Effects of iron and zinc supplementation in Indonesian infants on micronutrient status and growth.
What this study found
Iron and zinc supplementation improved micronutrient status and reduced anemia, but none of the regimens improved growth. At 6 months, the iron group had higher hemoglobin and ferritin and lower anemia than the iron plus zinc group (hemoglobin 115 ± 10 g/L, anemia 28%, ferritin 36.8 [19.1-61.2] g/L, iron deficiency anemia 3%), while the iron plus zinc group still showed benefit (hemoglobin 110 ± 11 g/L, anemia 46%, ferritin 26.6 [16.9-41.7] g/L, iron deficiency anemia 8%). Zinc supplementation increased plasma zinc concentrations, and the iron, zinc, and iron plus zinc groups had plasma zinc…
- Study & population
- Randomized, double-blind, placebo-controlled community trial in generally healthy, predominantly breastfed infants in rural West Java, Indonesia.
- Intervention
- Infants received iron syrup 10 mg/d, zinc syrup 10 mg/d, or iron plus zinc syrup providing 10 mg/d of each supplement, administered orally 5 days per week for 6 months.
- Key limitation
- Follow-up was limited to 6 months, and completion was lower in the iron plus zinc arm (78 of 120 randomized).
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Open PDFOriginal abstract
In this study the effects of supplementation of iron and zinc, alone or combined, on iron status, zinc status and growth in Indonesian infants is investigated. Micronutrient deficiencies are prevalent in infants in developing countries, and deficiencies often coexist; thus, combined supplementation is an attractive strategy. However, little is known about interactions between micronutrients. In a randomized, double-blind, placebo-controlled supplementation trial, 478 infants, 4 mo of age, were supplemented for 6 mo with iron (10 mg/d), zinc (10 mg/d), iron + zinc (10 mg of each/d) or placebo. Anthropometry was assessed monthly, and micronutrient status was assessed at the end of supplementation. Supplementation significantly reduced the prevalence of anemia, iron deficiency anemia and zinc deficiency. Iron supplementation did not negatively affect plasma zinc concentrations, and zinc supplementation did not increase the prevalence of anemia or iron deficiency anemia. However, iron supplementation combined with zinc was less effective than iron supplementation alone in reducing the prevalence of anemia (20% vs. 38% reduction) and in increasing hemoglobin and plasma ferritin concentrations. There were no differences among the groups in growth. The growth of all groups was insufficient to maintain the same Z-scores for height for age and weight for height. There is a high prevalence of deficiencies of iron and zinc in these infants, which can be overcome safely and effectively by supplementation of iron and zinc combined. However, overcoming these deficiencies is not sufficient to improve growth performance in these infants.