Effects of zinc supplementation on nutritional status and cognition in children
Keywords:
zinc deficiency, zinc supplementation, nutritional status, cognition
Abstract
Background Zinc deficiency is common in children in develop-ing countries and data suggests the effects are detrimental towards
children’s growth and neuropsychologic performance. Results of
multiple studies which assess these effects have been inconsis-
tent.
Objective To evaluate the effects of zinc supplementation on
nutritional status and cognition in children with zinc deficiency.
Methods Forty-six stunted children aged 50-80 months with low
hair zinc levels were randomly assigned to receive either 7.5 mg
elemental Zn or placebo twice a week for 3 months. Anthropom-
etry and cognition were assessed at the beginning and the end of
the supplementation period. Differences among both groups for
anthropometry and cognition before and after supplementation were
analyzed with paired t-test. A comparison of different anthropom-
etry and cognition among the two groups were analyzed using the
independent t-test.
Results There were no significant differences among baseline
characteristics except on sex distribution.There was a significant
difference in weight for age between the zinc group and placebo
[0.28 (SB 0.18) vs 0.09 (SB 0.14); P=0.0001]. Height increments
were also greater in the zinc group [0.34 (SB 0.15) vs 0.02 (SB
0.12); P=0.0001). There was no significant difference between
weight for height. Intelligence quotient (IQ) measured by the
Stanford-Binnet test was slightly higher in the zinc group [2.26 (SB
3.11) vs 2.00 (SB 2.81], but the difference was not significant ac-
cording to sex.
Conclusion Zinc supplementation produced highly positive re-
sponses in weight for age and height for age increments in chil-
dren with zinc deficiency compared with placebo. There was no
effect of zinc supplementation on weight for height index and none
on cognition measured by intelligence quotient (IQ)
References
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Marie J. Zinc supplementation increases growth and
circulating insulin-like growth factor (IGF-I) in growth
retarded Vietnamese children. Am J Clin Nutr
1996;63:514-9.
2. Rivera JA, Ruel MT, Santizo MC, Lõnnredal B, Brown
KH. Zinc supplementation improves the growth of
stunted rural Guatemalan infants. J Nutr 1998;
128:556-62.
3. Rahman MM, Tofail F, Wahed MA, Fuchs GJ, Baqui
AH, Alvarez JO. Short-term supplementation with zinc
and vitamin A has no significant effect on the growth
of undernourished Bangladeshi children. Am J Clin
Nutr 2002;75:87-91.
4. Siklar Z, Tuna C, Dallar Y, Tanyer G. Zinc deficiency: A
contributing factor of short stature in growth hormone
deficient children. J Trop Pediatr 2003;49:187-8.
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130:1344-9.
6. Bahijri SM. Serum zinc in infants and preschool
children in the Jeddah area: Effect of diet and di-
arrhea in relation to growth. Available from: URL:
http://www.kfshrc.edu.sa/annal/215_216/01-
017sr.htm.
7. Dijkhuizen MA, Wierenga FT, West CE, Martuti S,
Muhilal. Effects of iron and zinc supplementation in
Indonesian infants on micronutrient status and growth.
J Nutr 2001;131:2860-5.
8. Mundiastuti L. Pengaruh pemberian suplemen seng
(Zn) terhadap status gizi anak usia 1-3 tahun di
kelurahan Bendul Merisi, Kecamatan Wonocolo dan
di Kelurahan Jagir, Kecamatan Wonokromo, Kota
Surabaya [thesis]. Surabaya: Program Pasca Sarjana
Universitas Airlangga; 2002.
9. Nakamura T, Nishiyama S, Futagoishi-Suginohara Y,
Matsuda I, Higashi A. Mild to moderate zinc deficiency
in short children: Effect of zinc supplementation on lin-
ear growth velocity. J Pediatrics 1993;123:65-9.
10. Walfarens PA, Chakar A, Mokni R, Denise J,
Lemonnier D. Zinc supplements in breastfed infants.
Lancet 1992;340:683-5.
11. Meeks GJ, Witter MM, Ramdath DD. Zinc supplemen-
tation: Effect on the growth and morbidity of under-
nourished Jamaican children. Eur J Clin Nutr
1998;52:34-9.
12. Rosado JL. Lopez P, Munoz E, Martinez H, Allen LH.
Zinc supplementation reduced morbidity, but neither
zinc nor zinc supplementation affected growth or body
composition of Mexican preschoolers. Am J Clin Nutr
1997;65:13-9.
13. Schlesinger L, Arevalo M, Arredondo S, Diaz M,
Lõnnredal B, Sketel A. Effect of zinc-fortified formula
on immunocompetence and growth of malnourished
infants. Am J Clin Nutr 1992;56:491-8.
14. Hamadani JD, Fuchs GJ, Osendarp SJ, Khatun F, Huda
SN, Granthom SM. Randomized controlled trial of the
effect of zinc supplementation on the mental develop-
ment of Bangladeshi infants. Am J Clin Nutr
2001;74:381-6.
15. Golub MS, Keen CL, Gershwin ME, Heiydrick AG.
Developmental zinc deficiency and behaviour. J Nutr
1995;125:2263-71.
16. Cavan KR, Gibson RS, Grazioso CF. Growth and com-
position of periurban Guatemalan children in relation
to zinc status: A cross sectional study. Am J Clin Nutr
1993;57:334-43.
17. Gibson RS, Vanderkooy PDS, Donald AC, Goodman
A, Ryan BH, Berry M. A growth limiting, mild zinc
deficiency syndrome in some Southern Ontario boys
with low height percentile. Am J Clin Nutr 1989;
49:1266-73.
18. Sandstead H, Penland JG, Alcock NW, Dayal HH, Chen
XC, Li JS, et al. Effects of repletion with zinc and other
micronutrients on neuropsychologic performance and
growth of Chinese children. Am J Nutr 1998;
68(suppl):470s-5s.
19. Cun CX, An YT, Sheng HJ, Yan MQ, Min HZ, Xiang
LL. Low levels of zinc in hair and blood, pica, anorexia
and poor growth in Chinese preschool children. Am J
Clin Nutr 1985;42:694-700.
20. Castilo D, Heresi G, Fisberg M, Uauy R. Controlled
trial of zinc supplementation during recovery from
malnutrition: Effect on growth and immune function.
Am J Clin Nutr 1987;45:602-8.
21. Prasad AS. Discovery of human zinc deficiency and
studies in an experimental human model. Am J Clin
Nutr 1991;53:403-12.
22. Brown KH, Allen LH, Peerson JM, Rivera J. Effect of
supplemental zinc on growth and serum zinc concen-
trations of pre-pubertal children: A meta-analysis of
randomized controlled trials. Am J Clin Nutr
2002;75:1062-71.
23. Sazawal S, Bentley M, Black R, George S, Dhingra P,
Bhan MK. Effect of zinc supplementation on observed
activity in low social economic Indian preschool chil-
dren. Pediatrics 1996;98:1132-7.
Marie J. Zinc supplementation increases growth and
circulating insulin-like growth factor (IGF-I) in growth
retarded Vietnamese children. Am J Clin Nutr
1996;63:514-9.
2. Rivera JA, Ruel MT, Santizo MC, Lõnnredal B, Brown
KH. Zinc supplementation improves the growth of
stunted rural Guatemalan infants. J Nutr 1998;
128:556-62.
3. Rahman MM, Tofail F, Wahed MA, Fuchs GJ, Baqui
AH, Alvarez JO. Short-term supplementation with zinc
and vitamin A has no significant effect on the growth
of undernourished Bangladeshi children. Am J Clin
Nutr 2002;75:87-91.
4. Siklar Z, Tuna C, Dallar Y, Tanyer G. Zinc deficiency: A
contributing factor of short stature in growth hormone
deficient children. J Trop Pediatr 2003;49:187-8.
5. Hambidge M. Human zinc deficiency. J Nutr 2000;
130:1344-9.
6. Bahijri SM. Serum zinc in infants and preschool
children in the Jeddah area: Effect of diet and di-
arrhea in relation to growth. Available from: URL:
http://www.kfshrc.edu.sa/annal/215_216/01-
017sr.htm.
7. Dijkhuizen MA, Wierenga FT, West CE, Martuti S,
Muhilal. Effects of iron and zinc supplementation in
Indonesian infants on micronutrient status and growth.
J Nutr 2001;131:2860-5.
8. Mundiastuti L. Pengaruh pemberian suplemen seng
(Zn) terhadap status gizi anak usia 1-3 tahun di
kelurahan Bendul Merisi, Kecamatan Wonocolo dan
di Kelurahan Jagir, Kecamatan Wonokromo, Kota
Surabaya [thesis]. Surabaya: Program Pasca Sarjana
Universitas Airlangga; 2002.
9. Nakamura T, Nishiyama S, Futagoishi-Suginohara Y,
Matsuda I, Higashi A. Mild to moderate zinc deficiency
in short children: Effect of zinc supplementation on lin-
ear growth velocity. J Pediatrics 1993;123:65-9.
10. Walfarens PA, Chakar A, Mokni R, Denise J,
Lemonnier D. Zinc supplements in breastfed infants.
Lancet 1992;340:683-5.
11. Meeks GJ, Witter MM, Ramdath DD. Zinc supplemen-
tation: Effect on the growth and morbidity of under-
nourished Jamaican children. Eur J Clin Nutr
1998;52:34-9.
12. Rosado JL. Lopez P, Munoz E, Martinez H, Allen LH.
Zinc supplementation reduced morbidity, but neither
zinc nor zinc supplementation affected growth or body
composition of Mexican preschoolers. Am J Clin Nutr
1997;65:13-9.
13. Schlesinger L, Arevalo M, Arredondo S, Diaz M,
Lõnnredal B, Sketel A. Effect of zinc-fortified formula
on immunocompetence and growth of malnourished
infants. Am J Clin Nutr 1992;56:491-8.
14. Hamadani JD, Fuchs GJ, Osendarp SJ, Khatun F, Huda
SN, Granthom SM. Randomized controlled trial of the
effect of zinc supplementation on the mental develop-
ment of Bangladeshi infants. Am J Clin Nutr
2001;74:381-6.
15. Golub MS, Keen CL, Gershwin ME, Heiydrick AG.
Developmental zinc deficiency and behaviour. J Nutr
1995;125:2263-71.
16. Cavan KR, Gibson RS, Grazioso CF. Growth and com-
position of periurban Guatemalan children in relation
to zinc status: A cross sectional study. Am J Clin Nutr
1993;57:334-43.
17. Gibson RS, Vanderkooy PDS, Donald AC, Goodman
A, Ryan BH, Berry M. A growth limiting, mild zinc
deficiency syndrome in some Southern Ontario boys
with low height percentile. Am J Clin Nutr 1989;
49:1266-73.
18. Sandstead H, Penland JG, Alcock NW, Dayal HH, Chen
XC, Li JS, et al. Effects of repletion with zinc and other
micronutrients on neuropsychologic performance and
growth of Chinese children. Am J Nutr 1998;
68(suppl):470s-5s.
19. Cun CX, An YT, Sheng HJ, Yan MQ, Min HZ, Xiang
LL. Low levels of zinc in hair and blood, pica, anorexia
and poor growth in Chinese preschool children. Am J
Clin Nutr 1985;42:694-700.
20. Castilo D, Heresi G, Fisberg M, Uauy R. Controlled
trial of zinc supplementation during recovery from
malnutrition: Effect on growth and immune function.
Am J Clin Nutr 1987;45:602-8.
21. Prasad AS. Discovery of human zinc deficiency and
studies in an experimental human model. Am J Clin
Nutr 1991;53:403-12.
22. Brown KH, Allen LH, Peerson JM, Rivera J. Effect of
supplemental zinc on growth and serum zinc concen-
trations of pre-pubertal children: A meta-analysis of
randomized controlled trials. Am J Clin Nutr
2002;75:1062-71.
23. Sazawal S, Bentley M, Black R, George S, Dhingra P,
Bhan MK. Effect of zinc supplementation on observed
activity in low social economic Indian preschool chil-
dren. Pediatrics 1996;98:1132-7.
Published
2016-10-18
How to Cite
1.
S R, Warsiki E, Hidajat B. Effects of zinc supplementation on nutritional status and cognition in children. PI [Internet]. 18Oct.2016 [cited 22Nov.2024];46(2):64-0. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/903
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Received 2016-10-13
Accepted 2016-10-13
Published 2016-10-18
Accepted 2016-10-13
Published 2016-10-18
