Efficacy of combined iron and zinc supplementation on micronutrient status and growth in Vietnamese infants.
OBJECTIVE
To evaluate the effect of combined iron-zinc supplementation on micronutrient status, growth and morbidity.


METHODS
Randomized, double-masked, placebo-controlled supplementation trial.


METHODS
Rural district of Que Vo, in the Red River Delta in Vietnam.


METHODS
A total of 915 breast-fed infants aged 4-7 months were included and 784 completed the study.


METHODS
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 microg/l for SF) compared to Zn and placebo groups (Hb: 6.4 and 9.8 g/l; SF: -18.2 and -16.9 microg/l, P<0.0001). SZn increased more in Zn group (10.3 micromol/l) than in Fe+Zn group (8.0 micromol/l, P=0.03) and more in these groups compared to Fe and placebo groups (1.6 and 1.2 micromol/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.


BACKGROUND
UNICEF New York.
Berger
J
J
Institut de Recherche pour le Développement (IRD), UR 106 Nutrition, Alimentation, Sociétés, Montpellier Cedex, France. j.berger@fpt.vn
Ninh
N X
NX
Khan
N C
NC
Nhien
N V
NV
Lien
D K
DK
Trung
N Q
NQ
Khoi
H H
HH
D000886:Anthropometry; D019587:Dietary Supplements; D004311:Double-Blind Method; D004347:Drug Interactions; D005260:Female; D005293:Ferritins / Q000097:blood; D006128:Growth / Q000187:drug effects*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D019266:Iron, Dietary / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage / Q000097:blood / Q000172:deficiency / Q000494:pharmacology; D009752:Nutritional Status; D014131:Trace Elements; D016896:Treatment Outcome; D014744:Vietnam; D015032:Zinc / Q000008:administration & dosage / Q000097:blood / Q000172:deficiency / Q000494:pharmacology*
D006454:Hemoglobins; D019266:Iron, Dietary; D018977:Micronutrients; D014131:Trace Elements; D005293:Ferritins; D007501:Iron; D015032:Zinc