A trial of zinc supplementation in young rural Gambian children. A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: effects on growth and development. The impact of zinc supplementation on growth and body composition: A randomized, controlled trial among rural Zimbabwean schoolchildren Effects of Zinc Supplementation on Physical Growth in 2–5-Year-Old Children The impact of prenatal vitamin A and zinc supplementation on growth of children up to 2 years of age in rural Java, Indonesia. Effect of zinc supplementation on growth and body composition in children with sickle cell disease. Growth and body composition of periurban Guatemalan children in relation to zinc status: a longitudinal zinc intervention trial. Linear Growth and Zinc Supplementation in Children with Short Stature Effect of 12-month intervention with lipid-based nutrient supplement on the physical activity of Malawian toddlers: a randomised, controlled trial Hyperzincuria in individuals with insulin-dependent diabetes mellitus: concurrent zinc status and the effect of high-dose zinc supplementation. Effect of zinc supplementation on growth and body composition of Ugandan preschool children: a randomized, controlled, intervention trial. Randomized controlled trial of the effect of daily supplementation with zinc or multiple micronutrients on the morbidity, growth, and micronutrient status of young Peruvian children. Efficacy of combined iron and zinc supplementation on micronutrient status and growth in Vietnamese infants Ghanaian parents' perceptions of pre and postnatal nutrient supplements and their effects Longitudinal measures of circulating leptin and ghrelin concentrations are associated with the growth of young Peruvian children but are not affected by zinc supplementation. Combined iron and folic acid supplementation with or without zinc reduces time to walking unassisted among Zanzibari infants 5- to 11-mo old. Effect of small-quantity lipid-based nutrient supplements on growth, psychomotor development, iron status, and morbidity among 6- to 12-mo-old infants in South Africa: a randomized controlled trial
The present study tested the hypothesis that inadequate Zn intake might be responsible for failure to thrive and impaired catch-up growth in young rural Gambian children , and that Zn supplements might be beneficial . Gambian children might be deprived of Zn because of its poor availability from their predominantly plant-based diet . Rural Gambian children ( 110 ; fifty boys , sixty girls ) aged between 0.57 and 2.30 years were divided into two matched groups , one to receive 70 mg Zn twice weekly for 1.25 years , and the other a placebo . Growth and mid-upper-arm circumference were measured at weekly intervals throughout the study and illnesses were monitored .  Capillary blood and urine sample s were collected at 0 , 2 and 8 weeks . Body weights and arm circumferences showed a linear increase , plus a seasonal effect ( rainy season faltering ) . For body weight there was no significant overall effect of the supplement . For arm circumference , a very small ( 2 % ) but significant ( P < 0.01 ) difference favoured the supplemented group . Plasma thymulin was much lower at the first clinic than at the second and third clinics , and in vitro Zn stimulation was greater at the first clinic . There was , however , no effect of Zn in vivo . Likewise , Zn did not significantly benefit T-cell numbers or ratios , secretory IgA in urine , circulating hormone levels or biochemical indices of Zn status . One index of intestinal permeability , i.e. lactulose : creatinine , was improved ( P < 0.02 ) by the supplement , but the lactulose : mannitol value was not ; this requires further investigation . Dietary Zn deficiency is , thus , unlikely to be of major overall importance for rural Gambian children 's ability to thrive , and blanket Zn supplementation is not justified . There may , however , be vulnerable sub-groups who would benefit from Zn supplements BACKGROUND Deficiencies of iron and zinc are associated with delayed development , growth faltering , and increased infectious-disease morbidity during infancy and childhood . Combined iron and zinc supplementation may therefore be a logical preventive strategy . OBJECTIVE The objective of the study was to compare the effects of combined iron and zinc supplementation in infancy with the effects of iron and zinc as single micronutrients on growth , psychomotor development , and incidence of infectious disease . DESIGN Indonesian infants ( n = 680 ) were r and omly assigned to daily supplementation with 10 mg Fe ( Fe group ) , 10 mg Zn ( Zn group ) , 10 mg Fe and 10 mg Zn ( Fe+Zn group ) , or placebo from 6 to 12 mo of age . Anthropometric indexes , developmental indexes ( Bayley Scales of Infant Development ; BSID ) , and morbidity were recorded . RESULTS At 12 mo , two-factor analysis of variance showed a significant interaction between iron and zinc for weight-for-age z score , knee-heel length , and BSID psychomotor development . Weight-for-age z score was higher in the Zn group than in the placebo and Fe+Zn groups , knee-heel length was higher in the Zn and Fe groups than in the placebo group , and the BSID psychomotor development index was higher in the Fe group than in the placebo group . No significant effect on morbidity was found . CONCLUSIONS Single supplementation with zinc significantly improved growth , and single supplementation with iron significantly improved growth and psychomotor development , but combined supplementation with iron and zinc had no significant effect on growth or development . Combined , simultaneous supplementation with iron and zinc to infants can not be routinely recommended at the iron-to-zinc ratio used in this study OBJECTIVES : To assess the effect of zinc supplementation on growth and body composition among schoolchildren . DESIGN : R and omized , double-blind , placebo-controlled trial . SETTING AND SUBJECTS : 313 rural Zimbabwean schoolchildren ( 144 boys and 169 girls ) , 11–17 y ) . INTERVENTIONS : Supplementation with zinc ( 30 or 50 mg ) or placebo on schooldays for 12 months . Due to drought , a food programme was in operation during the last eight months of the study .VARIABLES : Weight , height , upper arm circumference , triceps skinfold thickness , and weight-for-age , height-for-age , weight-for-height , arm muscle-area-for-age and arm fat-area-for-age Z-scores . RESULTS : Significant effects on weight gain ( 0.51 vs 0.14 kg , P=0.01 ) , weight-for-age Z ( −0.08 vs −0.14 , P=0.01 ) and arm muscle area-for-age Z-score ( 0.10 vs 0.01 , P=0.03 ) were seen over the first three months , whereas no effects were seen over the full 12 months . CONCLUSIONS : Zinc deficiency impairing lean body mass and weight gain was documented . However , the effect of zinc seen over the first three months vanished during the last nine months when the food programme was in operation . Zinc deficiency may have persisted , but another nutrient may have become growth limiting during the last nine months . SPONSORSHIP : Danish International Development Assistance Physical growth disorders in under 5-year-old children are a common health problem in many countries including Iran . The aim of this study was to determine effects of supplemental zinc on physical growth in preschool children with retarded linear growth .  This study was a community-based r and omized controlled trial on 2–5-year-old children with height-for-age below 25th percentile of National Center for Health Statistics growth chart . Ninety children were r and omly assigned in  zinc  group ( ZG ) or placebo group ( PG ) . After 6 months of zinc or placebo supplementation , we followed up the children for another 6 months . Anthropometric indicators were measured before the intervention and then monthly for 11 months . Forty children in ZG and 45 in PG concluded the study . Zinc supplementation increased weight gain in boys ( P = 0.04 ) and girls ( P = 0.05 ) compared to placebo but had no significant effect on mid-upper arm circumference increment in either sexes . The most significant ( P = 0.001 ) effect of Zinc supplementation was seen in boys ’ height increment at the end of follow-up period . Stunted growth rate in ZG changed significantly ( P = 0.01 ) from 26.7 % to 2.5 % throughout the study . This study showed that daily supplementation of 5 mg elemental zinc for 6 months improves physical growth in terms of height increment and weight gain in children with undesirable linear growth , especially in boys OBJECTIVE To determine whether prenatal vitamin A and /or Zn supplementation affects postnatal growth . DESIGN Follow-up of a r and omized controlled trial monitoring growth in children from birth up to 24 months of age . SETTING Central Java , Indonesia . SUBJECTS Children ( n 343 ) of mothers participating in a double-blinded , r and omized controlled study of vitamin A and /or Zn supplementation during pregnancy . We report the effects of prenatal supplementation on infant growth , measured as weight-for-age Z-scores ( WAZ ) , height-for-age Z-scores ( HAZ ) and weight-for-height Z-scores ( WHZ ) , from 0 to 24 months , as well as differences in growth faltering among the supplementation groups . RESULTS For HAZ , the absolute differences between the vitamin A-only and vitamin A + Zn groups at 3 and 9 months were 0·34 SD and 0·37 SD , respectively , and the absolute difference between the vitamin A-only and Zn-only groups at 18 months was 0·31 SD . Compared with placebo , none of the supplements affected growth . Defining growth faltering as a downward crossing of two or more major percentile lines , 50 - 75 % of the children were found to be growth faltering within 9 months of age , whereas 17 % and 8 % scored < -2 SD for WAZ and HAZ , respectively . Prenatal supplementation did not reduce the prevalence of growth faltering . CONCLUSIONS Prenatal vitamin A supplementation had a small but significant effect on postnatal growth of children 's length until 18 months of age compared with supplementation with either vitamin A + Zn or Zn alone , but not compared with placebo . It had no effects on other anthropometric measures and did not reduce the prevalence of growth faltering . Future studies should duplicate these findings before recommendations can be made BACKGROUND Poor growth and delayed maturation in children with sickle cell disease ( SCD ) may be due , in part , to mild zinc deficiency . OBJECTIVE The objective was to determine the effects of zinc supplementation on growth and body composition in children with SCD . DESIGN Forty-two prepubertal children ( 20 girls and 22 boys ) aged 4 - 10 y with SCD-SS were r and omly assigned to receive 10 mg elemental Zn/d in cherry syrup ( zinc group ) or cherry syrup alone ( control group ) . The 2 groups were stratified by sex and initial height status . Dietary intakes were evaluated and anthropometric , high-precision knee-height , and plasma zinc measurements were made at baseline and at 3 , 6 , and 12 mo . Body composition was determined every 6 mo with dual-energy X-ray absorptiometry , and z scores for anthropometric variables were computed from national reference data . Longitudinal-mixed-effects analysis was used to test for differences between the groups over the 12-mo observation period . RESULTS Thirty-eight children completed the study . No significant differences were observed at baseline . After 12 mo , the zinc group had significantly greater mean ( + /- SE ) increases in height ( 0.66 + /- 0.29 cm/y ) , sitting height ( 0.97 + /- 0.40 cm/y ) , knee height ( 3.8 + /- 1.2 mm/y ) , and arm circumference z scores ( 0.27 + /- 0.12 cm/y ) . Height-for-age and weight-for-age z scores decreased significantly by 0.11 + /- 0.04 and 0.13 + /- 0.05 , respectively , in the control group but did not change significantly in the zinc group . CONCLUSIONS Prepubertal children with SCD-SS may have zinc deficiency and may benefit from zinc supplementation to improve linear growth and weight gain Changes in growth , body composition , and zinc indexes were evaluated after 25 wk in a double-blind zinc-supplementation study of 162 periurban Guatemalan children aged 81.5 + /- 7.0 mo ( mean + /- SD ) . Children receiving the zinc supplement ( 10 mg Zn/d as amino acid chelate ) for 90.1 + /- 9.2 d had higher mean fasting plasma zinc ( 16.2 + /- 2.9 vs 14.9 + /- 2.1 mumol/L , P < 0.01 ) , a greater increase in median triceps skinfold Z score ( 0.50 vs 0.38 , P < 0.05 ) , and a smaller deficit in median midarm circumference ( MAC ) Z score ( -0.03 vs -0.20 , P < 0.05 ) compared with the placebo group . Initial hair zinc classified as < 1.68 and > 1.68 mumol/g was the only laboratory variable that explained some of the variance in final Z scores of midarm-muscle area ( P < 0.05 ) and MAC ( P < 0.01 ) . Children responded to the zinc supplement with changes in indexes of body composition rather than growth Physical growth retardation is an early and prominent feature of zinc deficiency , but the effect of  zinc supplementation in children is still not completely clear . This study investigated the impact of zinc supplementation on linear growth , growth velocity , IGF-I levels , and skeletal maturation of short children during and after mineral supplementation . The study was design ed as a double-blind , r and omized , controlled trial of zinc supplementation during a 6-month period , with a subsequent 6-month follow-up . Anthropometric data were collected at 0 , 6 , and 12 months . Measurements included plasma Zn , IGF-I , height , weight , triceps skinfold thickness , and body mass index .  Eighteen healthy pre-pubertal short children ( z-score -2.0 ) 7 to 10 years old with normal GH and IGF-I levels were r and omized to two groups , one with zinc supplementation ( 5 mg/kg/d of ZnSO4 ) and the other with placebo . In the first 6 months , only height velocity increased significantly , 5.99+/-0.80 cm/yr vs 5.05+/-0.85 cm/yr ( p=0.03 ) . After 12 months , height velocity returned to the initial values , 3.92+/-0.59 cm/yr vs 4.19+/-1.08 cm/yr ( p=0.29 ) . This study indicates that zinc supplementation increased growth velocity , but these effects did not persist after supplementation was discontinued Physical activity is beneficial for children ’s well-being . The effect of dietary supplementation on children ’s physical activity in food-insecure areas remains little studied . We examined the effects of a lipid-based nutrient supplement ( LNS ) on children ’s objective ly measured physical activity in a r and omised , controlled , outcome -assessor-blinded trial . Mothers of the children received one capsule daily of Fe-folic acid ( IFA ) , one capsule containing eighteen micronutrients ( MMN ) or one 20 g sachet of LNS ( containing twenty-two MMN , protein , carbohydrates , essential fatty acids and 494 kJ ( 118 kcal ) ) during pregnancy and for 6 months thereafter . Children in the IFA and MMN groups received no supplementation , and these groups were collapsed into a single control group ; children in the LNS group received 20 g LNS from 6 to 18 months . We measured physical activity with accelerometers over 1 week at 18 months . The main outcome was mean vector magnitude counts/15 s.  Of the 728 children at the beginning of child intervention at 6 months , 570 ( 78 % ) provided sufficient data for analysis . The mean accelerometer counts for the 190 children in the LNS group and for the 380 children in the control group were 303 ( sd 59 ) and 301 ( sd 56 ) , respectively ( P for difference=0·65 ) . LNS , given to mothers during pregnancy and 6 months postpartum and to their infants from 6 to 18 months of age , did not increase physical activity among 18-month-old children The urinary excretion of zinc in individuals with insulin-dependent diabetes mellitus ( IDDM ) is approximately doubled . In the absence of a compensatory mechanism , this hyperzincuria should induce a deficient or marginal Zn status . We examined parameters of Zn status in plasma and in blood cells with respect to urinary Zn losses and Zn supplementation . We measured Zn levels in the urine , plasma , and erythrocytes of 14 IDDM subjects and 15 nondiabetics who kept dietary records for 3 consecutive days . Subsequently , six IDDM subjects and seven nondiabetics were supplemented with 50 mg Zn daily for 28 days . We measured the above parameters , as well as mononuclear leukocyte Zn ( MNL-Zn ) and the plasma subfraction of albumin-bound Zn ( alb-Zn ) . The total plasma Zn-binding capacity was also assessed . Plasma copper and erythrocyte Cu were monitored as indicators of potential Zn toxicity . Individuals with IDDM displayed the expected hyperzincuria , but had normal blood Zn parameters . Zincuria increased by a similar amount in both groups during supplementation , as did the MNL-Zn content . However , erythrocyte Zn ( e-Zn ) was refractory , so a trend toward lower e-Zn among IDDM subjects persisted during Zn supplementation . Hemoglobin A1c ( HbA1c ) increased markedly in the Zn-supplemented IDDM group . Despite their chronic hyperzincuria , individuals with IDDM appear not to be Zn-deficient . Large-dose Zn supplementation increases MNL-Zn and induces an undesirable elevation of HbA1c in all individuals . This is especially disconcerting for those with IDDM , and may reflect an exacerbation of a chronic " Zn diabetes . " These data suggest a potential for toxicity from large-dose Zn supplementation BACKGROUND Despite ample food supplies , the incidence of childhood underweight and stunting remains high in Ug and a. Many factors contribute to this situation , but the role of low zinc intakes has not been adequately explored . OBJECTIVE Our objective was to study the effect of zinc supplementation on growth and body composition of preschool children by using the outcome measures of weight , height , and midupper arm circumference ( MUAC ) . DESIGN The study was r and omized , double-blind , placebo-controlled , parallel , and 8 mo long , and incorporated 6 mo of zinc supplementation .  Children ( n = 153 ) aged 55.8 + /- 11.2 mo from 3 r and omly selected nursery schools of medium , low , and very low socioeconomic status in a suburb of Kampala took part . The intervention comprised 10 mg Zn ( as ZnSO4 ) or placebo daily in freshly prepared fruit juice , Monday to Friday inclusive . RESULTS Zinc supplementation increased MUAC by the end of the study ( P = 0.029 ) and led to greater weight gain in children from the school of medium socioeconomic status at 3 and 8 mo ( P = 0.019 and P = 0.038 , respectively ) . There was no effect on weight gain of the children from the other schools . Zinc supplementation had no influence on height . Infection rates ( of which 82 % were recorded as malaria ) were lower in the zinc-supplemented group than in control subjects ( P = 0.063 ) . CONCLUSIONS Zinc supplementation may counter the age-related decrease in MUAC often observed in preschool children in developing countries . The study provides evidence that zinc may not be the most limiting nutrient for weight gain in children of poor nutritional status , but may become so as nutritional status improves BACKGROUND Zinc supplements reduce  childhood morbidity in population s in whom zinc deficiency is common . In such population s , deficiencies in other micronutrients may also occur . OBJECTIVE The objective was to determine whether the administration of other micronutrients with zinc modifies the effect of  zinc supplementation on children 's morbidity and physical growth . DESIGN Two hundred forty-six children aged 6 - 35 mo with persistent diarrhea were r and omly assigned to 1 of 3 groups to receive a daily supplement of 10 mg Zn alone ( Zn ; n = 81 ) , zinc plus vitamins and other minerals at 1 - 2 times recommended daily intakes ( Zn+VM ; n = 82 ) , or placebo ( n = 83 ) for approximately 6 mo after the diarrhea episode ended . Morbidity information was collected on weekdays . Weight , length , and other anthropometric indicators were measured monthly , and plasma zinc and other indicators of micronutrient status were measured at baseline and 6 mo . RESULTS Supplement consumption was high ( approximately 90 % ) in all groups , although slightly more vomiting was reported in the Zn+VM group ( P < 0.0001 , analysis of variance ) . The change in plasma zinc from baseline to 6 mo was greater in the 2 zinc groups ( 6.1 , 27.3 , and 16.2 micro g/dL in the placebo , Zn , and Zn+VM groups , respectively ; P < 0.0001 , analysis of variance ) . The Zn group had fewer episodes of diarrhea , dysentery , and respiratory illness and a lower prevalence of fever and cough than did the Zn+VM group and a lower prevalence of cough than did the placebo group ( P = 0.05 ) . No significant effects of supplementation on growth were observed . CONCLUSION Morbidity was greater after supplementation with zinc plus multivitamins and minerals than it was after supplementation with zinc alone Objective : To evaluate the effect of combined iron – zinc supplementation on micronutrient status , growth and morbidity . Design : R and omized , double-masked , placebo-controlled supplementation trial . Setting : Rural district of Que Vo , in the Red River Delta in Vietnam . Subjects : A total of 915 breast-fed infants aged 4–7 months were included and 784 completed the study . Interventions : The Fe-group received daily and for a 6-month period 10 mg of iron , the Zn-group 10 mg zinc , the Fe – Zn group 10 mg iron+10 mg zinc and the placebo group a placebo . Hemoglobin ( Hb ) , serum ferritin ( SF ) and zinc ( SZn ) , and anthropometry were measured before and at the end of the intervention . Morbidity was recorded daily . Results : Changes of Hb and SF were higher in both Fe and Fe+Zn groups ( respectively 22.6 and 20.6 g/l for Hb ; 36.0 and 24.8 μg/l for SF ) compared to Zn and placebo groups ( Hb : 6.4 and 9.8 g/l ; SF : −18.2 and −16.9 μg/l , P<0.0001 ) . SZn increased more in Zn group ( 10.3 μmol/l ) than in Fe+Zn group ( 8.0 μmol/l , P=0.03 ) and more in these groups compared to Fe and placebo groups ( 1.6 and 1.2 μmol/l , P<0.0001 ) . Weight gain was higher in the Zn group . No significant effects of supplementations on growth in length or morbidity . Conclusions : Combined iron – zinc supplementation had a positive effect on iron and zinc status in infants . However , the positive effect of zinc alone on SZn and weight would indicate a negative interaction of iron when added to zinc supplements . Sponsorship : UNICEF New York Abstract Small‐quantity lipid‐based nutrient supplements ( SQ‐LNS ) have been studied in efficacy and effectiveness trials , but little is known about how parents perceive the products and their effects . In a r and omised trial in Ghana , efficacy of SQ‐LNS provided to women during pregnancy and the first 6 months postpartum and to their children from 6 to 18 months of age was assessed by comparison with iron‐folic acid ( IFA ) capsules and multiple micronutrient ( MMN ) capsules provided to women . In a follow‐up study conducted when the index children from the original trial were between 4 and 6 years of age , we used survey‐based methods to assess retrospective and current parental perceptions of nutrient supplements generally and of SQ‐LNS and their effects compared with perceptions IFA and MMN capsules . Most parents perceived that the assigned supplements ( SQ‐LNS , IFA , or MMN ) positively impacted the mother during pregnancy ( approximately 89 % of both mothers and fathers ) and during lactation ( 84 % of mothers and 86 % of fathers ) . Almost all ( ≥90 % ) of mothers and fathers perceived that the assigned supplement positively impacted the index child and expected continued positive impacts on the child 's health and human capital into the future . A smaller percentage of parents perceived negative impacts of the supplements ( 7%–17 % of mothers and 4%–12 % of fathers ) . Perceptions of positive impacts and of negative impacts did not differ by intervention group . The results suggest that similar population s would likely be receptive to programs to deliver SQ‐LNS or micronutrient capsules BACKGROUND Leptin , ghrelin , and insulin are hormonal regulators of energy balance and , therefore , may be related to growth during infancy . Zinc is essential for growth , and its growth effects may be mediated through these hormones . OBJECTIVE We examined the effects of supplemental zinc on plasma leptin , ghrelin , and insulin concentrations among young children at risk of zinc deficiency and examined the relations between these hormones and physical growth . DESIGN Children ( n = 142 ) aged 6 - 8 mo were r and omly assigned to receive 3 mg Zn/d as a supplement , in a fortified food , or as a placebo for 6 mo . Relations between hormones and anthropometric z scores , body composition , and growth rates were examined at baseline and 3 and 6 mo after the start of the intervention . RESULTS No treatment group-related differences were found in plasma leptin , ghrelin , or glucose concentrations or in anthropometric z scores at 3 or 6 mo after the start of the zinc intervention . Neither plasma leptin nor ghrelin concentrations at baseline or 3 mo were predictive of subsequent changes in growth . However , changes in weight-for-age z scores over the two 3-mo time intervals were positively associated with subsequent leptin concentrations and inversely associated with subsequent plasma ghrelin concentrations . CONCLUSIONS Supplemental zinc did not affect the children 's  growth , anthropometric indexes , or plasma hormone concentrations in this study population . Our results suggest that plasma leptin and ghrelin concentrations in later infancy are a consequence of previous weight changes rather than predictors of short-term growth Iron and zinc deficiencies have been associated with delayed motor development in nutritionally at-risk children , albeit inconsistently . In this community-based , r and omized double-blind trial , iron+folic acid ( FeFA ) ( 12.5 mg Fe + 50 mug folic acid ) , zinc ( Zn ) ( 10 mg ) , and iron+folic acid+zinc ( FeFA+Zn ) supplements or a placebo were given daily for 1 y to nutritionally at-risk children in Pemba , Zanzibar . The effects of these treatments on attaining unassisted walking were evaluated using survival analysis for 354 children aged 5 - 11 mo at the start of supplementation . Treatment effects on changes in hemoglobin ( Hb ) and zinc protoporphyrin ( ZPP ) and height-for-age ( HAZ ) and weight-for-age ( WAZ ) Z scores were evaluated using linear regression . Attained motor milestone was recorded every 2 wk for 1 y. Hb , ZPP , HAZ , and WAZ were measured at baseline and after 6 mo of treatment . FeFA with or without Zn reduced the time it took for children to walk assisted . Children who received any iron  walked unassisted sooner than those who received no iron [ median difference approximately 15 d , P = 0.035 , risk ratio ( RR ) = 1.28 , 95 % CI = 1.02 , 1.61 ] and this effect was stronger in those who had iron deficiency anemia ( IDA ) at baseline ( median difference was approximately 30 d ; P = 0.002 ; RR = 1.68 ; 95 % CI = 1.21 , 2.32 ) . FeFA alone and Zn alone improved Hb and ZPP compared with placebo . There were no significant treatment effects on changes in HAZ or WAZ . The effects of treatment on time to walking may have been mediated by improvements in iron status or hemoglobin , but were not mediated through improvements in growth ABSTRACT Background Evidence on the effect of small-quantity lipid-based nutrient supplements ( SQ-LNSs ) on early child growth and development is mixed . Objective This study assessed the effect of daily consumption of 2 different SQ-LNS formulations on linear growth ( primary outcome ) , psychomotor development , iron status ( secondary outcomes ) , and morbidity in infants from age 6 to 12 mo within the context of a maize-based complementary diet . Methods Infants ( n = 750 ) were r and omly assigned to receive SQ-LNS , SQ-LNS-plus , or no supplement . Both SQ-LNS products contained micronutrients and essential fatty acids . SQ-LNS-plus contained , in addition , docosahexaenoic acid , arachidonic acid ( important for brain and eye development ) , lysine ( limiting amino acid in maize ) , phytase ( enhances iron absorption ) , and other nutrients . Infants ’ weight and length were measured bimonthly . At age 6 and 12 mo , psychomotor development using the Kilifi Developmental Inventory and South African Parent Rating Scale and hemoglobin , plasma ferritin , C-reactive protein , and α1-acid glycoprotein were assessed . WHO Motor Milestone outcomes , adherence , and morbidity were monitored weekly through home visits . Primary analysis was by intention-to-treat , comparing each SQ-LNS group with the control . Results SQ-LNS-plus had a positive effect on length-for-age zscore at age 8 mo ( mean difference : 0.11 ; 95 % CI : 0.01 , 0.22 ; P = 0.032 ) and 10 mo ( 0.16 ; 95 % CI : 0.04 , 0.27 ; P = 0.008 ) but not at 12 mo ( 0.09 ; 95 % CI : −0.02 , 0.21 ; P = 0.115 ) , locomotor development score ( 2.05 ; 95 % CI : 0.72 , 3.38 ; P = 0.003 ) , and Parent Rating Score ( 1.10 ; 95 % CI : 0.14 , 2.07 ; P = 0.025 ) , but no effect for weight-for-age zscore . Both SQ-LNS ( P = 0.027 ) and SQ-LNS-plus ( P = 0.005 ) improved hemoglobin concentration and reduced the risk of anemia , iron deficiency , and iron-deficiency anemia  . Both SQ-LNS products reduced longitudinal prevalence of fever , coughing , and wheezing but increased incidence and longitudinal prevalence of diarrhea , vomiting , and rash/sores . Conclusions Point-of-use fortification with SQ-LNS-plus showed an early transient effect on linear growth and improved locomotor development . Both SQ-LNS products had positive impacts on anemia and iron status . This trial was registered at clinical trials.gov as NCT01845610
Zn supplementation was associated with increased fat-free mass among stunted children .
Due to the use of anthropometry when determining body composition , a majority of the studies could not accurately address whether alterations in the fat and /or fat-free mass components of the body were responsible for the observed changes in body composition .
The effect of Zn supplementation on body composition is not consistent but may modify fat-free mass among children with pre-existing growth failure
OBJECTIVE To provide a comprehensive synthesis of the effects of Zn supplementation on childhood body composition and adiposity-related hormone levels .