Reduced serum zinc levels while improving growth of underweight school children in trial of zinc-fortified milk in Indonesia

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Endang Dewi Lestari
Lilisianawati Lilisianawati
Saptawati Bardosono
Leilani Lestarina
Harsono Salimo


Background Most children in low-income countries have
inadequate dietary zinc. The study was aimed to demonstrate the
effect of iron-zinc fortified milk in improving zinc status among
underweight school children in Indonesia.
Objective To evaluate the effects of milk fortification with zinc on
serum zinc levels in underweight Indonesian school children.
Methods A double-blind, randomized, controlled, communitybased
study was conducted on 426 underweight children aged 7
to 9 years in several low economic income level elementary schools
in Jakarta and Solo. Subjects were randomly allocated to receive
either zinc-fortified milk (n= 217) or standard milk (n=209) for
6 months. The fortified milk provided an 2.38 mg zinc per day
and the standard milk provided 0.88 mg zinc per day.
Results Among underweight children, the prevalence of stunting
with a height-for-age z-score < - 2.0 SD was 39.7%. Almost all
subjects (98%) had zinc intake ofless than 60% of the Indonesian
recommended daily allowance (RDA) for that particular age
group. After receiving the milk intervention, mean serum zinc
concentration declined significantly in both groups (from 13 .50
±3.05 μmol/Lat baseline to 10.59±1.93 μmol/L, P< 0.05), but
growth parameters (weight and height) improved.
Conclusion Reduced mean serum zinc levels were observed in
children who received standard milk, as well as those who received
zinc-fortified milk. These reduction in serum zinc levels may be a
part of homeostatic control mechanim for improving the negative
zinc balance in zinc pools, as a negative effect on linear growth
was not observed. Larger clinical trials of adequate sample size
need to be conducted in order to provide better understanding
on zinc regulation among underweight school children. [Paediatr
lndones. 2012;52:118-24).

Article Details

How to Cite
Lestari E, Lilisianawati L, Bardosono S, Lestarina L, Salimo H. Reduced serum zinc levels while improving growth of underweight school children in trial of zinc-fortified milk in Indonesia. PI [Internet]. 30Apr.2012 [cited 15Aug.2020];52(2):118-24. Available from:
Received 2016-08-22
Accepted 2016-08-22
Published 2012-04-30


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