{"doi":"10.1016/j.ajcnut.2023.05.025","title":"Prenatal and postnatal small-quantity lipid-based nutrient supplements and children’s social–emotional difficulties at ages 9–11 y in Ghana: follow-up of a randomized controlled trial","abstract":"BACKGROUND: Provision of small-quantity lipid-based nutrient supplements (SQ-LNSs) during early life improves growth and development. In the International Lipid-Based Nutrient Supplements DYAD-Ghana trial, prenatal and postnatal SQ-LNS reduced social-emotional difficulties at age 5 y, with greater effects among children in less-enriched home environments. OBJECTIVES: We aimed to investigate the effect of prenatal and postnatal SQ-LNS on children's social-emotional problems at age 9-11 y. METHODS: In 2009-2011, 1320 pregnant women ≤20 wk gestation were randomly assigned to receive the following daily until 6 mo postpartum: 1) iron and folic acid until delivery, then placebo, 2) multiple micronutrients (MMNs), or 3) SQ-LNS (20 g/d). Children in group 3 received SQ-LNS from 6 to 18 mo. In 2021, we evaluated children's social-emotional outcomes with 6 assessment tools that used caregiver, teacher, and/or self-report to measure socioemotional difficulties, conduct problems, temperament, mood, anxiety, and emotion management. RESULTS: We assessed outcomes in 966 children, comprising 79.4% of 1217 participants eligible for re-enrolment. No significant differences were found between the SQ-LNS and control (non-LNS groups combined) groups. Few children (<2%) experienced high parent-reported social-emotional difficulties at 9-11 y, in contrast to the high prevalence at age 5 in this cohort (25%). Among children in less-enriched early childhood home environments, the SQ-LNS group had 0.37 SD (-0.04 to 0.82) lower self-reported conduct problems than the control group (P-interaction = 0.047). CONCLUSIONS: Overall positive effects of SQ-LNS on social-emotional development previously found at age 5 y are not sustained to age 9-11 y; however, there is some evidence of positive effects among children in less-enriched environments. The lack of effects may be owing to low prevalence of social-emotional problems at preadolescence, resulting in little potential to benefit from early nutritional intervention at this age in this outcome domain. Follow-up during adolescence, when social-emotional problems more typically onset, may yield further insights. This trial was registered at clinicaltrials.gov as NCT00970866. https://clinicaltrials.gov/ct2/show/record/NCT00970866.","journal":"American Journal of Clinical Nutrition","year":2023,"id":351203,"datarank":0.38031270248175036,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.034924938532643425,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.034924938532643425,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":3,"citers_with_citation_signal":2,"citers_with_endowment":2,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9477,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT00970866"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":605908,"name":"Seth Adu‐Afarwuah","orcid":"0000-0002-2720-5474","position":1,"is_corresponding":false},{"id":370959,"name":"Charles D. Arnold","orcid":"0000-0001-6510-3172","position":2,"is_corresponding":false},{"id":1092176,"name":"Ebenezer Adjetey","orcid":null,"position":3,"is_corresponding":false},{"id":1091720,"name":"Benjamin Amponsah","orcid":"0000-0002-2597-4229","position":4,"is_corresponding":false},{"id":1091715,"name":"Helena Bentil","orcid":"0000-0001-8728-6715","position":5,"is_corresponding":false},{"id":605907,"name":"Kathryn G. Dewey","orcid":"0000-0002-4185-3451","position":6,"is_corresponding":false},{"id":372416,"name":"Amanda E. Guyer","orcid":"0000-0003-1817-8766","position":7,"is_corresponding":false},{"id":1091718,"name":"Adom Manu","orcid":"0000-0002-1099-8623","position":8,"is_corresponding":false},{"id":1091717,"name":"Mavis Mensah","orcid":"0000-0003-2259-421X","position":9,"is_corresponding":false},{"id":458391,"name":"Brietta M. Oaks","orcid":"0000-0001-6056-0585","position":10,"is_corresponding":false},{"id":1095908,"name":"Maku Ocansey","orcid":"0000-0001-9275-7526","position":11,"is_corresponding":false},{"id":1091719,"name":"Xiuping Tan","orcid":"0000-0003-0198-864X","position":12,"is_corresponding":false},{"id":294702,"name":"Paul D. Hastings","orcid":"0000-0003-2978-7364","position":13,"is_corresponding":false},{"id":1091716,"name":"Elizabeth L. Prado","orcid":"0000-0002-5388-081X","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-19T01:12:41.740237Z","pmid":"37257564","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}