Effect of a zinc-fortified formula on immunocompetence and growth of malnourished infants

Schlesinger, Liana; Arévalo, Marianela; Arredondo, Sonia; Díaz, M. Llopis; Lönnerdal, Bo; Stekel, A

doi:10.1093/ajcn/56.3.491

Cited by 111 publications

(101 citation statements)

References 37 publications

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“…Several previous studies have detected growth differences between zinc supplemented and control groups with similar or smaller sample sizes (Walravens et al, 1976(Walravens et al, , 1983(Walravens et al, , 1989(Walravens et al, , 1992Gibson et al, 1989;Castillo-Duran et al, 1987Schlesinger et al, 1992;Nakamura et al, 1993;Shrivastava et al, 1993), and this difference was detected within three months in some cases. However, we found no signi®cant effects of zinc supplementation on growth.…”

Section: Discussionmentioning

confidence: 88%

“…However, the effect of zinc supplementation on growth is unclear. Several studies have been carried out worldwide and many of these showed a positive effect of zinc supplementation on growth among groups of children who were nutritionally disadvantaged in some way, including stunted children (Walravens & Hambridge, 1976;Walravens et al, 1983Walravens et al, , 1989Nakamura et al, 1993), and in particular among malnourished children (Golden & Golden, 1981;Castillo-Duran et al, 1987;Schlesinger et al, 1992;Shrivastava et al, 1993;Ninh et al, 1996). However, different anthropometric parameters were affected.…”

Section: Introductionmentioning

confidence: 99%

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Zinc supplementation: effects on the growth and morbidity of undernourished Jamaican children

1998

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Objective: We investigated whether there was a growth or morbidity response to zinc supplementation. Design: The study was randomized, placebo-controlled, and double-blind. Setting: Children were recruited at clinics in Kingston, Jamaica, and supplemented at home. Subjects: Children selected were singletons aged 6±24 months, and stunted (`À2.0 s.d. length for age, NCHS references). They were strati®ed by sex and age and randomly assigned to receive zinc supplement (n 31) or placebo (n 30). Four children were excluded because of hospitalization; all others had all measurements. Adequately nourished children (n 24) were recruited from a well-baby clinic. Interventions: The supplement provided 5 mg elemental zinc in a syrup daily for 12 weeks; the placebo comprised the syrup only. Main outcome measures: Caretakers were interviewed to obtain social background data, number of clinic visits and hospitalizations. Anthropometric measurements were done on enrolment, and after 6 weeks, 12 weeks and 12 months. Children's health was determined by weekly questionnaire to caretakers of the undernourished groups during the supplementation period. Results: The supplemented and placebo groups were similar on enrolment. The adequately nourished children were from signi®cantly better socio-economic circumstances. Mean initial hair zinc content was 5.5 AE 4.8 mmolag (supplemented group) and 6.7 AE 12.1 mmolag (placebo)(n.s.). Regression analyses showed that there were no signi®cant effects of supplementation on length, height or head circumference, nor on the incidence of any morbidity symptom. Mean duration of the episodes was signi®cantly shorter for skin rashes in the supplemented group compared with the control group (ANCOVA, P 0.02), and longer for vomiting (P 0.02). The incidence of hospitalization was signi®cantly greater in the control group (Fisher's exact test, P 0.02). Conclusions: Zinc supplementation reduced the hospitalizations which probably re¯ect severity of morbidity, but did not improve growth.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Zinc supplementation: effects on the growth and morbidity of undernourished Jamaican children

1998

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“…The positive association of dietary zinc intake with weight velocity from 6 to 12 months is not surprising considering the importance of zinc for growth (Brown et al, 1998b;Schlesinger et al, 1992). Among the study infants given the vitamin ± mineral forti®ed weanimix (WM), this food contributed about 89% of their total zinc intake from complementary foods; in the other three groups (W, WF and KF), the unforti®ed project foods contributed 66% of the zinc intake from foods.…”

Section: Growth Predictors Of Ghanaian Infantsmentioning

confidence: 91%

Predictors of growth from 1 to 18 months among breast-fed Ghanaian infants

et al. 2000

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Objective: To examine factors associated with the physical growth of breast-fed Ghanaian infants during the ®rst 18 months of life. Design: A community-based longitudinal study. Setting: The study was carried out in Techiman, a district capital and major food trading center in the Brong Ahafo region of Ghana. Subjects: One-month old infants n 216 with birth weight ! 2X5 kg were recruited from Maternal and Child Health Centers. Method: From 6 to 12 months, infants were provided with one of four types of nutritionally enhanced complementary foods. Anthropometric assessments were completed monthly from 1 to 12 months and every other month from 12 to 18 months. Information was collected on household characteristics, morbidity from common infections and dietary intakes. Blood samples were collected at 6 and 12 months to assess iron, zinc, ribo¯avin and vitamin A status. Multiple regression analysis was used to examine factors associated with growth during the age intervals of 1 ± 6, 4 ± 6, 6 ± 12 and 12 ± 18 months as well as size attained at 12 and 18 months. Results: Prevalence of diarrhea and fever were negatively associated with growth during the ®rst year of life. No signi®cant relationship was found between respiratory illness (de®ned as cough or purulent nasal discharge) and growth. With the exception of dietary zinc intake, dietary variables were generally not signi®cantly associated with growth. Maternal education was positively associated with growth during most of the age intervals. Conclusion: These ®ndings suggest that interventions to reduce morbidity and improve the education of girls may bene®t children's growth in this population.

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“…Thirteen trials [68][69][70][71][72][73][74][75][76][77][78][79][80][81][82] were included that investigated the efficacy of treatments for correcting micronutrient deficiencies in children with SAM. Any supplements or combinations of supplements were eligible for inclusion, providing other review inclusion criteria (e.g.…”

mentioning

confidence: 99%

“…reported outcomes) were met. Within this section, 10 trials [68][69][70][71][72][73][74][75][76][77][78][79] (12 publications Quantity and quality of research available: zinc A summary of the key characteristics of the 10 trials [68][69][70][71][72][73][74][75][76][77][78][79] can be seen in Table 51, with further details of the trials in Appendix 12. Three trials took place in Bangladesh, 68,69,73,77 two in India, 72,78 and one trial each in Pakistan, 79 Kenya, 70 Jamaica, 71 South Africa 74,75 and Chile.…”

mentioning

confidence: 99%

The effectiveness of interventions to treat severe acute malnutrition in young children: a systematic review.

Picot

Hartwell²,

Harris³

et al. 2012

Health Technol Assess

105

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Effect of a zinc-fortified formula on immunocompetence and growth of malnourished infants

Cited by 111 publications

References 37 publications

Zinc supplementation: effects on the growth and morbidity of undernourished Jamaican children

Zinc supplementation: effects on the growth and morbidity of undernourished Jamaican children

Predictors of growth from 1 to 18 months among breast-fed Ghanaian infants

The effectiveness of interventions to treat severe acute malnutrition in young children: a systematic review.

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