Effects of Daily Zinc, Daily Multiple Micronutrient Powder, or Therapeutic Zinc Supplementation for Diarrhea Prevention on Physical Growth, Anemia, and Micronutrient Status in Rural Laotian Children: A Randomized Controlled Trial.
Study Goal
The researchers aimed to evaluate the impact of iron-containing micronutrient powder on iron deficiency and anemia in young Laotian children.
Results Summary
The micronutrient powder (containing 6 mg/d iron) reduced iron deficiency by 44%-55% compared to other groups but had no overall impact on anemia, though it showed a tendency to reduce anemia by 11%-16% among children who were anemic at baseline.
Population
Laotian children aged 6-23 months with high baseline stunting (37.9%) and anemia (55.6%) prevalence.
Effective Dosage
6 mg/d iron (as part of a micronutrient powder containing 10 mg/d zinc and 13 other micronutrients).
Duration
~9 months.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
preventive zinc tablets (7 mg/d) | decrease | zinc deficiency | young Laotian children aged 6-23 months | - | were significantly lower | #1 |
high-zinc, low-iron micronutrient powder (10 mg/d zinc, 6 mg/d iron, and 13 other micronutrients) | decrease | zinc deficiency | young Laotian children aged 6-23 months | - | were significantly lower | #2 |
preventive zinc tablets (7 mg/d) | no change | growth | young Laotian children aged 6-23 months | - | had no impact | #3 |
high-zinc, low-iron micronutrient powder (10 mg/d zinc, 6 mg/d iron, and 13 other micronutrients) | no change | growth | young Laotian children aged 6-23 months | - | had no impact | #4 |
high-zinc, low-iron micronutrient powder (10 mg/d zinc, 6 mg/d iron, and 13 other micronutrients) | decrease | iron deficiency | young Laotian children aged 6-23 months | 44%-55% | reduced | #5 |
high-zinc, low-iron micronutrient powder (10 mg/d zinc, 6 mg/d iron, and 13 other micronutrients) | no change | anemia | young Laotian children aged 6-23 months | - | had no overall impact | #6 |
high-zinc, low-iron micronutrient powder (10 mg/d zinc, 6 mg/d iron, and 13 other micronutrients) | decrease | anemia | children who were anemic at baseline | 11%-16% | tended to reduce | #7 |
high-zinc, low-iron micronutrient powder (10 mg/d zinc, 6 mg/d iron, and 13 other micronutrients) | increase | iron status | young Laotian children aged 6-23 months | - | improved | #8 |
OBJECTIVES: To evaluate the optimal zinc supplementation strategy for improving growth and hematologic and micronutrient status in young Laotian children. STUDY DESIGN: In total, 3407 children aged 6-23 months were randomized to receive either daily preventive zinc tablets (7 mg/d), high-zinc, low-iron micronutrient powder (10 mg/d zinc, 6 mg/d iron, and 13 other micronutrients), therapeutic zinc supplementation for diarrhea (20 mg/d for 10 days per episode), or daily placebo powder; all were followed for ~9 months. Anthropometry, hemoglobin, zinc, and iron status were assessed at baseline and endline. Analyses were by intention-to-treat, using linear and modified Poisson regression. RESULTS: At baseline, mean (±SD) age was 14.2 ± 5.1 months and stunting and anemia prevalence were 37.9% and 55.6%, respectively. At endline, zinc deficiency in the preventive zinc (50.7%) and micronutrient powder (59.1%) groups were significantly lower than in the therapeutic zinc (79.2%) and control groups (78.6%; P < .001), with no impact on stunting (37.1%-41.3% across the groups, P = .37). The micronutrient powder reduced iron deficiency by 44%-55% compared with other groups (P < .001), with no overall impact on anemia (P = .14). Micronutrient powder tended to reduce anemia by 11%-16% among children who were anemic at baseline (P = .06). CONCLUSIONS: Despite improving zinc status, preventive zinc and micronutrient powder had no impact on growth. The micronutrient powder improved iron status and tended to reduce anemia among the subset of previously anemic children. TRIAL REGISTRATION: ClinicalTrials.govNCT02428647.