A trial of zinc supplementation in young rural Gambian children

Bates, Christopher J.; Bates, PC; Dardenne, Mireille; Prentice, Ann; Lunn, P. G.; Northrop-Clewes, Christine A.; Hoare, Simon; Cole, Tim; Horan, Sheila; Longman, S. C.; Stirling, Dorothy M.; Aggett, Peter

doi:10.1079/bjn19930026

Cited by 181 publications

(163 citation statements)

References 29 publications

(29 reference statements)

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“…A zinc supplementation trial was ineffective in improving growth (Bates, 1993). Iron and vitamin supplements have also been given without success (Bates et al, 1987).…”

Section: Discussionmentioning

confidence: 99%

High fat versus high carbohydrate nutritional supplementation: a one year trial in stunted rural Gambian children

1998

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Objective: The study tests the hypothesis that a low daily fat intake may induce a negative fat balance and impair catch-up growth in stunted children between 3 and 9 y of age. Design: Randomized case-control study. Setting: Three rural villages of the West Kiang District, The Gambia. Subjects: Three groups of 30 stunted but not wasted children (height for age z-score 72.0, weight for height zscore ! 7 2.0) 3±9 y of age were selected by anthropometric survey. Groups were matched for age, sex, village, degree of stunting and season. Intervention: Two groups were randomly assigned to be supplemented ®ve days a week for one year with either a high fat (n 29) or a high carbohydrate biscuit (n 30) each containing approximately 1600 kJ. The third group was a non supplemented control group (n 29). Growth, nutritional status, dietary intake, resting energy expenditure and morbidity were compared. Results: Neither the high fat nor the high carbohydrate supplement had an effect on weight or height gain. The high fat supplement did slightly increase adipose tissue mass. There was no effect of supplementation on resting energy expenditure or morbidity. In addition, the annual growth rate was not associated with a morbidity score. Conclusions: Results show that neither a high fat nor a high carbohydrate supplement given during 12 months to stunted Gambian children induced catch-up growth. The authors suggest that an adverse effect of the environment on catch-up growth persists despite the nutritional interventions. Sponsorship: Nestle Â Foundation for the Study of the Problems of Nutrition in the World, Lausanne, Switzerland. Descriptors: stunting; dietary fats; dietary carbohydrates; nutritional supplementation; catch-up growth; energy intake; resting energy expenditure; morbidity IntroductionIn 1983 the prevalence of stunting in children under ®ve years of age in developing countries was estimated using national prevalence values at approximately 40%, yielding a total of 125 million children (Keller, 1988). Ten years later, in a recent WHO report on child growth, the prevalence was estimated at 43% and a total of 230 million children were identi®ed as being stunted (de Onis et al, 1993). These ®gures illustrate the magnitude of the problem of stunting and serve as a reminder of how little is known about its causes in nutritional, metabolic and biochemical terms.Despite access to medical care, young children in Keneba (West Kiang District, Gambia) have repeated infectious episodes with growth faltering followed by inadequate catch-up growth (Rowland et al, 1977). Children gradually become stunted during the ®rst two years of life and tend to remain stunted through childhood into adult life. There is however evidence that stunting can be reversed during infancy and even during late childhood through adoption and to a lesser degree with nutritional supplementation (Martorell et al, 1994). This suggests that catch-up growth is impaired by conditions found in the environment in which the children became stunted. It is well esta...

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“…A zinc supplementation trial was ineffective in improving growth (Bates, 1993). Iron and vitamin supplements have also been given without success (Bates et al, 1987).…”

Section: Discussionmentioning

confidence: 99%

High fat versus high carbohydrate nutritional supplementation: a one year trial in stunted rural Gambian children

1998

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“…Zinc deficiency is a serious problem in developing countries. Many studies have shown the adverse effects on growth and morbidity as well as the prevention of infection by zinc supplementation in pregnant women, infants and children (Bates et al, 1993;Goldenberg et al, 1995;Brown et al, 1998;Bhutta et al, 1999;Caulfield et al, 1999;Shankar et al, 2000;Osendarp et al, 2001;Black et al, 2004). Zinc deficiency has also been reported in industrialized countries.…”

Section: Introductionmentioning

confidence: 99%

Ratio of low serum zinc levels in elderly Japanese people living in the central part of Japan

et al. 2006

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Objective: Elderly patients often have impaired taste, nausea, anorexia and delayed healing of decubitus. In many of these patients, serum zinc levels are low and they respond to zinc supplementation. To date, no epidemics of zinc deficiency have been reported in Japan. We studied the prevalence of zinc deficiency and its causative factors in a typical local town in Japan. Design: Cross-sectional study. Setting: Nagano Prefecture (central Japan). Subjects and methods: Serum zinc levels were measured in 1009 habitants (18-96 years old) who participated in an annual mass health examination program of the City in 2003. Of all subjects, 86 with low serum zinc (o65 mg/dl) or high zinc (X90 mg/ dl) levels were randomly selected, and a dietary survey using 24-h recalling methods for 2 consecutive days was performed in 2004. Among them, blood was collected in the morning from 50 subjects (26-94 years old). Results: The percentage of those with low serum zinc levels (2.5th percentile of Americans) was 37.9% in the elderly (X60 years old). The age-adjusted prevalence of low serum zinc was 21.1% in the aged population. A positive correlation was detected between zinc intake and serum zinc levels in elderly subjects (X60 years old). Conclusions: The possibility of zinc deficiency in adult inhabitants in central Japan rises with age. The deficiency correlates with dietary zinc intake. Sponsorship: This research was supported by a grant from local government officials in Tomi City (2004) and the funding of Fancl Corporation.

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“…However, knowledge about zinc nutriture in Africa is scarce (Ferguson et al, 1993). The recent study of 110 young Gambian children (Bates et al, 1993) apparently represents the only previous randomized controlled zinc supplementation trial conducted in Africa. However, zinc given twice weekly had no significant effects on the overall change in either weight, length or mid-upper arm circumference.…”

Section: Introductionmentioning

confidence: 99%

The impact of zinc supplementation on growth and body composition: A randomized, controlled trial among rural Zimbabwean schoolchildren

Friis¹,

Ndhlovu

Mduluza

et al. 1997

Eur J Clin Nutr

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Objectives:To assess the effect of zinc supplementation on growth and body composition among schoolchildren. Design: Randomized, double-blind, placebo-controlled trial. Setting and Subjects: 313 rural Zimbabwean schoolchildren (144 boys and 169 girls), 11-17 y). Interventions: Supplementation with zinc (30 or 50 mg) or placebo on schooldays for 12 months. Due to drought, a food programme was in operation during the last eight months of the study. Variables: Weight, height, upper arm circumference, triceps skinfold thickness, and weight-for-age, height-forage, weight-for-height, arm muscle-area-for-age and arm fat-area-for-age Z-scores. Results: Significant effects on weight gain (0.51 vs 0.14 kg, P 0.01), weight-for-age Z (70.08 vs 7 0.14, P 0.01) and arm muscle area-for-age Z-score (0.10 vs 0.01, P 0.03) were seen over the first three months, whereas no effects were seen over the full 12 months. Conclusions: Zinc deficiency impairing lean body mass and weight gain was documented. However, the effect of zinc seen over the first three months vanished during the last nine months when the food programme was in operation. Zinc deficiency may have persisted, but another nutrient may have become growth limiting during the last nine months.

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A trial of zinc supplementation in young rural Gambian children

Cited by 181 publications

References 29 publications

High fat versus high carbohydrate nutritional supplementation: a one year trial in stunted rural Gambian children

High fat versus high carbohydrate nutritional supplementation: a one year trial in stunted rural Gambian children

Ratio of low serum zinc levels in elderly Japanese people living in the central part of Japan

The impact of zinc supplementation on growth and body composition: A randomized, controlled trial among rural Zimbabwean schoolchildren

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