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Short-term supplementation with zinc and vitamin A has no significant effect on the growth of undernourished Bangladeshi children^1,2,3

¹ From the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; the Department of Epidemiology & International Health, the School of Public Health, University of Alabama at Birmingham; and the Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA.

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 randomized, double-blind, placebo-controlled intervention trial. Six hundred fifty-three children aged 12–35 mo were randomly 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.

Key Words: Zinc • vitamin A • weight • length • catch-up growth • children • supplementation trial • Bangladesh

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