medwireNews: A balanced nutritional supplement promotes height and weight gain in lean prepubertal children with idiopathic short stature, show the findings of a randomised trial.

The supplement contained 25% of the children’s recommended daily calorie and fat intake, was high in protein (28% of calories) and had 47% of their recommended carbohydrate, vitamin and mineral intake.

The effect was dose-dependent, with children who consumed at least half of the prescribed amount of the supplement achieving an average height standard deviation score (SDS) increase of 0.12 during 6 months of study.

“This magnitude of improvement in height approaches the successful first year minimal response to growth hormone treatment (height-SDS of 0.3) expected in idiopathic short stature”, researcher Moshe Phillip (Children’s Medical Center of Israel, Petah Tikva) and team write in The Journal of Pediatrics.

By contrast, children who consumed less than 50% of the recommended amount of supplement had no change in height SDS from baseline. Children with good adherence to the placebo supplement had a 0.05 increase in height SDS, and those with poor adherence had a 0.02 decrease.

A total of 171 children completed the 6-month treatment period, of whom 80 were randomly assigned to receive the nutritional supplement and 91 the placebo supplement. They were aged between 3 and 9 years, and were in or below the 10th percentile for height and weight and were in a lower weight than height percentile.

Children with good adherence to the nutritional supplement also had a significant gain in weight SDS of 0.28 over 6 months, compared with 0.02 to 0.12 among children who had poor adherence or were in the placebo group. Body mass index SDS also increased, by 0.23, but this was not a significantly larger change than the increases in the other groups, of about 0.09.

The results suggest “growth without an ‘obesogenic’ effect”, say the researchers. The children’s parents also recorded their children’s dietary intake for 3 days before the baseline and 6-month assessments. Dietary nutritional intake did not significantly change between these time points, indicating that the gains in height and weight SDS were caused by the nutritional supplement.

Phillip et al say their study is notable for having been performed in a developed country among middle-class participants for whom fussy eating was the most likely contributing factor to their short stature. Indeed, the most common reason for not completing the study was children refusing to consume the supplement, and only about half of the study completers had good adherence.

“We assume that the clinical effect should be even more pronounced in other areas of the world where the food supply is limited”, says the team.

By Eleanor McDermid, Senior medwireNews Reporter

J Pediatr 2014; Advance online publication

Free abstract