{
  "abstract": "Approximately 14% of United States children show ≥1 indicator of undernutrition, highlighting an opportunity to deepen research evaluating oral nutrition supplements (ONSs) on growth in United States children. The purpose of this 2-arm, individually randomized, parallel controlled trial was to evaluate the impact of ONS plus dietary counseling (ONS+DC) compared with DC alone on growth in undernourished United States children (36-107 mo) over 120 d. Over the 120-d intervention, participants [mid-upper arm circumference (MUAC) or body mass index (BMI)-for-age z-score between -3 and -1) attended 2 DC sessions, and ONS+DC group ingested 2 servings of ONS (480 kcal) daily. Growth measurements occurred at baseline, days 30, 60, and 120. Parents/caregivers completed a 24-h dietary recall and questionnaires at all timepoints. A total of 279 children participated (ONS+DC: n = 174 enrolled, n = 89 protocol evaluable; DC: n = 105 enrolled, n = 82 protocol evaluable). The primary outcome was change in weight-for-age z-score at 120 d. ONS+DC had a significantly higher change in weight-for-age z-score than DC at 120 d (group difference: 0.255 ± 0.058, P < 0.001). Average and change from baseline in weight, weight-for-age, weight-for-height, and BMI-for-age z-scores and percentiles were larger in ONS+DC than DC at all timepoints (P < 0.05). Change in MUAC-for-age z-score was higher in ONS+DC than DC at 30 and 120 d (P < 0.05). Change in height-for-age percentile was higher in ONS+DC than DC at 120 d (P < 0.05). Change in muscle area was larger in ONS+DC than DC over 120 d (P < 0.05), with no differences in arm fat area or index (P > 0.05). In undernourished United States children, 2 servings of ONS over 120 d improved growth measures more than DC alone.This trial was registered at clinicaltrials.gov as NCT05161000 (https://clinicaltrials.gov/study/NCT05161000?intr=NCT05161000&rank=1; registered 3 December 2021).",
  "abstract_shown": true,
  "affiliations": [
    "Abbott Laboratories, Nutrition Division, Nutrition Science, Columbus, OH, United States.",
    "MARS Group Inc., Bloomington, IL, United States."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Grace M Niemiro"
    },
    {
      "affs": [
        0
      ],
      "name": "Tricia L Hart"
    },
    {
      "affs": [
        0
      ],
      "name": "Jennifer A Williams"
    },
    {
      "affs": [
        1
      ],
      "name": "Menaka Yalawar"
    },
    {
      "affs": [
        0
      ],
      "name": "Geraldine E Baggs"
    },
    {
      "affs": [
        0
      ],
      "name": "Penni D Hicks"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7s6cdwj86d924.bib",
  "cited_by": 0,
  "doi": "10.1016/j.cdnut.2026.109552",
  "fulltext_url": "https://europepmc.org/articles/PMC13743383",
  "id": "7s6cdwj86d924",
  "issns": [
    "2475-2991"
  ],
  "landing_url": "https://europepmc.org/article/MED/42999576",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2916|Child Nutrition and Water Access"
    ]
  ],
  "openalex": "W7221079904",
  "pdf_url": "https://europepmc.org/articles/PMC13743383?pdf=render",
  "pmcid": "PMC13743383",
  "pmid": "42999576",
  "published": "2026-10-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7s6cdwj86d924.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42999576",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42999576"
    }
  ],
  "subjects": [],
  "title": "Combination of Oral Nutritional Supplements and Dietary Counseling Is More Effective than Dietary Counseling Alone in Improving Growth Indicators among Undernourished United States Children: A Randomized Controlled Clinical Trial.",
  "title_text": "Combination of Oral Nutritional Supplements and Dietary Counseling Is More Effective than Dietary Counseling Alone in Improving Growth Indicators among Undernourished United States Children: A Randomized Controlled Clinical Trial.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/7s6cdwj86d924",
  "venue": "Current developments in nutrition",
  "versions": []
}