Urinary Excretion of 8-isoprostane-F2α, a Biomarker of In vivo Lipid Peroxidation and Oxidative Stress, is Increased in Pregnant Ghanaian Women Taking 60 mg Iron Compared to 20 mg Iron and Multiple Micronutrients.

Objectives: To compare the effects of 3 different iron-containing supplements on 8-isoprostane- F2α, a subclinical indicator of oxidative stress, in pregnant women in Ghana. Methods: Pregnant women were randomly assigned to receive one of the following 3 interventions: Fe/FA: 60 mg iron and 400 μg folic acid capsule, MMN: 20 mg iron and 18 micronutrients capsule, or LNS: 20 mg iron and multiple micronutrients in a lipid-based nutrient supplement as part of the International Lipid-based Nutrient Supplement trial. We measured urinary 8-isoprostane-F2α and creatinine, to calculate 8-isoprostane-F2α: creatinine ratio in a subsample of 217 women at <20 wk and 36 wk gestation. Results: The overall effect of intervention group on mean (± SE) 8-isoprostane-F2α: creatinine at 36 wk was significant (p=0.04). The significant pairwise comparison was between the Fe/FA group (1.87±0.12 ng/mg creatinine) and the MMN group (1.48±0.09, p=0.02). The LNS group (1.64±0.10) was not significantly different from either of the other two groups. Conclusions: Our findings suggest that an increase in oxidative stress may occur with daily 60 mg iron compared to 20 mg iron with multiple micronutrients among pregnant women in Ghana.

Impact of Small-quantity Lipid-based Nutrient Supplements on Infant and Young Child Feeding Practices.

Objectives: Lipid-based nutrient supplements (LNS) are energy-dense and could change infant and young child feeding (IYCF) practices by changing caregiver perceptions of needs and/or child appetite and demand for breast milk and local complementary foods. We hypothesized that LNS (10-40g/day) would not have significant impacts on IYCF practices. Methods: Infants in three randomized controlled trials were assigned to receive either LNS from 9- 18 mo (Burkina Faso) or 6-18 mo (Ghana and Malawi) or a delayed intervention (DI). All caregivers were given brief didactic messages promoting continued breastfeeding and diverse diets at first distribution of LNS; messages were repeated periodically in Ghana and Malawi (all groups) and not repeated systematically in Burkina Faso. IYCF practices were assessed at 18 mo by caregiver recall of the preceding day and week. Results: The reported prevalence of continued breastfeeding did not vary by intervention group in any site, and was 97%, 74%, and 89% in Burkina Faso, Ghana, and Malawi. Reported frequency of breastfeeding yesterday also did not vary. The proportion of infants meeting the WHO recommendation for minimum dietary diversity (4+ food groups) did not differ by intervention group and was 37%, 75%, and 68% in Burkina Faso, Ghana and Malawi. In Burkina Faso, infants in the LNS group were more likely to meet the WHO recommendation for number of meals/snacks yesterday (79%, vs. 66% in DI group). Conclusions: Provision of LNS did not change most IYCF practices but increased frequency of feeding in one site.