Food-based approaches to improve nutritional quality of the complementary diet to address stunting

The prevalence of stunting remains persistently high in South Africa, with a sub-optimal complementary diet being a contributing factor. Nutritional adequacy of the complementary diet could potentially be improved by mixing small-quantity lipid-based nutrient supplements (SQ-LNSs) with usual complementary food or by adding nutrient-rich foods such as egg to the complementary diet. We provide a narrative overview of two randomised controlled trials with SQ-LNS or egg, both conducted in South Africa. Neither study showed improved linear growth after 6 months. Reasons for the lack of effect within the context of these specific studies provide valuable insights and are discussed within the broader context of food-based approaches, including improving dietary diversity, and encouraging milk and animal source foods as complementary foods. Nutrition education and considering context-specific conditions are critical elements for successful implementation of food-based strategies to improve the nutritional quality of the complementary diet.