Efficacy of zinc supplementation in reducing the incidence and prevalence of acute diarrhea--a community-based, double-blind, controlled trial

Sazawal, Sunil; Black, Robert E.; Bhan, Maharaj Kishan; Jalla, Sanju; Sinha, Anju; Bhandari, Nita

doi:10.1093/ajcn/66.2.413

Cited by 138 publications

(78 citation statements)

References 36 publications

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“…Some studies have indicated that the effects of zinc supplementation on morbidity tend to be more marked in boys (Ruel et al, 1995;Sazawal et al, 1997), but our sample was small for performing sub-sample analyses.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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

1998

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“…La propuesta de incluir al zinc en la fórmula se basa en estudios recientes que demuestran que la deficiencia moderada de zinc aumenta la presencia de enfermedades infecciosas en niños y que la suplementación con el mineral disminuye la morbilidad 20,21 debido, probablemente, a un estímulo de la respuesta inmune. En uno de estos estudios, la suplementación con zinc redujo en 35% la incidencia de diarrea de prescolares mexicanos.…”

Section: Selección De Nutrimentos Y Su Concentraciónunclassified

Adición de vitaminas y minerales a harinas de maíz y de trigo en México

Rosado¹,

Camacho-Solís²,

Bourges³

1999

Salud pública Méx

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In Mexico, marginal micronutrient deficiency is widespread and affects the health status and function of many Mexicans. A program to add nutrients to corn and wheat flour has been promoted by the Ministry of Health. This document describes the scientific and technological bases of the program. The main objective is to restore the nutrients which are lost during cereal processing to obtain flour and food products. Also, certain nutrients which are known to be deficient in a high proportion of Mexicans, and which should be supplemented in the diet for the benefit of the population are also included. In the definition of the formula to be added to flours various other factors were considered such as the absorption levels of the nutrients, potential interactions among them and a wide range of security to eliminate the risk of an adverse effect on health even at the highest level of food intake. Finally, the most appropriate compounds to be added to flours are suggested considering their reactivity and their possible negative effects on the stability of flour, as well as the bioavailability, market availability and cost. The recommended compounds were 5 mg/kg of thiamine (thiamine mononitrate), 3 mg/kg of riboflavin (riboflavin hydrochlorhidrate), 35 mg/kg of niacine (nicotinamide), 30 mg/kg of iron (extrafine reduced iron) and 20 mg/kg of zinc (zinc oxide) for both types of flour, as well as 2 mg/kg and 0.5 mg/kg of folic acid for wheat and corn flour, respectively. ResumenEn México la deficiencia marginal de algunas vitaminas y minerales afecta la salud y la funcionalidad de un número elevado de mexicanos, por lo que la Secretaría de Salud ha iniciado un programa para promover la adición de nutrimentos a las harinas de trigo y de maíz que se procesan industrialmente. El presente documento expone las bases científicas y tecnológicas para dicha adición. El objetivo primordial es restaurar los nutrimentos que se pierden durante el proceso de obtención de las harinas y durante la fabricación de los alimentos a partir de las harinas; además, se adicionan aquellos nutrimentos cuya presencia es deficiente en una proporción importante de la población y cuya suplementación en la dieta ha demostrado ser benéfica en la salud y la funcionalidad de la población. En la definición de la fórmula para adicionar a las harinas de trigo y maíz se consideraron, además de los factores mencionados, los niveles de absorción de los diferentes nutrimentos, la interacción probable entre nutrimentos y un malgar muy amplio de seguridad, de manera que se eliminara cualquier riesgo de algún efecto adverso en la salud, aun en los niveles más altos de ingestión de los alimentos. Finalmente, se sugieren los compuestos más apropiados para la adición a las harinas considerando su reactividad y sus posibles efectos negativos en la estabilidad de las harinas, así como su biodisponibilidad, su disponibilidad en el mercado y su costo. Con lo anterior se recomienda la adición de 5 mg/kg de tiamina (mononitrato de tiamina), 3 mg/kg de riboflavina ...

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“…17 M K Bhan et.al zinc supplementation had no effect in children of 6-11 months old. 25 In children >11 months, there was significantly less diarrhoea in the zinc group. Zinc supplementation resulted in a 17% lower diarrhoeal incidence in children with plasma zinc concentrations<9.18µmol/L at enrollment and a 33% lower incidence in children with concentration <50µmol/L.…”

Section: Discussionmentioning

confidence: 92%

Serum zinc levels and effect of zinc and vitamin A supplementation in children with diarrhea: a randomized control study

Kalvakuri

Nalisetty

2017

Int J Contemp Pediatr

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Background: Zinc deficiency affects about two billion people in the developing world and is associated with many diseases. Zinc is crucial for normal development and function of cells mediating nonspecific immunity such as neutrophils and natural killer cells. Zinc supplementation has been shown to be effective for preventing diarrhea in children. Vitamin A helps to regulate the immune system, which helps to prevent or fight off infections by making white blood cells that destroy harmful bacteria and viruses. Methods: In this randomized control study 82 children aged 6months to 5 years were randomized 52 in the group of acute diarrhoea and 30 in the control group. Blood samples were drawn for estimation of serum zinc levels. Children in the acute diarrhoea group 23 received zinc alone and 23 received zinc and vitamin A and followed up for 6 months. Results: The serum zinc levels were significantly lower in children with acute diarrhea (66.7µg/dl) as compared to that of the children in the control group (80.5433 µg/dl) (p=<0.001). The children with malnourishment had a mean zinc level that was significantly lesser (p=<0.01). In the acute diarrhea group, children receiving zinc supplementation alone, 10 of the children had at least 1 episode of diarrhea over the next 6 months. Children receiving zinc and vitamin A supplementation, there were only 5 such children with at least 1 episode of acute diarrhea. Conclusions: Combination of zinc and vitamin A supplementation in acute diarrhea decreases the chances of recurrence of diarrhoea and reduces the hospital stay significantly.

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Efficacy of zinc supplementation in reducing the incidence and prevalence of acute diarrhea--a community-based, double-blind, controlled trial

Cited by 138 publications

References 36 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

Adición de vitaminas y minerales a harinas de maíz y de trigo en México

Serum zinc levels and effect of zinc and vitamin A supplementation in children with diarrhea: a randomized control study

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