(P12-34-26) Effect of Early Life Small Quantity Lipid-Based Nutrient Supplementation on Cognitive Ability at 9 Years: A Follow-Up Study in Malawi

Saturday, July 25, 2026

11:30 AM - 12:30 PM ET

Location: Poster Board C-83

Presenting Author(s)

Yvonne Muthiani, Msc

Doctoral researcher
Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere
Tampere, Pirkanmaa, Finland

Co-Author(s)

CM

Charles Mangani

School of Global and Public Health, Kamuzu University of Health Sciences, Malawi
EK

Eero Kajantie

University of Oulu, Clinical Medicine Research Unit, Finland
EV

Eeva Virtanen

University of Oulu, Clinical Medicine Research Unit, Finland
Kathryn G. Dewey, PhD (she/her/hers)

Distinguished Professor Emerita
University of California, Davis
Davis, California, United States
KM

Kenneth Maleta

School of Global and Public Health, Kamuzu University of Health Sciences, Malawi
LH

Lotta Hallamaa

Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
PA

Per Ashorn, MD, PhD

Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere
Tampere, Pirkanmaa, Finland
JL

Jukka Leppänen

Department of Psychology and Speech-Language Pathology, University of Turku, Finland
UA

Ulla Ashorn, PhD

Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere
Tampere, Pirkanmaa, Finland

Disclosure(s):

Yvonne Muthiani, Msc: No relevant financial relationship(s) with ineligible companies to disclose.

Kathryn G. Dewey, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Currently, there is little evidence on the long-term cognitive effects of early small-quantity lipid-based nutrient supplementation (SQ-LNS). We aimed to examine the effect of SQ-LNS on cognitive ability at 9 years.

Methods: This study is a follow-up to a randomized controlled trial conducted between 2011 and 2015 in southern Malawi. 1391 pregnant women between 10- and 20-weeks’ gestation were randomized to receive SQ-LNS (20 g/d) during pregnancy and 6 months postpartum and SQ-LNS for children from 6 to 18 months of age; or multiple (18) micronutrients (MMN) during pregnancy and 6 months postpartum; or iron and folic acid (IFA) during pregnancy only. In 2021, all available children born to the trial were invited for follow-up assessment at 9 years. We assessed cognitive ability by 3 processing speed measures (saccadic reaction time (SRT), manual choice reaction time (CRT), P3 event-related potential (ERP) latency (will be reported separately), and tests of nonverbal reasoning (coloured progressive matrices (CPM)), and early numeracy (early grade mathematics assessment (EGMA)). We compared the SQ-LNS and non-LNS groups (MMN and IFA combined) and estimated the intervention effect using linear regression.

Results: 828 children participated, representing 64% of the liveborn infants from parent trial. The mean (SD) age of children was 9.3 (0.2) y, with 53% being girls. The children had mean (SD) SRT of 277.36 (23) milliseconds (ms), mean CRT of 1105.89 (205.59) ms, mean CPM scores of 13.47 (3.18) and an EGMA composite score that ranged from –1.14 to 2.70. There were no significant differences between SQ-LNS and control group in SRT: adjusted mean difference = 2.05 milliseconds(ms), 95% CI (-1.57, 5.67); CRT: -10.45ms, 95% CI (-43.84, 22.93); CPM: 0.15 (-0.34, 0.63); or EGMA: 0.03 (-0.08, 0.15).

Conclusions: Although we hypothesized that early SQ-LNS supplementation, which contains nutrient components that may positively influence neurodevelopment, would lead to better cognitive outcomes later in childhood, the findings at this age for the outcomes measured do not support this hypothesis. This may possibly be explained by post intervention factors that may constrain children at this age from exhibiting long-term benefits from early life SQ-LNS.

Funding Sources: Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital