The effect of supplementation with locally available foods on stunting: A review of theory and evidence

There is vigorous debate and mixed evidence concerning what diets or how many food groups can be used to prevent stunting in resource poor settings. Inherently, recommendations focus on food supply, availability and access other than household functions, behaviours and child care practices. We review the evidence on the effects of supplementation using locally available diverse and non-diverse foods on stunting among children below the age of five years. We review evidence from Sub-Saharan Africa, where 22 of the 34 countries that contribute to ninety percent of the global burden of stunting are. We searched the empirical literature that captured anthropometry outcomes for children of age 0-5 years. Studies assessing the effects of fortified foods, or food used for treatment rather than prevention were excluded. Four studies are reviewed. Only one study provided food supplements comprising seven locally available food items, while the others provided fewer food items. The studies show that supplementing with diverse local foods has neither superior nor inferior linear growth benefits than supplementing with non-diverse local foods. We however find positive and consistent significant effects especially of milk and maternal factors on preventing wasting and underweight. Our review demonstrates that supplementing with locally available foods is feasible in resource poor settings. Our findings partially substantiate the challenges of prescribing the quality or a threshold of food groups for the prevention of stunting. Due to limited evidence, further research on local diverse and non-diverse supplementation is required.