TY - JOUR
T1 - Effects of zinc and iron supplementation fail to improve motor and language milestone scores of infants and toddlers
AU - Surkan, Pamela J.
AU - Siegel, Emily H.
AU - Patel, Shivani A.
AU - Katz, Joanne
AU - Khatry, Subarna K.
AU - Stoltzfus, Rebecca J.
AU - LeClerq, Steven C.
AU - Tielsch, James M.
N1 - Funding Information:
This work was supported by grant HD 38753 from the National Institutes of Health , Bethesda, MD; grant 810-2054 from the Bill and Melinda Gates Foundation , Seattle, WA; and a Cooperative Agreement ( HRN-A-00-97-00015-00 ) between Johns Hopkins University and the Office of Health and Nutrition, U.S. Agency for International Development , Washington, D.C.
PY - 2013/3
Y1 - 2013/3
N2 - Objective: To assess the effects of zinc and iron-folic acid supplementation on motor and language milestones in Nepali children. Methods: Five hundred forty-four children 4 to 17 mo old residing in Ishwarpur, Nepal were randomized to receive placebo, iron-folic acid, zinc, or zinc plus iron-folic acid daily. Data were collected at baseline and at 3-mo intervals for 1 y. The main effects of zinc and iron folic-acid supplementation were estimated for motor and language milestones. Crude and adjusted mean cumulative changes in scores from visits 1 to 5 and adjusted rates of change were modeled. Results: Adjusted differences in motor milestone scores from visits 1 to 5 and rates of change were not significantly different for the zinc and non-zinc groups (adjusted β = -0.7, 95% confidence interval [CI] -1.4 to 0.01; adjusted β = -0.1, 95% CI -0.5 to 0.3, respectively). Motor milestones in children receiving and not receiving iron supplements were not significantly different (adjusted β = 0.1, 95% CI -0.7 to 0.8, from visits 1 to 5; adjusted β = 0.1, 95% CI -0.3 to 0.5, for rate of change). Children receiving zinc had a 0.8 lower mean crude change in language score from visits 1 to 5 compared with children not receiving zinc (95% CI -1.3 to -0.3), but the significance was lost after adjustment (adjusted β = -0.2, 95% CI -0.6 to 0.2, for visits 1 to 5; β = -0.1, 95% CI -0.3 to 0.2, for rate of change). No significant difference in motor or language milestone scores from iron supplementation was observed. Conclusion: After 1 y, neither zinc nor iron-folic acid supplementation in Nepali children improved the attainment of motor or language milestones.
AB - Objective: To assess the effects of zinc and iron-folic acid supplementation on motor and language milestones in Nepali children. Methods: Five hundred forty-four children 4 to 17 mo old residing in Ishwarpur, Nepal were randomized to receive placebo, iron-folic acid, zinc, or zinc plus iron-folic acid daily. Data were collected at baseline and at 3-mo intervals for 1 y. The main effects of zinc and iron folic-acid supplementation were estimated for motor and language milestones. Crude and adjusted mean cumulative changes in scores from visits 1 to 5 and adjusted rates of change were modeled. Results: Adjusted differences in motor milestone scores from visits 1 to 5 and rates of change were not significantly different for the zinc and non-zinc groups (adjusted β = -0.7, 95% confidence interval [CI] -1.4 to 0.01; adjusted β = -0.1, 95% CI -0.5 to 0.3, respectively). Motor milestones in children receiving and not receiving iron supplements were not significantly different (adjusted β = 0.1, 95% CI -0.7 to 0.8, from visits 1 to 5; adjusted β = 0.1, 95% CI -0.3 to 0.5, for rate of change). Children receiving zinc had a 0.8 lower mean crude change in language score from visits 1 to 5 compared with children not receiving zinc (95% CI -1.3 to -0.3), but the significance was lost after adjustment (adjusted β = -0.2, 95% CI -0.6 to 0.2, for visits 1 to 5; β = -0.1, 95% CI -0.3 to 0.2, for rate of change). No significant difference in motor or language milestone scores from iron supplementation was observed. Conclusion: After 1 y, neither zinc nor iron-folic acid supplementation in Nepali children improved the attainment of motor or language milestones.
KW - Children
KW - Iron
KW - Language development
KW - Micronutrients
KW - Nepal
KW - Psychomotor performance
KW - Zinc
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U2 - 10.1016/j.nut.2012.09.003
DO - 10.1016/j.nut.2012.09.003
M3 - Article
C2 - 23298972
AN - SCOPUS:84873568470
SN - 0899-9007
VL - 29
SP - 542
EP - 548
JO - Nutrition
JF - Nutrition
IS - 3
ER -