title: Effect of zinc supplementation on growth and body composition of Ugandan preschool children: a randomized, controlled, intervention trial. Short-term supplementation with zinc and vitamin A has no significant effect on the growth of undernourished Bangladeshi children. Dose-response trial of prophylactic zinc supplements, with or without copper, in young Ecuadorian children at risk of zinc deficiency. Zinc absorption as a function of the dose of zinc sulfate in aqueous solution. Linear growth of low income preschool children receiving a zinc supplement. Growth and body composition of periurban Guatemalan children in relation to zinc status: a longitudinal zinc intervention trial. Effects of Zinc Supplementation on Physical Growth in 2–5-Year-Old Children Zinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected growth or body composition of Mexican preschoolers. Effects of zinc supplementation on 1- to 5-year old children. Effects of short-term zinc supplementation on cellular immunity, respiratory symptoms, and growth of malnourished Equadorian children. A growth-limiting, mild zinc-deficiency syndrome in some southern Ontario boys with low height percentiles.
abstract: BACKGROUND Despite ample food supplies , the incidence of childhood underweight and stunting remains high in Ug and a. Many factors contribute to this situation , but the role of low zinc intakes has not been adequately explored . OBJECTIVE Our objective was to study the effect of zinc supplementation on growth and body composition of preschool children by using the outcome measures of weight , height , and midupper arm circumference ( MUAC ) . DESIGN The study was r and omized , double-blind , placebo-controlled , parallel , and 8 mo long , and incorporated 6 mo of zinc supplementation .  Children ( n = 153 ) aged 55.8 + /- 11.2 mo from 3 r and omly selected nursery schools of medium , low , and very low socioeconomic status in a suburb of Kampala took part . The intervention comprised 10 mg Zn ( as ZnSO4 ) or placebo daily in freshly prepared fruit juice , Monday to Friday inclusive . RESULTS Zinc supplementation increased MUAC by the end of the study ( P = 0.029 ) and led to greater weight gain in children from the school of medium socioeconomic status at 3 and 8 mo ( P = 0.019 and P = 0.038 , respectively ) . There was no effect on weight gain of the children from the other schools . Zinc supplementation had no influence on height . Infection rates ( of which 82 % were recorded as malaria ) were lower in the zinc-supplemented group than in control subjects ( P = 0.063 ) . CONCLUSIONS Zinc supplementation may counter the age-related decrease in MUAC often observed in preschool children in developing countries . The study provides evidence that zinc may not be the most limiting nutrient for weight gain in children of poor nutritional status , but may become so as nutritional status improves BACKGROUND Several vitamin A supplementation trials have failed to improve the  growth rate  in children . Addition of zinc to vitamin A might result in enhanced growth . OBJECTIVE This study evaluated the effect on growth in children of simultaneous supplementation with zinc and vitamin A.  DESIGN This was a r and omized , double-blind , placebo-controlled intervention trial . Six hundred fifty-three children aged 12 - 35 mo were r and omly assigned to 1 of 4 intervention groups : 20 mg Zn/d for 14 d ( Z group ) , 60000 retinol equivalents ( 200000 IU ) vitamin A on day 14 ( A group ) , zinc plus vitamin A ( ZA group ) , or placebo syrup and placebo capsule ( placebo group ) . Weight and length were measured at enrollment and again after 3 and 6 mo . RESULTS Gains in weight and length during the 6-mo follow-up period were not significantly different among the 4 groups by analysis of variance . Catch-up growth also did not differ significantly among the groups . The proportions of children whose weight-for-age z scores did not change or decreased were 57 % in the Z group , 46 % in the A group , 50 % in the ZA group , and 54 % in the placebo group ( NS ) . The proportions of children whose length-for-age z scores did not change or decreased were 42 % in the Z group , 48 % in the A group , 53 % in the ZA group , and 46 % in the placebo group ( NS ) . CONCLUSION Combined short-term zinc supplementation and a single dose of vitamin A has no significant effects on weight and length increments in children over a 6-mo period BACKGROUND Multiple studies have shown the benefits of zinc supplementation among young children in high-risk population s. However , the optimal dose and safe upper level of zinc have not been determined . OBJECTIVES The objectives of this study were to measure the effects of different doses of supplemental zinc on the plasma zinc concentration , morbidity , and growth of young children ; to detect any adverse effects of 10 mg supplemental Zn on markers of copper or iron status ; and to determine whether any adverse effects are alleviated by providing copper with zinc . DESIGN This r and omized , double-masked , community-based intervention trial was conducted in 631 Ecuadorian children who were 12 - 30 mo old at baseline and who had initial length-for-age z scores < -1.3 . Children received 1 of 5 daily supplements for 6 mo : 3 , 7 , or 10 mg Zn as zinc sulfate , 10 mg Zn + 0.5 mg Cu as copper sulfate , or placebo . RESULTS The change in plasma zinc concentration from baseline was positively related to the zinc dose ( P < 0.001 ) . Zinc supplementation , including doses as low as 3 mg/d , reduced the incidence of diarrhea by 21 - 42 % ( P < 0.01 ) . There were no other significant group-wise differences . CONCLUSIONS Zinc supplementation with a dose as low as 3 mg/d increased plasma zinc concentrations and reduced diarrhea incidence in the study population . There were no observed adverse effects of 10 mg Zn/d on indicators of copper or iron status . The current tolerable upper level of zinc recommended by the Institute of Medicine should be reassessed for young children BACKGROUND Zinc supplements are used extensively in medicine and research and for public health purpose s in the prevention and treatment of zinc deficiency . However , little is known about the efficiency of zinc utilization after different doses . OBJECTIVE The objective was to determine the relation between dose of aqueous zinc and absorbed zinc ( AZ ) in healthy adults . DESIGN Eight healthy adults ( 3 men and 5 women ) aged 33.8 + /- 9.8 y ( x + /- SD ) received 3 pairs of zinc doses ( 2 and 5 , 10 and 15 , and 20 and 30 mg ) in r and om order in 3 phases ( 1 pair per phase ) . There was a 3-wk washout between phases . Aqueous zinc sulfate labeled with 70Zn or 68Zn was orally administered in the postabsorptive state on days 1 and 6 , respectively ; intravenous 67Zn was administered 1 h after the first oral zinc dose . Two urine sample s were collected daily from days 3 to 15 ; zinc isotopic ratios were determined by inductively coupled plasma mass spectrometry . Fractional absorption of zinc ( FAZ ) was determined by dual-isotope-tracer ratio ; AZ was calculated by multiplying FAZ by dose . RESULTS Mean ( + /-SD ) AZ values at doses of 2.2 , 5.2 , 10.4 , 15.2 , 20.3 , and 30.1 mg ingested Zn were 1.6 + /- 0.4 , 3.5 + /- 1.3 , 7.4 + /- 1.0 , 9.5 + /- 2.2 , 11.0 + /- 4.4 , and 11.2 + /- 2.1 mg , respectively . A saturable dose-response model , the Hill equation , was selected to model the relation of AZ to ingested zinc . Parameter estimation by nonlinear regression predicted a maximum zinc absorption of 13 mg for larger doses . CONCLUSIONS Increases in aqueous zinc doses > 20 mg result in relatively small and progressively diminishing increases in AZ postabsorptively in healthy adults The effects of a zinc supplement on growth velocity were assessed in a double-blind , pair-matched controlled study in 40 children with low growth percentiles . Participants were low-income Spanish-American children , 2 to 6 yr of age with heights below the 10th percentile and nutritional or biochemical evidence of zinc deficiency . After 1 yr , the mean height velocity of the zinc-supplemented children was slightly , but significantly ( p less than 0.005 ) , greater than that of control children . This effect was primarily due to a greater height achievement of the zinc-supplemented boys . Increases in height-for-age z-scores were also significant for the supplemented males ( p less than 0.001 ) and for the combined sexes ( p less than 0.05 ) . This study indicates the existence of a growth-limiting syndrome of mild zinc deficiency in children Changes in growth , body composition , and zinc indexes were evaluated after 25 wk in a double-blind zinc-supplementation study of 162 periurban Guatemalan children aged 81.5 + /- 7.0 mo ( mean + /- SD ) . Children receiving the zinc supplement ( 10 mg Zn/d as amino acid chelate ) for 90.1 + /- 9.2 d had higher mean fasting plasma zinc ( 16.2 + /- 2.9 vs 14.9 + /- 2.1 mumol/L , P < 0.01 ) , a greater increase in median triceps skinfold Z score ( 0.50 vs 0.38 , P < 0.05 ) , and a smaller deficit in median midarm circumference ( MAC ) Z score ( -0.03 vs -0.20 , P < 0.05 ) compared with the placebo group . Initial hair zinc classified as < 1.68 and > 1.68 mumol/g was the only laboratory variable that explained some of the variance in final Z scores of midarm-muscle area ( P < 0.05 ) and MAC ( P < 0.01 ) . Children responded to the zinc supplement with changes in indexes of body composition rather than growth Physical growth disorders in under 5-year-old children are a common health problem in many countries including Iran . The aim of this study was to determine effects of supplemental zinc on physical growth in preschool children with retarded linear growth .  This study was a community-based r and omized controlled trial on 2–5-year-old children with height-for-age below 25th percentile of National Center for Health Statistics growth chart . Ninety children were r and omly assigned in  zinc  group ( ZG ) or placebo group ( PG ) . After 6 months of zinc or placebo supplementation , we followed up the children for another 6 months . Anthropometric indicators were measured before the intervention and then monthly for 11 months . Forty children in ZG and 45 in PG concluded the study . Zinc supplementation increased weight gain in boys ( P = 0.04 ) and girls ( P = 0.05 ) compared to placebo but had no significant effect on mid-upper arm circumference increment in either sexes . The most significant ( P = 0.001 ) effect of Zinc supplementation was seen in boys ’ height increment at the end of follow-up period . Stunted growth rate in ZG changed significantly ( P = 0.01 ) from 26.7 % to 2.5 % throughout the study . This study showed that daily supplementation of 5 mg elemental zinc for 6 months improves physical growth in terms of height increment and weight gain in children with undesirable linear growth , especially in boys In rural Mexico and in many developing countries micronutrient deficiencies , growth stunting , and morbidity from infectious diseases are highly prevalent in young children . We assessed the extent to which growth stunting could be reversed and the number of infectious disease episodes reduced by zinc and /or iron supplementation . In a double-blind , r and omized community trial 219 Mexican preschoolers were supplemented with either 20 mg Zn as zinc methionine , 20 mg Fe as ferrous sulfate , 20 mg Zn + 20 mg Fe , or a placebo . After 12 mo , plasma zinc increased significantly in the two zinc-treated groups , and plasma ferritin was significantly higher in the two iron-treated groups . There was no effect of treatments on growth velocity or body composition . Children in both zinc-supplemented groups had fewer episodes of disease ( zinc alone , 3.9 + /- 0.3 ; zinc+iron , 3.7 + /- 0.4 ; placebo , 4.6 + /- 0.5 ; P < 0.03 ) , including diarrhea ( zinc alone , 0.7 + /- 0.1 ; zinc+iron , 0.8 + /- 0.1 ; placebo , 1.1 + /- 0.2 ; P < 0.01 ) . Zinc and zinc+iron supplements reduced morbidity but had no effect on growth or body composition OBJECTIVE To assess the impact of zinc supplementation on nutritional and biochemical parameters among children aged 12 to 59 months . METHODS A blinded r and omized clinical trial was carried out with 58 children aged 12 to 59 months included in the Programa Governamental de Combate a Carências Nutricionais ( National Child Nutritional Program ) , which provided them with 2 kg of  iron-fortified milk . The supplementation group ( n = 28 ) received 10 mg/day of zinc sulfate for four months , and the control group ( n = 30 ) received placebo . The following parameters were used to assess the nutritional status : weight-for-height and height-for-age expressed as z scores , according to National Center for Health Statistics ( NCHS ) st and ards , biochemical measurements of serum iron and serum zinc , and hemoglobin and hematocrit levels . RESULTS Zinc supplementation did not have a remarkable influence on anthropometric parameters . Baseline serum zinc levels were low in both groups . After supplementation , variations in mean hemoglobin ( p = 0.002 ) , hematocrit ( p = 0.001 ) , serum zinc ( p = 0.023 ) , and serum iron ( p = 0.013 ) levels significantly increased in the zinc supplementation group . CONCLUSION Zinc supplementation improved hemoglobin response and normalized serum zinc concentration . The results show the importance of establishing policies for nutritional care that can tackle zinc deficiency as well OBJECTIVE To assess the effect of zinc supplementation on respiratory tract disease , immunity and growth in malnourished children .  DESIGN A r and omized double-blind placebo-controlled trial . SETTING A day-care center in Quito , Ecuador . SUBJECTS Fifty children ( 12 - 59 months old ) recruited by height-for-age and weight-for-age deficit . INTERVENTIONS Twenty-five children ( supplemented , S group ) received 10 mg/day of zinc as zinc sulfate , and 25 ( nonsupplemented , NS group ) received a placebo during 60 days . All were also observed during a 60-day postsupplementation period . Two children of the S group dropped out . Daily the clinical presence of cough , respiratory tract secretions , and fever , was recorded . On days 0,60 and 120 , the cutaneous delayed-type hypersensitivity ( DTH ) to multiple antigens , and anthropometric parameters were assessed . On days 0 and 60 serum zinc levels were also measured . RESULTS On day 60 , DTH was significantly larger ( 20.8 + /- 7.1 vs 16.1 + /- 9.7 mm ) , and serum zinc levels were significantly higher ( 118.6 + /- 47.1 vs 83.1 + /- 24.5 micrograms/dl ) in the S group than in the NS group ( P < 0.05 for each ) . The incidence of fever [ relative risk ( RR ) : 0.30 , c.i . = 0.08- 0.95 , P = 0.02 ] , cough ( RR ) : 0.52 , c.i . = 0.32 - 0.84 , P = 0.004 ) and upper respiratory tract secretions (RR):0.72 , c.i . = 0.59 - 0.88 , P = 0.001 ) was lower in the S group than in the NS group at day 60 . At the end of the postsupplementation observation period ( day 120 ) , the incidence of fever and upper respiratory tract secretions was the same in both the S and NS groups . The incidence of cough was higher at day 120 in the S group than in the NS group ( RR ) : 2.28 , c.i . = 1.37 - 3.83 , P = 0.001 ) . CONCLUSIONS This study supports a role for zinc in immunity , and immunity to respiratory infections , while pointing out the need for larger studies A double-blind , pair-matched 12-mo study examined the effects of a zinc supplement ( 10 mg Zn/d as ZnSO4 ) on linear growth , taste acuity , attention span , biochemical indices , and energy intakes of 60 boys ( aged 5 - 7 y ) with height less than or equal to 15th and midparent height greater than 25th percentiles . Boys with initial hair Zn less than 1.68 mumol/g ( n = 16 ) had a lower mean ( + /- SD ) weight-for-age Z score ( -0.44 + /- 0.59 vs -0.08 + /- 0.84 ) , and a higher median recognition threshold for salt ( 15 vs 7.5 mmol ; p = 0.02 ) than those with hair Zn greater than 1.68 mumol/g . Only boys with hair Zn less than 1.68 mumol/g responded to the Zn supplement with a higher mean change in height-for-age Z score ( p less than 0.05 ) ; taste acuity , energy intakes , and attention span were unaffected . A growth-limiting Zn deficiency syndrome exists in boys with low height percentiles , hair Zn levels less than 1.68 mumol/g , and impaired taste acuity
target: Conclusions : Many of the children in the included studies were already stunted and may have been suffering from multiple micronutrient deficiencies , and therefore zinc supplementation alone may have only a limited effect on growth
background: Background / objectives : It is estimated that zinc deficiency affects 17 % of the world 's population , and because of periods of rapid growth children are at an increased risk of deficiency , which may lead to stunting .
  This paper presents a systematic review and meta- analysis of the r and omised controlled trials ( RCTs ) that assess zinc intake and growth in children aged 1–8 years .