title: Iron and zinc supplementation does not improve parent or teacher ratings of behavior in first grade Mexican children exposed to lead.
abstract: OBJECTIVE
  To determine the efficacy of iron and zinc supplementation on behavior ratings of lead-exposed children.
  
  
  METHODS
  In this double-blind, randomized trial, 602 first-grade children received 30 mg ferrous fumarate, 30 mg zinc oxide, both, or placebo daily for 6 months. Lead, iron, and zinc status were determined at baseline and follow-up. Parents and teachers provided ratings of child behavior using the Conners Rating Scales.
  
  
  RESULTS
  The baseline mean (SD) blood lead concentration was 11.5 (6.1) mug/dL, with 51% of children > or = 10 microg/dL. The prevalence of attention deficit hyperactivity disorder, estimated by combined parent and teacher ratings, was 6%. At follow-up, parent ratings of oppositional, hyperactive, cognitive problems, and attention deficit hyperactivity disorder decreased by 1.5, 1.2, 2.5, and 3.4 points, respectively (P < .05). Teacher ratings of hyperactivity increased by 1.1 points (P = .008), and the mean cognitive problem score declined by 0.7 points (P = .038). There were no treatment effects on mean change in scores, but children receiving any zinc had a higher likelihood of no longer receiving clinically-significant teacher ratings of oppositional behaviors.
  
  
  CONCLUSIONS
  This regimen of supplementation did not result in consistent improvements in ratings of behavior in lead-exposed children over 6 months.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA. kk326@cornell.edu
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kordas
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Stoltzfus
authors.forename: Patricia
authors.initials: P
authors.lastname: López
authors.forename: Javier Alatorre
authors.initials: JA
authors.lastname: Rico
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Rosado
mesh_terms: D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use*; D000090463:Iron Deficiencies; D007854:Lead / Q000009:adverse effects / Q000097:blood*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D015032:Zinc / Q000008:administration & dosage / Q000172:deficiency / Q000627:therapeutic use*
chemical_list: D007854:Lead; D007501:Iron; D015032:Zinc