Efficacy of zinc in young infants with acute watery diarrhea

Brooks, W. Abdullah; Santosham, Mathuram; Sk, Roy; Faruque, A. S. G.; Wahed, M. A.; Nahar, Kamrun; Khan, Ashraful Islam; Khan, Alfazal; Fuchs, George J.; Black, Robert E.

doi:10.1093/ajcn/82.3.605

Cited by 50 publications

(27 citation statements)

References 20 publications

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“…Previous studies of this age group suggest that in infants < 6 months of age, treatment of acute diarrhoea with zinc does not reduce the duration or severity of the treated episode. 5,6 This contrasts with findings in children ≥ 6 months of age, in whom zinc given with ORS during an episode of acute diarrhoea has been shown to reduce the mean duration and severity of the treated episode.…”

Section: Discussionmentioning

confidence: 70%

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Effectiveness of zinc supplementation plus oral rehydration salts for diarrhoea in infants aged less than 6 months in Haryana state, India

Mazumder

Taneja

Bhandari

et al. 2010

Bull. World Health Organ.

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Section: Discussionmentioning

confidence: 70%

“…5,6 The effect of treatment in younger infants is important to document because of high death rates. It is plausible that zinc administered to children during acute diarrhoea may reduce the overall incidence and severity of diarrhoea and pneumonia in subsequent months.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of zinc supplementation plus oral rehydration salts for diarrhoea in infants aged less than 6 months in Haryana state, India

Mazumder

Taneja

Bhandari

et al. 2010

Bull. World Health Organ.

Self Cite

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“…The only two studies that specifically recruited children <6 months of age [16,17] failed to demonstrate efficacy and, currently, there is no evidence of a benefit of zinc supplements in this age group [4,13,14]. However, the issue is not closed because in some trials, there does seem to be benefit for younger infants.…”

Section: Zinc As Adjunct Therapy In the Treatment Of Diarrheal Diseasementioning

confidence: 99%

Zinc Supplementation in Public Health

Penny

2013

Ann Nutr Metab

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Zinc is necessary for physiological processes including defense against infections. Zinc deficiency is responsible for 4% of global child morbidity and mortality. Zinc supplements given for 10-14 days together with low-osmolarity oral rehydration solution (Lo-ORS) are recommended for the treatment of childhood diarrhea. In children aged ≥6 months, daily zinc supplements reduce the duration of acute diarrhea episodes by 12 h and persistent diarrhea by 17 h. Zinc supplements could reduce diarrhea mortality in children aged 12-59 months by an estimated 23%; they are very safe but are associated with an increase in vomiting especially with the first dose. Heterogeneity between the results of trials is not understood but may be related to dose and the etiology of the diarrhea infection. Integration of zinc and Lo-ORS into national programs is underway but slowly, procurement problems are being overcome and the greatest challenge is changing health provider and caregiver attitudes to diarrhea management. Fewer trials have been conducted of zinc adjunct therapy in severe respiratory tract infections and there is as yet insufficient evidence to recommend addition of zinc to antibiotic therapy. Daily zinc supplements for all children >12 months of age in zinc deficient populations are estimated to reduce diarrhea incidence by 11-23%. The greatest impact is in reducing multiple episodes of diarrhea. The effect on duration of diarrheal episodes is less clear, but there may be up to 9% reduction. Zinc is also efficacious in reducing dysentery and persistent diarrhea. Zinc supplements may also prevent pneumonia by about 19%, but heterogeneity across studies has not yet been explained. When analyses are restricted to better quality studies using CHERG (Child Health Epidemiology Reference Group) methodology, zinc supplements are estimated to reduce diarrheal deaths by 13% and pneumonia deaths by 20%. National-level programs to combat childhood zinc deficiency should be accelerated.

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“…También modifica la absorción de minerales la presencia de aminoácidos (sobre todo de origen animal) o ácidos orgánicos propios del alimentos y que actúan favoreciendo dicha absorción (13 según el modo de alimentación, ya que los alimentos con biberón presentan un requerimiento más alto debido a la menor disponibilidad de Zn que han demostrado tener las formulas infantiles (14). A diferencia del Fe, el Zn no figura como micronutriente deficitario dentro de la población pediátrica en Honduras, aunque sí que está sujeto a iniciativas de enriquecimiento de la dieta (Plan de Nación y el Plan Nacional de Salud 2010-2014, SM2015), como el suministro de Zn en polvo a niños de entre 6 y 23 meses para el tratamiento de las diarreas (15). Por todo lo anteriormente mencionado, el contenido de Fe y Zn son señalados como "nutrientes críticos" durante esta etapa de la vida, por lo que se hace necesaria la búsqueda de una optimización en la absorción de los mismos (16).…”

Section: Introductionunclassified

Aporte de hierro y zinc bioaccesible a la dieta de niños hondureños menores de 24 meses

Fernández-Palacios

Ros‐Berruezo

Barrientos-Augustinus

et al. 2017

Nutr Hosp

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Objetivo: en el presente estudio se han analizado 18 alimentos infantiles (10 elaborados con recetas tradicionales hondureñas y 8 papillas industriales comercializadas en ese país), que suponen la base de la alimentación de los lactantes hondureños excluida la leche materna y las fórmulas infantiles.Material y métodos: se determinó el contenido y bioacesiblidad (fracciones solubes y dializables) de Fe y Zn. Para ello se simuló una digestión in vitro gastrointestinal con una primera fase de digestión gástrica (con pepsina), seguida de una segunda fase de digestión intestinal (con pancreatina y sales biliares). La espectrometría de absorción atómica midió el contenido mineral en las fracciones soluble y dializable.Resultados: las papillas tradicionales hondureñas (PTH) mostraron baja densidad de los micronutrientes estudiados, siendo las PTH elaboradas con base de “arroz con frijoles y hojas verdes”, “arroz con frijol molido” y “frijoles con plátano” las que presentaron un contenido superior con valores de 1,96, 1,56, y 1,46 mg Fe/100 g, respectivamente, aunque con valores de disponibilidad in vitro inferiores al 50% de su contenido. Para el Zn en estas recetas, los valores encontrados fueron muy bajos y están por debajo del límite de detección. En relación a las papillas industriales (PIH), las de “arroz”, “trigo con leche” y “5 cereales” presentaron un mayor contenido de Fe (9,4, 8,53 y 7,56 mg Fe/100 g, respectivamente). Su disponibilidad in vitro fue mayor del 70% en todos los casos. Las PIH mostraron valores de Zn de 1,36, y 0,99 mg Zn/100 g en las muestras de “trigo con leche” y “trigo con miel”, respectivamente, y una disponibilidad mayor del 75%.Conclusión: queda demostrado que las PTH poseen algunas limitaciones en su formulación que hace que los micronutrientes seleccionados se encuentren en menor cantidad e incluso menos bioaccesibles, frente a los PIH, por lo que se recomienda su revisión para evitar la suplementación de estos micronutrientes y ayudar a mejorar el estado nutricional de la población infantil hondureña como país modelo de la región centroamericana.

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Efficacy of zinc in young infants with acute watery diarrhea

Abstract: Zinc supplementation did not affect diarrhea duration or stool volume in young infants. Young infants tolerated both zinc doses. A beneficial effect on subsequent illness cannot be ruled out.

Cited by 50 publications

References 20 publications

Effectiveness of zinc supplementation plus oral rehydration salts for diarrhoea in infants aged less than 6 months in Haryana state, India

Effectiveness of zinc supplementation plus oral rehydration salts for diarrhoea in infants aged less than 6 months in Haryana state, India

Zinc Supplementation in Public Health

Aporte de hierro y zinc bioaccesible a la dieta de niños hondureños menores de 24 meses

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