Supplementing iron and zinc

Double blind, randomized evaluation of separate or combined delivery

S. Chang, S. El Arifeen, S. Bari, M. A. Wahed, K. M. Rahman, M. T. Rahman, A. B A Mahmud, N. Begum, K. Zaman, Abdullah Baqui, Robert E Black

Research output: Contribution to journalArticle

Abstract

Background/Objectives: Many children have diets deficient in both iron and zinc, but there has been some evidence of negative interactions when they are supplemented together. The optimal delivery approach would maximize clinical benefits of both nutrients. We studied the effectiveness of different iron and zinc supplement delivery approaches to improve diarrhea and anemia in a rural Bangladesh population.Study Design: Randomized, double blind, placebo-controlled factorial community trial. Results: Iron supplementation alone increased diarrhea, but adding zinc, separately or together, attenuated these harmful effects. Combined zinc and iron was as effective as iron alone for iron outcomes. All supplements were vomited 1% of the time, but combined iron and zinc were vomited significantly more than any of the other supplements. Children receiving zinc and iron (together or separately) had fewer hospitalizations. Separating delivery of iron and zinc may have some additional benefit in stunted children. Conclusions: Separate and combined administration of iron and zinc are equally effective for reducing diarrhea, hospitalizations and improving iron outcomes. There may be some benefit in separate administration in stunted children.

Original languageEnglish (US)
Pages (from-to)153-160
Number of pages8
JournalEuropean Journal of Clinical Nutrition
Volume64
Issue number2
DOIs
StatePublished - Feb 2010

Fingerprint

Zinc
Iron
Diarrhea
Hospitalization
Bangladesh
Rural Population
Anemia
Placebos
Diet
Food

Keywords

  • Delivery
  • Diarrhea
  • Interaction
  • Iron
  • Supplement
  • Zinc

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Supplementing iron and zinc : Double blind, randomized evaluation of separate or combined delivery. / Chang, S.; El Arifeen, S.; Bari, S.; Wahed, M. A.; Rahman, K. M.; Rahman, M. T.; Mahmud, A. B A; Begum, N.; Zaman, K.; Baqui, Abdullah; Black, Robert E.

In: European Journal of Clinical Nutrition, Vol. 64, No. 2, 02.2010, p. 153-160.

Research output: Contribution to journalArticle

Chang, S, El Arifeen, S, Bari, S, Wahed, MA, Rahman, KM, Rahman, MT, Mahmud, ABA, Begum, N, Zaman, K, Baqui, A & Black, RE 2010, 'Supplementing iron and zinc: Double blind, randomized evaluation of separate or combined delivery', European Journal of Clinical Nutrition, vol. 64, no. 2, pp. 153-160. https://doi.org/10.1038/ejcn.2009.127
Chang, S. ; El Arifeen, S. ; Bari, S. ; Wahed, M. A. ; Rahman, K. M. ; Rahman, M. T. ; Mahmud, A. B A ; Begum, N. ; Zaman, K. ; Baqui, Abdullah ; Black, Robert E. / Supplementing iron and zinc : Double blind, randomized evaluation of separate or combined delivery. In: European Journal of Clinical Nutrition. 2010 ; Vol. 64, No. 2. pp. 153-160.
@article{0443e0d2db0e484e93103bad7a968a7b,
title = "Supplementing iron and zinc: Double blind, randomized evaluation of separate or combined delivery",
abstract = "Background/Objectives: Many children have diets deficient in both iron and zinc, but there has been some evidence of negative interactions when they are supplemented together. The optimal delivery approach would maximize clinical benefits of both nutrients. We studied the effectiveness of different iron and zinc supplement delivery approaches to improve diarrhea and anemia in a rural Bangladesh population.Study Design: Randomized, double blind, placebo-controlled factorial community trial. Results: Iron supplementation alone increased diarrhea, but adding zinc, separately or together, attenuated these harmful effects. Combined zinc and iron was as effective as iron alone for iron outcomes. All supplements were vomited 1{\%} of the time, but combined iron and zinc were vomited significantly more than any of the other supplements. Children receiving zinc and iron (together or separately) had fewer hospitalizations. Separating delivery of iron and zinc may have some additional benefit in stunted children. Conclusions: Separate and combined administration of iron and zinc are equally effective for reducing diarrhea, hospitalizations and improving iron outcomes. There may be some benefit in separate administration in stunted children.",
keywords = "Delivery, Diarrhea, Interaction, Iron, Supplement, Zinc",
author = "S. Chang and {El Arifeen}, S. and S. Bari and Wahed, {M. A.} and Rahman, {K. M.} and Rahman, {M. T.} and Mahmud, {A. B A} and N. Begum and K. Zaman and Abdullah Baqui and Black, {Robert E}",
year = "2010",
month = "2",
doi = "10.1038/ejcn.2009.127",
language = "English (US)",
volume = "64",
pages = "153--160",
journal = "European Journal of Clinical Nutrition",
issn = "0954-3007",
publisher = "Nature Publishing Group",
number = "2",

}

TY - JOUR

T1 - Supplementing iron and zinc

T2 - Double blind, randomized evaluation of separate or combined delivery

AU - Chang, S.

AU - El Arifeen, S.

AU - Bari, S.

AU - Wahed, M. A.

AU - Rahman, K. M.

AU - Rahman, M. T.

AU - Mahmud, A. B A

AU - Begum, N.

AU - Zaman, K.

AU - Baqui, Abdullah

AU - Black, Robert E

PY - 2010/2

Y1 - 2010/2

N2 - Background/Objectives: Many children have diets deficient in both iron and zinc, but there has been some evidence of negative interactions when they are supplemented together. The optimal delivery approach would maximize clinical benefits of both nutrients. We studied the effectiveness of different iron and zinc supplement delivery approaches to improve diarrhea and anemia in a rural Bangladesh population.Study Design: Randomized, double blind, placebo-controlled factorial community trial. Results: Iron supplementation alone increased diarrhea, but adding zinc, separately or together, attenuated these harmful effects. Combined zinc and iron was as effective as iron alone for iron outcomes. All supplements were vomited 1% of the time, but combined iron and zinc were vomited significantly more than any of the other supplements. Children receiving zinc and iron (together or separately) had fewer hospitalizations. Separating delivery of iron and zinc may have some additional benefit in stunted children. Conclusions: Separate and combined administration of iron and zinc are equally effective for reducing diarrhea, hospitalizations and improving iron outcomes. There may be some benefit in separate administration in stunted children.

AB - Background/Objectives: Many children have diets deficient in both iron and zinc, but there has been some evidence of negative interactions when they are supplemented together. The optimal delivery approach would maximize clinical benefits of both nutrients. We studied the effectiveness of different iron and zinc supplement delivery approaches to improve diarrhea and anemia in a rural Bangladesh population.Study Design: Randomized, double blind, placebo-controlled factorial community trial. Results: Iron supplementation alone increased diarrhea, but adding zinc, separately or together, attenuated these harmful effects. Combined zinc and iron was as effective as iron alone for iron outcomes. All supplements were vomited 1% of the time, but combined iron and zinc were vomited significantly more than any of the other supplements. Children receiving zinc and iron (together or separately) had fewer hospitalizations. Separating delivery of iron and zinc may have some additional benefit in stunted children. Conclusions: Separate and combined administration of iron and zinc are equally effective for reducing diarrhea, hospitalizations and improving iron outcomes. There may be some benefit in separate administration in stunted children.

KW - Delivery

KW - Diarrhea

KW - Interaction

KW - Iron

KW - Supplement

KW - Zinc

UR - http://www.scopus.com/inward/record.url?scp=76649118771&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=76649118771&partnerID=8YFLogxK

U2 - 10.1038/ejcn.2009.127

DO - 10.1038/ejcn.2009.127

M3 - Article

VL - 64

SP - 153

EP - 160

JO - European Journal of Clinical Nutrition

JF - European Journal of Clinical Nutrition

SN - 0954-3007

IS - 2

ER -