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Effect of zinc and multivitamin supplementation on the growth of Tanzanian children aged 6-84 wk: a randomized, placebo-controlled, double-blind trial.
- Source :
- American Journal of Clinical Nutrition; 3/1/2016, Vol. 103 Issue 3, p910-918, 9p
- Publication Year :
- 2016
-
Abstract
- Background: Poor child growth increases risks of mortality and morbidity. Micronutrient supplements have the potential to improve child growth. Objective: We assessed the effect of daily zinc, multivitamin (vitamins C, E, and B-complex), and zinc and multivitamin (Zn+MV) supplementation on growth in infants in Tanzania. Design: In this randomized, 232 factorial, double-blind trial, 2400 infants were randomly assigned to receive zinc, multivitamins, Zn+MVs, or a placebo at 6 wk of age and were followed up for 18 mo with monthly growth measurements. Mixed-effects models with restricted cubic splines for the mean change in anthropometric z scores were fit for each group. Likelihood ratio tests were used to compare the effect of supplements on growth trajectories. Cox proportional hazards models were used to compare incidences of stunting, wasting, and underweight. Results: Children in all groups experienced growth faltering. At 19 mo of age, prevalences of stunting, wasting, and underweight were 19.8%, 6.0%, and 10.8%, respectively. Changes in weight-for-age z scores (WAZs) and weight-for-height z scores (WHZs) were significantly different across the 4 groups (P < 0.001 for both). The mean ± SE decline in the WAZ from baseline to the end of follow-up in the Zn+MV group was significantly less than in the placebo group (-0.36 ± 0.04 compared with -0.50 ± 0.04; P = 0.020), whereas the decline in the WHZ was significantly greater in the zinc-only group than in the placebo group (-0.57 ± 0.07 compared with 20.35 ± 0.07; P = 0.021). Supplements did not have a significant effect on mean change in the height-for-age z score or on rates of stunting, wasting, or underweight. Conclusions: Although there were small but significant improvements in the WAZ in the Zn+MV group, daily zinc supplementation alone, multivitamin supplementation alone, and the combined Zn+MV did not reduce the incidences of underweight, stunting, or wasting in Tanzanian infants. Alternative approaches to prevent growth faltering should be pursued. This trial was registered at clinicaltrials.gov as NCT00421668. [ABSTRACT FROM AUTHOR]
- Subjects :
- ANALYSIS of variance
ANTHROPOMETRY
CHI-squared test
CHILD development deviations
CONFIDENCE intervals
DIETARY supplements
GROWTH disorders
HUMAN growth
INFANTS
INFANT development
INFANT nutrition
LONGITUDINAL method
MOTHERS
NUTRITIONAL requirements
NUTRITION disorders in infants
PROBABILITY theory
RESEARCH funding
STATISTICAL sampling
T-test (Statistics)
VITAMIN B complex
VITAMIN C
VITAMIN E
VITAMINS
ZINC compounds
STATISTICAL power analysis
RANDOMIZED controlled trials
PROPORTIONAL hazards models
BLIND experiment
DATA analysis software
DESCRIPTIVE statistics
KAPLAN-Meier estimator
ODDS ratio
CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 00029165
- Volume :
- 103
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- American Journal of Clinical Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 113556006
- Full Text :
- https://doi.org/10.3945/ajcn.115.120055