Antenatal supplementation with folic acid + iron + zinc improves linear growth and reduces peripheral adiposity in school-age children in rural Nepal

Christine P. Stewart, Parul Christian, Steven C. LeClerq, Keith P. West, Subarna K. Khatry

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We previously reported that a randomized controlled trial of antenatal micronutrient supplements in rural Nepal decreased the risk of low birth weight by ≈15%. Objective: The objective was to examine the effects of micronutrient supplementation on growth and body composition in children of supplemented mothers through school age. Design: Mothers received 1 of 5 micronutrient supplements daily: folic acid, folic acid + iron, folic acid + iron + zinc, multiple micronutrients, or a control. All of the supplements contained vitamin A. Children born during this trial were revisited at age 6-8 y to measure height, weight, midupper arm circumference, waist circumference, and triceps and subscapular skinfold thicknesses. Arm fat and muscle area were estimated by using standard formulas, and height-for-age, weight-for-age, and body mass index-for-age z scores were calculated by using the World Health Organization growth standard. Results: Of the 3771 surviving children, 3324 were revisited and consented to anthropometric measurements. Maternal supplementation with folic acid + iron + zinc resulted in an increase in mean height (0.64 cm; 95% CI: 0.04, 1.25) and a reduction in mean triceps skinfold thickness (20.25 mm; 95% CI: 20.44, 20.06), subscapular skinfold thickness (20.20 mm; 95% CI: 20.33, 20.06), and arm fat area (20.18 cm2; -0.34, -0.01). No significant differences were found between groups in mean weight or body mass index-for-age z scores, waist circumference, or arm muscle area. Other micronutrient combinations including a multiple micronutrient formulation failed to show a growth benefit. Conclusion: Antenatal supplementation with zinc may benefit child growth, particularly in areas where a deficiency of this nutrient is common.

Original languageEnglish (US)
Pages (from-to)132-140
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume90
Issue number1
DOIs
StatePublished - Jul 1 2009

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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