Long-term effects of iron and zinc supplementation during infancy on cognitive function at 9 y of age in northeast Thai children: a follow-up study

Pongcharoen, Tippawan; DiGirolamo, Ann; Ramakrishnan, Usha; Winichagoon, Pattanee; Flores, Rafael; Martorell, Reynaldo

doi:10.3945/ajcn.110.002220

Cited by 45 publications

(43 citation statements)

References 33 publications

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“…Two follow-up studies of school-age children (age 7–9 years) who received iron + zinc supplementation during infancy showed no long term effects on cognition [40,41]. In one study from Thailand, iron + zinc supplementation was given for 6 months beginning at 4–6 months of age and cognitive functioning was measured with global measures and school performance [40].…”

Section: Iron Supplementation/fortificationmentioning

confidence: 99%

“…In one study from Thailand, iron + zinc supplementation was given for 6 months beginning at 4–6 months of age and cognitive functioning was measured with global measures and school performance [40]. In the other study from Nepal, iron-folic acid or zinc was given to 12–36 month old children who had participated in an antenatal supplementation trial of iron or zinc, separately, and in combination [41].…”

Section: Iron Supplementation/fortificationmentioning

confidence: 99%

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Integrated strategies needed to prevent iron deficiency and to promote early child development

Black

2012

Journal of Trace Elements in Medicine and Biology

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Iron deficiency (ID) and iron deficiency anemia (IDA) are global public health problems that differentially impact pregnant women and infants in low and middle income countries. IDA during the first 1000 days of life (prenatally through 24 months) has been associated with long term deficits in children’s socio-emotional, motor, cognitive, and physiological functioning. Mechanisms linking iron deficiency to children’s development may include alterations to dopamine metabolism, myelination, and hippocampal structure and function; as well as maternal depression and unresponsive caregiving, potentially associated with maternal ID. Iron supplementation trials have had mixed success in promoting children’s development. Evidence suggests that the most effective interventions to prevent iron deficiency and to promote early child development begin early in life and integrate strategies to ensure adequate iron and nutritional status, along with strategies to promote responsive mother-child interactions and early learning opportunities.

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Section: Iron Supplementation/fortificationmentioning

confidence: 99%

Section: Iron Supplementation/fortificationmentioning

confidence: 99%

Integrated strategies needed to prevent iron deficiency and to promote early child development

Black

2012

Journal of Trace Elements in Medicine and Biology

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“…93,94 Therapeutic responses to Zn supplementation have been observed in multiple infectious diseases 95 and recently, a number of controlled intervention trials have been conducted to unveil the impact of Zn supplementation on cognitive performance and other health outcomes in children. A metaanalysis of 33 randomized controlled trials on Zn supplementation in children found a large effect on height and weight increments, 96 while the evidence regarding the effects of Zn on cognitive function in children lacks a clear consensus [97][98][99] which may be due to the dependency on further micronutrients, the life period and degree of deficiency, or the methodological features mentioned above. On the other hand, high Zn intake interferes with the intestinal absorption of copper and can induce a copper deficiency 92 (and vice versa 100 ), which is made use of in the utilization of Zn for the treatment of Wilson's disease.…”

Section: Zinc Deficiency and Healthmentioning

confidence: 99%

Zinc diet and Alzheimer's disease: a systematic review

Loef

Stillfried

Walach

2012

Nutritional Neuroscience

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The current state of evidence does not allow conclusions to be drawn on whether supplementation of Zn is beneficial for the prevention or treatment of AD, although a subclinical deficiency appears common in the elderly and subjects with AD. Dietary studies with animals suggest that the impact of dietary Zn on cognitive performance depend on additional nutrients. Further studies are necessary to determine whether Zn deficiency is a risk factor for AD in general terms or under certain dietary circumstances only.

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“…Children were followed up at the age of 9 years, when the authors found no differences overall or in any domain of the Wechsler Intelligence Scale for Children-III between the groups, or in the Raven's Colored Progressive Matrices score. Moreover, no differences in school performance in any subject (Thai, English, Mathematics, or Science) were observed [49] . Collectively, these studies do not support the hypothesis that even quite sustained courses of iron supplementation in young children benefit cognitive performance in the long term.…”

Section: Does Supplementation In Preschool Children Improve Short-termentioning

confidence: 99%

Iron and Cognitive Development: What Is the Evidence?

2017

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The theoretical irreversible damage that iron deficiency and iron deficiency anemia can exert on child development makes a compelling argument for action to alleviate the burden. However, a critical analysis of evidence from iron interventions in early life is necessary to determine whether and how iron interventions improve cognitive outcomes. Key iron interventions used in clinical and public health practice include oral iron supplementation and, in young children, iron-containing multiple micronutrient powders. This article examines the evidence to answer 4 main questions. (1) Does antenatal iron supplementation influence long-term child cognitive development? (2) Does oral iron supplementation in preschool children improve short-term cognitive development? (3) Does oral iron supplementation in older children improve cognitive development? And (4), can provision of iron harm cognitive development? Early trials indicated benefit from parenteral iron in young children regardless of anemia status. There also appears to be evidence for benefit using oral iron treatment on cognitive performance in anemic primary school children. However, antenatal and early childhood oral iron intervention studies show inconsistent effects on early and long-term childhood cognitive outcomes. These data suggest either that (a) effects from oral iron on cognitive development in young children are small or nonexistent or that (b) heterogeneity between trials and the low quality of many studies make assessment of effect difficult. Importantly, few large, placebo-controlled trials in under-2-year-old children in low-income settings assessing effects of iron interventions on cognition have been performed; high-quality, placebo-controlled, adequately powered trials of universal iron interventions on cognitive performance in young children are urgently needed to justify policies of universal iron intervention in this group.

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Long-term effects of iron and zinc supplementation during infancy on cognitive function at 9 y of age in northeast Thai children: a follow-up study

Abstract: Supplementation with iron or zinc or both during infancy does not lead to long-term cognitive improvement in 9-y-old children. This trial was registered at clinicaltrials.gov as NCT00824304.

Cited by 45 publications

References 33 publications

Integrated strategies needed to prevent iron deficiency and to promote early child development

Integrated strategies needed to prevent iron deficiency and to promote early child development

Zinc diet and Alzheimer's disease: a systematic review

Iron and Cognitive Development: What Is the Evidence?

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