Consumption of Micronutrient Powder, Syrup or Fortified Food Significantly Improves Zinc and Iron Status in Young Mexican Children: A Cluster Randomized Trial

Abstract

The objective of this study was to compare the effect of three micronutrient products on biomarkers of iron and zinc status of Mexican children 6–12 months of age. As part of research to improve the impact of a national program, 54 communities were randomly assigned to receive: (1) fortified food (FF), provided by the program at the time, or (2) micronutrient powders (MNP) or (3) syrup. Each product contained 10 mg each of zinc and iron, plus other micronutrients. Children consumed the product 6 days/week for four months. Primary outcomes were changes in serum zinc, ferritin, soluble transferrin receptor, hemoglobin concentrations, and their deficiencies. Zinc concentration increased significantly from baseline to follow-up in all groups, with the largest change in the syrup group (geometric mean difference: +4.4 µmol/L; 95%CI: 3.2, 5.5), followed by MNP (+2.9 µmol/L; 95%CI: 2.1, 3.6) and FF (+0.9 µmol/L; 95%CI: 0.3, 1.6). There was a significant increase in hemoglobin concentration (+5.5 g/L; 2.5, 8.4) and a significant reduction in anemia prevalence (44.2% to 26.8%, p < 0.01) only in the MNP group. Compliance differed significantly among groups (MNP vs. FF, p = 0.04; MNP vs. syrup, p = 0.04), but may not fully explain the greater improvement in zinc and iron status in the syrup and MNP groups. The food matrix may influence nutrient utilization from supplements.

Long-Term Impact of Multiple Micronutrient Supplementation on Micronutrient Status, Hemoglobin Level, and Growth in Children 24 to 59 Months of Age: A Non-Randomized Community-Based Trial from Pakistan

“…A randomized control trial, conducted in Vietnam, found a considerable reduction (17.3%) in the plasma zinc level in 6–9-year-old children [ 39 ]. A study conducted by García-Guerra et al, which examined the impact of MNP supplements on the serum zinc levels of infants aged 6–12 months, administered 6 days per week for 4 months, showed a significant increase in plasma zinc level [ 40 ]. Likewise, in a recent trial, zinc was provided to children aged 6–23 months in three different forms (Preventive zinc, Micronutrient powder, and Therapeutic zinc group) for 32–40 weeks.…”

Dietary zinc supplements: beneficial health effects and application in food, medicine and animals

“…The reasons for these inconsistent results are uncertain but may be related to the choice of food vehicle, the age group and zinc status of the study population, or specific aspects of the study design. [144][145][146] Application in the treatment of diseases Providing zinc supplements has a range of health benefits, and most studies have focused on relieving or preventing diarrhea. 147 However, zinc has been used very successfully as a treatment for acute diarrhea in children, Wilson's disease, the common cold and to prevent blindness in patients with age-related dry macular degeneration, and is very effective in reducing the incidence of infections in the elderly.…”

“…Despite the positive effect of zinc fortification on total zinc absorption, only a few studies have found a positive effect of zinc fortification on serum zinc concentrations or functional indicators of zinc status. The reasons for these inconsistent results are uncertain but may be related to the choice of food vehicle, the age group and zinc status of the study population, or specific aspects of the study design 144‐146 …”