Community‐based supplementary feeding for food insecure, vulnerable and malnourished populations – an overview of systematic reviews
What was the aim of this review?
To summarise the effect of supplementary feeding on populations that were food insecure, vulnerable and malnourished. The overview authors found eight systematic reviews examining supplementary feeding in a variety of populations.
Across a range of vulnerable populations, supplementary feeding programmes sometimes show modest benefit in nutritional outcomes. In a few studies examining mortality (death), effects were either small or absent, and research mostly looked at short‐term effects.
What was studied in the review?
Supplementary feeding means providing extra food to people or families over and above their home diet and has been used in populations that are food insecure (limited access to adequate and nutritious food) and vulnerable (including women and young children; school‐aged children; people living with diseases such as tuberculosis, HIV, and Alzheimer's disease; and older people) to improve their health and quality of life.
What are the main results of the review?
The evidence presented here was current to January 2017. We found eight systematic reviews to include in this summary. These reviews included 95 studies (including up to 7940 adults, and more than 12,595 children in a few studies). Most of the included studies lasted from six weeks to two years, with only three studies following people for longer periods of time (up to 17 years). In these reviews, there were a wide range of different types of supplementary feeding given to vulnerable groups over different periods of time, and often in combination with vitamins or minerals.
In pregnancy, we found that energy and protein supplements that were balanced (i.e. providing adequate amounts of energy and nutrients, in this case protein) may have decreased the rate of stillbirth (death or loss of a baby before or during delivery), improved infant birth weight and reduced the risk of infants born small‐for‐gestational age (infants that are smaller than expected). We observed no long‐term benefits for children in terms of growth and cognitive (intellectual) development (although very few studies reported long‐term effects). High‐protein supplements (containing protein in higher amounts) were associated with risk and harm (increased risk of small‐for‐gestational age babies).
We found that the effects of supplementary feeding on growth in children were varied. In children under five years of age from low‐ and middle‐income countries, supplementary feeding had a small impact on child growth. We observed some benefits in terms of weight and height gains, especially in younger children (those younger than two years of age) and in those who were poorer or less well‐nourished (or both). Some benefit could be seen in children with moderate acute malnutrition in terms of weight gain, other growth factors and recovery rate. School meals seemed to lead to a number of small benefits in school children (including improvements in weight, height, intelligence tests, and maths and spelling performance).
Supplementary feeding in adults who were HIV positive increased the daily intake of energy and protein and led to an early improvement in weight gain or body mass index (measure of whether someone is overweight or underweight), or both, but did not seem to lead to long‐term benefits (although few studies reported long‐term effects). In adults with tuberculosis (serious infectious lung disease), we observed small benefits in terms of weight gain during active tuberculosis.
In Alzheimer's disease (a type of dementia), providing a daily oral nutrition supplement for three months improved nutritional outcomes (such as weight and energy intake).
There was little or no evidence available regarding people's quality of life, adherence to treatment, attendance at clinic or the costs of supplementary feeding programmes.