In areas of the world where daily nutrition is insecure, pregnancy and newborn health are even more precarious. A new study led by epidemiologist Dongqing Wang of the George Mason University School of Public Health further strengthens the evidence that improving maternal nutrition during pregnancy may be an important intervention to improve birth outcomes.
The study looked at eight clinical trials in Africa and South Asia and found that balanced energy and protein (BEP) supplements – food-based products such as beverages and nutritious pastes designed to increase calorie and protein intake – are associated with healthier birth weights and fewer high-risk babies in low- and middle-income countries. The survey results are PLOS Medicine.
“In situations where pregnant women don’t get enough calories and protein, it’s important to act early,” said Wang, assistant professor of epidemiology in the School of International and Community Health.
Improving maternal nutritional status can reduce the risk of poor birth outcomes. ”
Dongqing Wang, George Mason University School of Public Health
why is this important
Maternal malnutrition increases the risk of infant death, disease, and developmental delay.
Interventions have often focused on micronutrient supplements, but this study shows that food-based approaches to increasing calorie and protein intake may better support fetal growth. BEP supplements can also be delivered through existing maternal and child health programs, making them a practical solution for scale-up. Dr. Wang is currently conducting further research examining the cost-effectiveness of different approaches to BEP supplementation in Ethiopia.
Research content
Wang and colleagues combined individual-level data from randomized controlled trials conducted in Nepal, Gambia, Pakistan, and several other low- and middle-income settings. The research team compared outcomes for pregnant women who received BEP supplements with those who did not.
Key findings include:
- BEP supplements were associated with increased birth weight and reduced risk of having a baby that was low birth weight or small for gestational age.
- This effect was particularly pronounced in infants who were small for gestational age, a group with high neonatal mortality.
- The effects seemed to be stronger in women who started taking supplements early in pregnancy, especially before 20 weeks.
Dr. Wang collaborated with a global network of researchers from institutions including the Harvard School of Public Health, the Food and Agriculture Organization of the United Nations, the Aga Khan University, and partners in Europe, South Asia, and Africa.

