title: Effect of zinc added to multi-vitamin supplementation containing low-dose vitamin A on plasma retinol level in children--a double-blind randomized, controlled trial.
abstract: In a community-based double-blind randomized trial in children aged 6-35 months, both intervention and control groups received a multi-vitamin syrup containing vitamin A, while the intervention group had zinc gluconate (equivalent to 10 mg of elemental zinc) additional in the syrup. There was a significant decrease in diarrhoea and pneumonia in the intervention group. This study was undertaken to investigate if addition of zinc to vitamin A had improved plasma retinol levels, which, in turn, was responsible for the effects observed in the intervention group. In a randomly-selected subsample of 200 children--100 each from the intervention and the control group, plasma retinol levels after 120 days of supplementation were measured. There was no difference in the mean plasma retinol levels [the difference in the mean 0.46 microg/dL (95% confidence interval -1.42-2.36)] between the two groups following supplementation. No difference in plasma retinol levels was observed in the subgroups based on base-line nutritional status and plasma zinc levels. Addition of zinc to low-dose vitamin A in this study did not improve the vitamin A status of children and cannot explain morbidity effects of the intervention.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room W5517, Baltimore, MD 21205, USA. ssazawal@jhsph.edu
authors.forename: Sunil
authors.initials: S
authors.lastname: Sazawal
authors.forename: Usha
authors.initials: U
authors.lastname: Dhingra
authors.forename: Saikat
authors.initials: S
authors.lastname: Deb
authors.forename: Maharaj K
authors.initials: MK
authors.lastname: Bhan
authors.forename: Venugopal P
authors.initials: VP
authors.lastname: Menon
authors.forename: Robert E
authors.initials: RE
authors.lastname: Black
mesh_terms: D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D011014:Pneumonia / Q000453:epidemiology / Q000517:prevention & control; D014131:Trace Elements / Q000008:administration & dosage*; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism; D014815:Vitamins / Q000008:administration & dosage*; D015032:Zinc / Q000008:administration & dosage*
chemical_list: D014131:Trace Elements; D014815:Vitamins; D014801:Vitamin A; D015032:Zinc