Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-23T15:45:15.446Z Has data issue: false hasContentIssue false

Effect of micronutrient supplementation on linear growth of children

Published online by Cambridge University Press:  09 March 2007

Nita Bhandari*
Affiliation:
All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
Rajiv Bahl
Affiliation:
All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
Sunita Taneja
Affiliation:
All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
*
*Corresponding author: Dr Nita Bhandari, fax +91 11 6016449, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

This review summarizes the results of published, randomized clinical trials that have examined the impact of administration of micronutrients, singly or in combination to infants, preschool and school children on linear growth. Supplementation of single micronutrients resulted in small or no benefits on linear growth. A meta-analysis of zinc supplementation trials confirmed that zinc has a significant but small impact (0.22 SD units) on length gain in children 0–13 years of age. however, a recent study reported a substantially greater benefit (>1 sd) in stunted and non-stunted breast-fed infants 6–12 months of age. With iron supplementation, a beneficial effect was found only in anemic children. Vitamin A supplementation trials have reported little or no benefit on linear growth. Data currently available suggest some impact in children with clinical or biochemical vitamin A deficiency, but this issue needs confirmation. Few studies could be identified where a combination of micronutrients was given as a supplement or as fortified food; in the latter set of studies energy availability was assured. The impact on length without multiple micronutrient supplementation was no greater than that observed with single micronutrients. In conclusion, zinc and iron seem to have a modest effect on linear growth in deficient populations. Vitamin A is unlikely to have an important effect on linear growth. Limited available evidence does not allow us to conclude whether a combination of micronutrients, with or without additional food, would have a greater impact than that seen with zinc alone.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2001

References

Adish, AA, Esrey, SA, Gyorkos, TW, Jean, Baptiste J & Rojhani, A (1999) Effect of consumption of food cooked in iron pots on iron status and growth of young children: a randomized trial. Lancet 353(9154), 712716.CrossRefGoogle Scholar
Allen, LH (1994) Nutritional influences on linear growth: a general review. European Journal of Clinical Nutrition 48 (S1), S75-S89.Google ScholarPubMed
Angeles, IT, Schultink, WJ, Matulessi, P, Gross, R & Sastroamidjojo, S (1993) Decreased rate of stunting among anemic Indonesian preschool children through iron supplementation. American Journal of Clinical Nutrition 58, 339342.CrossRefGoogle ScholarPubMed
Aykroyd, WR & Krishnan, BG (1938) The effect of calcium lactate on children in a nursery school. Lancet 2, 153155.CrossRefGoogle Scholar
Aykroyd, WR & Krishnan, BG (1939) A further experiment on the value of calcium lactate on children in rural community. Indian Journal of Medical Research 52, 219223.Google Scholar
Bahl, R, Bhandari, N, Taneja, S & Bhan, MK (1997) The impact of vitamin A supplementation on physical growth of children is dependent on season. European Journal of Clinical Nutrition 51, 2629.CrossRefGoogle ScholarPubMed
Bansal, P, Rau, P, Venkatachalam, PS & Gopalan, C (1964) Effect of calcium supplementation on children in a rural community. Indian Journal of Medical Research 52, 219223.Google Scholar
Bhatia, D & Seshadari, S (1992) Growth performance in anemia and following iron supplementation. Indian Pediatrics 30, 195200.Google Scholar
Brink, EW, Perera, WD, Broske, SP, Cash, RA, Smith, JL, Sauberlich, HE & Bashor, MM (1979) Vitamin A status of children in Sri Lanka. American Journal of Clinical Nutrition 32, 8491.CrossRefGoogle ScholarPubMed
Brown, KH, Peerson, JM & Allen, LH (1998) Effect of zinc supplementation on children's growth: a meta-analysis of intervention trials. Bibliotheca Nutritio et Dieta 54, 7683.Google Scholar
Castillo-Duran, C & Uauy, R (1988) Copper deficiency impairs growth of infants recovering from malnutrition. American Journal of Clinical Nutrition 47, 710714.CrossRefGoogle ScholarPubMed
Chuwa, LM, Mwiruki, G, Bilal, MG, Mnubhi, EK & Swai, AB (1996) Serum iron, zinc, copper and bromine in malnourished children in Dar es Salaam, Tanzania. East African Medical Journal 73 (5 Suppl), S21-S23.Google ScholarPubMed
Chwang, L, Soemantri, AG & Pollitt, E (1988) Iron supplementation and physical growth of rural Indonesian children. American Journal of Clinical Nutrition 47, 496501.CrossRefGoogle ScholarPubMed
Donnen, P, Brasseur, D, Dramaix, M, Vertongen, F, Zihindula, M, Muharmiriza, M & Hennart, P (1998) Vitamin A supplementation but not deworming improves growth of malnourished preschool children in Eastern Zaire. Journal of Nutrition 12, 13201327.CrossRefGoogle Scholar
Fawzi, WW, Herrera, MG, Willett, WC, Nestel, P, Amin, AE & Mohamed, KA (1997) The effect of vitamin A supplementation on the growth of preschool children in the Sudan. American Journal of Public Health 87, 13591362.CrossRefGoogle ScholarPubMed
Greene, LS (1980) Social and biological predictors of physical growth and neurological development in an area where iodine and protein energy malnutrition are endemic. In Social and Biological Predictors of Nutritional Status, Physical Growth and Neurological Development, pp. 223256. New York: Academic Press.Google Scholar
Hadi, H, Stoltzfus, RJ, Dibley, MJ, Mouton, LH, West, KP & Kjolhede, CL (2000) Vitamin A supplementation selectively improves the linear growth of Indonesian preschool children: results from a randomized controlled trial. American Journal of Clinical Nutrition 71, 507513.CrossRefGoogle ScholarPubMed
Halstead, JA, Ronaghy, HA & Abadi, P (1972) Zinc deficiency in man. American Journal of Medicine 53, 277284.CrossRefGoogle Scholar
Hautvast, JL, van der Heijden, LJ, Luneta, AK, van Staveren, WA, Tolboom, JJ & van Gastel, SM (1999) Food consumption of young stunted and non-stunted children in rural Zambia. European Journal of Clinical Nutrition 53, 5059.CrossRefGoogle ScholarPubMed
Idjradinata, P, Watkins, WE & Pollitt, E (1994) Adverse effect of iron supplementation on weight gain of iron replete young children. Lancet 343, 12521254.CrossRefGoogle ScholarPubMed
Lartey, A, Manu, A, Brown, KH, Peerson, JM & Dewey, KG (1999) A randomized, community based trial of the effects of improved, centrally processed complementary foods on growth and micronutrient status of Ghanaian infants from 6 to 12 months of age. American Journal of Clinical Nutrition 70, 391404.CrossRefGoogle Scholar
Lawless, JW, Latham, MC & Stephenson, LS (1994) Iron supplementation improves appetite and growth in anemic Kenyan primary school children. Journal of Nutrition 124, 645654.CrossRefGoogle ScholarPubMed
Lee, WTK, Leung, SSF, Wang, S, Xu, Y, Zeng, W, Lau, J, Oppenheimer, SJ & Cheng, JCY (1994) Double blind, controlled calcium supplementation and bone mineral accretion in children accustomed to a low-calcium diet. American Journal of Clinical Nutrition 60, 744750.CrossRefGoogle ScholarPubMed
Lie, C, Ying, C, En-Lin, W, Brun, T & Geissler, C (1993) Impact of large dose vitamin A supplementation on childhood diarrhea, respiratory disease and growth. European Journal of Clinical Nutrition 47, 8896.Google ScholarPubMed
Mele, L, West, KP, Kusdiono, PA, Nendrawati, H, Tilden, RJ & Tarwotjo, I (1991) Nutritional and household risk factors for xeropthalmia in Aceh, Indonesia: a case control study. American Journal of Clinical Nutrition 53, 14601465.CrossRefGoogle Scholar
Morley, R, Abbott, R, Fairweather-Tait, S, MacFadyen, U, Stephenson, T & Lucas, A (1999) Iron fortified follow on formula from 9 to 18 months improves iron status but not development or growth: a randomized trial. Archives of Diseases in Childhood 81, 247252.CrossRefGoogle Scholar
Muhilal, , Permeisih, D, Idjradinata, YR, Muherdiyantiningsih, and Karyadi, D (1988) Vitamin A fortified monosodium glutamate and health, growth and survival of children: a controlled field trial. American Journal of Clinical Nutrition 48, 12711276.CrossRefGoogle ScholarPubMed
Neumann, C, Bwibo, N & Sigman, M (1992) Diet quantity and quality Functional Effects on Kenyan Families.Google Scholar
Neumann, CG & Harrison, GG (1994) Onset and evolution of stunting in infants and children. Examples from Human Nutrition Collaborative Research Support Program. Kenya and Egypt Studies. European Journal of Clinical Nutrition 48 (Suppl 1), S90-S102.Google ScholarPubMed
Nichols, BL, Alvarado, J, Hazlewood, CF & Viteri, F (1978) Magnesium supplementation in protein calorie malnutrition. American Journal of Clinical Nutrition 31, 176188.CrossRefGoogle ScholarPubMed
Pettifor, JM, Ross, P, Moodley, G & Shuenyane, E (1981) The effect of dietary calcium supplementation on serum calcium, phosphorus and alkaline phosphatase concentrations in a rural black population. American Journal of Clinical Nutrition 34, 21872191.CrossRefGoogle Scholar
Prentice, A & Bates, CJ (1994) Adequacy of dietary mineral supply for human bone growth and mineralization. European Journal of Clinical Nutrition 48 (Suppl 1), S161-S176.Google Scholar
Rahman, MM, Akramuzzaman, SM, Mitra, AK, Fuchs, GJ & Mahalanabis, D (1999) Long term supplementation with iron does not enhance growth in malnourished Bangladeshi children. Journal of Nutrition 129, 13191322.CrossRefGoogle Scholar
Rahmathullah, L, Underwood, BA, Thulasiraj, RD & Milton, RC (1991) Diarrhea, respiratory infections and growth are not affected by a weekly low dose vitamin A supplement: a masked, controlled field trial in children in Southern India. American Journal of Clinical Nutrition 54, 568577.CrossRefGoogle Scholar
Ramakrishnan, U, Latham, MC & Abel, R (1995) Vitamin A supplementation dies not improve growth of preschool children: a randomized, double blind field trial in South India. Journal of Nutrition 125, 202211.Google Scholar
Rosado, JL, Lopez, P, Munoz, E, Martinez, H & Allen, LH (1997) Zinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected growth or body composition of Mexican preschoolers. American Journal of Clinical Nutrition 65, 1319.CrossRefGoogle ScholarPubMed
Rosado, JL (1999) Separate and joint effects of micronutrient deficiencies on linear growth. Journal of Nutrition 129, 531S-533S.CrossRefGoogle ScholarPubMed
Sandstead, HH, Penland, JG, Alcock, NW, Dayal, HH, Chen, XC, Li, JS, Zhao, F & Yang, JJ (1998) Effects of repletion with zinc and other micronutrients on neuropsychologic performance and growth of Chinese children. American Journal of Clinical Nutrition 68(Suppl), 470S-475S.CrossRefGoogle ScholarPubMed
Santos, LMP, Dacto, JM, Ascuitti, LS & Dricot-d'Ams, C (1983) Xeropthalmia in the state of Paraiba, northeast of Brazil: clinical findings. American Journal of Nutrition 38, 139144.Google Scholar
Simondon, KB, Gartner, A, Berger, J, Cornu, A, Massamba, JP, Miguel, JS, Missotte, CLI, Simondon, F, Traissac, P, Delpeuch, F & Maire, B (1996) Effect of early, short-term supplementation on weight and linear growth of 4–7 month old infants in developing countries: a four country randomized trial. American Journal of Clinical Nutrition 64, 537545.CrossRefGoogle ScholarPubMed
Singla, PN, Chand, P, Kumar, A & Kachhawaha, JS (1996) Serum, zinc and copper levels in children with protein energy malnutrition. Indian Journal of Pediatrics 63, 199203.CrossRefGoogle ScholarPubMed
Singla, PN, Chand, P, Kumar, A & Kachhawaka, JS (1998) Serum magnesium levels in protein energy malnutrition. Journal of Tropical Pediatrics 44, 117119.CrossRefGoogle ScholarPubMed
Stuijvenberg, ME, Kvalsvig, JD, Faber, M, Kruger, M, Kenoyer, DG & Benade, AJS (1999) Effect of iron-, iodine-, and β-carotene-fortified biscuits on the micronutrient status of primary school children: a randomized controlled trial. American Journal of Clinical Nutrition 69, 497503.CrossRefGoogle ScholarPubMed
Subotzky, EF, Heese, HD, Sive, AA, Depster, WS, Sacks, R & Malan, H (1992) Plasma zinc, copper, selenium, ferritin and whole blood manganese concentrations in children with kwashiorkor in the acute stage and during refeeding. Annals of Tropical Pediatrics 12, 1322.CrossRefGoogle ScholarPubMed
Tanzer, F & Ozalp, I (1988) Plasma and leukocyte zinc and copper levels in patients with protein energy malnutrition. Journal of Tropical Pediatrics 34, 306308.CrossRefGoogle ScholarPubMed
Thu, BD, Schultink, W, Dillon, D, Gross, R, Leswara, ND & Khoi, HH (1999) Effect of daily and weekly micronutrient supplementation on micronutrient deficiencies and growth in young Vietnamese children. American Journal of Clinical Nutrition 69, 8086.CrossRefGoogle ScholarPubMed
Umeta, M, West, CE, Haidar, J, Deurenberg, P & Hautvast, GAJ (2000) Zinc supplementation and stunted infants in Ethiopia: a randomized controlled trial. Lancet 355, 20212026.CrossRefGoogle Scholar
Waterlow, JC, Ashworth, A & Griffiths, M (1980) Faltering in infants' growth in less developed countries. Lancet 2, 11761178.CrossRefGoogle ScholarPubMed
West, KP, Djunaedi, E, Pandji, A, Kusdiono, , Tarwotjo, I, Sommer, A & The Aceh Study Group (1988) Vitamin A supplementation and growth: a randomized community trial. American Journal of Clinical Nutrition 48, 12571264.CrossRefGoogle ScholarPubMed
West, KP, LeClerq, SC, Shrestha, SR, Wu, Lee SF, Pradhan, EK, Khatry, SK, Katz, J, Adhikari, R & Sommer, A (1997) Effect of vitamin A on growth of vitamin A deficient children: field studies in Nepal. Journal of Nutrition 127, 19571965.CrossRefGoogle ScholarPubMed
World Health Organization (1996) Trace elements in human nutrition and health. WHO, Geneva.Google Scholar