TY - JOUR
T1 - Impact of home food production on nutritional blindness, stunting, wasting, underweight and mortality in children
T2 - a systematic review and meta-analysis of controlled trials
AU - Bassey, Chizoba
AU - Crooks, Harriet
AU - Paterson, Katherine
AU - Ball, Rachel
AU - Howell, Kristoffer
AU - Humphries-Cuff, Iona
AU - Gaffigan, Kirsty
AU - Rao, Nitya
AU - Whitty, Jennifer A.
AU - Hooper, Lee
N1 - Funding Information:
This work was carried out as part of a self-funded PhD (CB). Internal funding was provided by the University of East Anglia for NR, JAW, and LH. J.A. Whitty is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2020 Taylor & Francis Group, LLC.
PY - 2022
Y1 - 2022
N2 - Vitamin A deficiency is highly prevalent and remains the major cause of nutritional blindness in children in low-and middle-income countries, despite supplementation programmes. Xeropthalmia (severe drying and thickening of the conjunctiva) is caused by vitamin A deficiency and leads to irreversible blindness. Vitamin A supplementation programmes effectively reduce vitamin A deficiency but many rural children are not reached. Home food production may help prevent rural children’s vitamin A deficiency. We aimed to systematically review trials assessing effects of home food production (also called homestead food production and agricultural interventions) on xeropthalmia, nightblindness, stunting, wasting, underweight and mortality (primary outcomes). We searched Medline, Embase, Scopus, Cochrane CENTRAL and trials registers to February 2019. Inclusion of studies, data extraction and risk of bias were assessed independently in duplicate. Random-effects meta-analysis, sensitivity analyses, subgrouping and GRADE were used. We included 16 trials randomizing 2498 children, none reported xerophthalmia, night-blindness or mortality. Home food production may slightly reduce stunting (mean difference (MD) 0.13 (z-score), 95% CI 0.01 to 0.24), wasting (MD 0.05 (z-score), 95% CI −0.04 to 0.14) and underweight (MD 0.07 (z-score), 95% CI −0.01 to 0.15) in young children (all GRADE low-consistency evidence), and increase dietary diversity (standardized mean difference (SMD) 0.24, 95% CI 0.15 to 0.34). Home food production may usefully complement vitamin A supplementation for rural children. Large, long-duration trials with good randomization, allocation concealment and correct adjustment for clustering are needed to assess effectiveness of home food production on nutritional blindness in young children.
AB - Vitamin A deficiency is highly prevalent and remains the major cause of nutritional blindness in children in low-and middle-income countries, despite supplementation programmes. Xeropthalmia (severe drying and thickening of the conjunctiva) is caused by vitamin A deficiency and leads to irreversible blindness. Vitamin A supplementation programmes effectively reduce vitamin A deficiency but many rural children are not reached. Home food production may help prevent rural children’s vitamin A deficiency. We aimed to systematically review trials assessing effects of home food production (also called homestead food production and agricultural interventions) on xeropthalmia, nightblindness, stunting, wasting, underweight and mortality (primary outcomes). We searched Medline, Embase, Scopus, Cochrane CENTRAL and trials registers to February 2019. Inclusion of studies, data extraction and risk of bias were assessed independently in duplicate. Random-effects meta-analysis, sensitivity analyses, subgrouping and GRADE were used. We included 16 trials randomizing 2498 children, none reported xerophthalmia, night-blindness or mortality. Home food production may slightly reduce stunting (mean difference (MD) 0.13 (z-score), 95% CI 0.01 to 0.24), wasting (MD 0.05 (z-score), 95% CI −0.04 to 0.14) and underweight (MD 0.07 (z-score), 95% CI −0.01 to 0.15) in young children (all GRADE low-consistency evidence), and increase dietary diversity (standardized mean difference (SMD) 0.24, 95% CI 0.15 to 0.34). Home food production may usefully complement vitamin A supplementation for rural children. Large, long-duration trials with good randomization, allocation concealment and correct adjustment for clustering are needed to assess effectiveness of home food production on nutritional blindness in young children.
KW - Retinol
KW - anthropometry
KW - child nutrition disorders
KW - gardening
KW - infant nutrition disorders
KW - meta-analysis
KW - night blindness
KW - xerophthalmia
UR - http://www.scopus.com/inward/record.url?scp=85097096578&partnerID=8YFLogxK
U2 - 10.1080/10408398.2020.1848786
DO - 10.1080/10408398.2020.1848786
M3 - Review article
C2 - 33272038
AN - SCOPUS:85097096578
SN - 1040-8398
VL - 62
SP - 1856
EP - 1869
JO - Critical Reviews in Food Science and Nutrition
JF - Critical Reviews in Food Science and Nutrition
IS - 7
ER -