Interaction of zinc or vitamin A supplementation and specific parasite infections on Mexican infants' growth: a randomized clinical trial

Background: The efficacy of micronutrient supplementation on growth may be modified by specific gastrointestinal parasite infections. Methods: We carried out a double-blind placebo-controlled trial to evaluate the effect of vitamin A and zinc supplementation on gastro-intestinal pathogen infections...

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Published in:	European journal of clinical nutrition Vol. 63; no. 10; pp. 1176 - 1184
Main Authors:	Rosado, J.L, Caamano, M.C, Montoya, Y.A, Solano Lourdes, M. de, Santos, J.I, Long, K.Z
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 01-10-2009 Nature Publishing Group
Subjects:	Animals Ascariasis - complications Ascaris lumbricoides Babies Biological and medical sciences Body height Body Height - drug effects Body Height - physiology Body Weight - drug effects Body Weight - physiology Child development Children Clinical Nutrition Clinical trials Complications and side effects dietary mineral supplements Dietary Supplements digestive system diseases Dysentery, Amebic - complications Entamoeba Epidemiology Evaluation Feces - parasitology Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Gastrointestinal diseases General aspects Giardia Giardia duodenalis Giardia lamblia Giardiasis - complications Growth Growth - drug effects Growth - physiology Growth Disorders - etiology Growth Disorders - prevention & control Health aspects human diseases Human growth Humans Infant infant growth infant nutrition Infants Infections Infectious diseases Internal Medicine Intestinal Diseases, Parasitic - complications Intestine Male Medical sciences Medicine Medicine & Public Health Metabolic Diseases Mexico Morbidity original-article Parasites Parasitic diseases parasitoses Pathogens Placebos Public Health randomized clinical trials Regression analysis Regression models Retinene Supplements synergism Trace Elements - pharmacology Vertebrates: anatomy and physiology, studies on body, several organs or systems Vitamin A Vitamin A - pharmacology Vitamin E vitamin supplements vitamin-mineral supplements Vitamins - pharmacology Zinc Zinc - pharmacology Zinc in the body Mexico Central America America Mexico City Mexico parasites growth vitamin A infants zinc Human Growth Interaction Vitamin Metabolic diseases Infant Parasitosis Zinc Retinol Infection Randomization Clinical trial Supplementation
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Summary:	Background: The efficacy of micronutrient supplementation on growth may be modified by specific gastrointestinal parasite infections. Methods: We carried out a double-blind placebo-controlled trial to evaluate the effect of vitamin A and zinc supplementation on gastro-intestinal pathogen infections and growth among 584 infants in Mexico City. Children aged 5–15 months were assigned to receive either a vitamin A supplement every 2 months (20 000 IU of retinol for infants <or=; 1 year or 45 000 IU for infants >1 year), a daily supplement of 20 mg of zinc, a combined vitamin A–zinc supplement or a placebo, and were followed up for 1 year. Weight and length were measured once a month and morbidity histories were recorded twice a week for 12 months. Monthly stool samples were screened for Giardia duodenalis, Ascaris lumbricoides and Entamoeba spp. Growth velocity slopes, generated from the linear regression of individual child length, and height-for-age z-scores on time were analyzed as end points in regression models, adjusting for the presence of parasite infections. Results: The main effect of vitamin A supplementation was in height improvement (P<0.05), and was only found in the model evaluating infants with any parasite. There was an interaction effect of slower growth (P<0.05) found in infants infected with any parasite and supplemented with vitamin A in slower growth (P<0.05). In addition, the interaction of zinc supplementation and Giardia duodenalis or A. lumbricoides was associated with reduced growth (P<0.05). Conclusion: Gastro-intestinal parasite infections may modify the effect that zinc or vitamin A supplementation has on childhood growth.
Bibliography:	http://dx.doi.org/10.1038/ejcn.2009.53 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0954-3007 1476-5640
DOI:	10.1038/ejcn.2009.53