Impact of home food production on nutritional blindness, stunting, wasting, underweight and mortality in children: a systematic review and meta-analysis of controlled trials

Chizoba Bassey, Harriet Crooks, Katherine Paterson, Rachel Ball, Kristoffer Howell, Iona Humphries-Cuff, Kirsty Gaffigan, Nitya Rao, Jennifer A. Whitty, Lee Hooper

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

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, night blindness, 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.

Prospero registration: CRD42019126455 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019126455)
Original languageEnglish
JournalCritical Reviews in Food Science and Nutrition
Early online date4 Dec 2020
DOIs
Publication statusE-pub ahead of print - 4 Dec 2020

Keywords

  • retinol
  • xerophthalmia
  • infant nutrition disorders
  • night blindness
  • gardening
  • anthropometry
  • meta-analysis
  • child nutrition disorders

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