 0-6 mo postpartum; (2) multiple micronutrients (MMN) during pregnancy and 0-6 mo postpartum; or (3) small-quantity lipid-based nutrient supplements (SQ-LNS) during pregnancy and 0-6 mo postpartum and for their children from 6 to 18 mo. At 9-11 y of age, usable hair samples were obtained from 680 children from which cortisol was assayed. ANCOVA models assessed differences between groups and potential effect modifiers, including maternal education, household asset index, pre-pregnancy BMI, child sex, child BMI, and pubertal stage. HCC did not differ between SQ-LNS and control groups in adjusted and unadjusted models (p > 0.10), but maternal education was a significant effect modifier (P-interaction = 0.043). Children exposed to SQ-LNS had lower HCC than control children among those whose mothers had 0-5 years schooling (Median (interquartile range): 6.3 (4.8, 9.9) vs. 7.8 (5.3, 9.9); p = 0.031) but not among those whose mothers had > 5 years of schooling (p = 0.949). No other interactions were significant. Although these findings should be viewed with caution, they suggest that early-life SQ-LNS may…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 680 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free