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Efficacy of combined iron and zinc supplementation on micronutrient status and growth in Vietnamese infants

European Journal of Clinical Nutrition volume 60, pages 443–454 (2006)Cite this article

Abstract

Objective:

To evaluate the effect of combined iron–zinc supplementation on micronutrient status, growth and morbidity.

Design:

Randomized, double-masked, placebo-controlled supplementation trial.

Setting:

Rural district of Que Vo, in the Red River Delta in Vietnam.

Subjects:

A total of 915 breast-fed infants aged 4–7 months were included and 784 completed the study.

Interventions:

The Fe-group received daily and for a 6-month period 10 mg of iron, the Zn-group 10 mg zinc, the Fe–Zn group 10 mg iron+10 mg zinc and the placebo group a placebo. Hemoglobin (Hb), serum ferritin (SF) and zinc (SZn), and anthropometry were measured before and at the end of the intervention. Morbidity was recorded daily.

Results:

Changes of Hb and SF were higher in both Fe and Fe+Zn groups (respectively 22.6 and 20.6 g/l for Hb; 36.0 and 24.8 μg/l for SF) compared to Zn and placebo groups (Hb: 6.4 and 9.8 g/l; SF: −18.2 and −16.9 μg/l, P<0.0001). SZn increased more in Zn group (10.3 μmol/l) than in Fe+Zn group (8.0 μmol/l, P=0.03) and more in these groups compared to Fe and placebo groups (1.6 and 1.2 μmol/l, P<0.0001). Weight gain was higher in the Zn group. No significant effects of supplementations on growth in length or morbidity.

Conclusions:

Combined iron–zinc supplementation had a positive effect on iron and zinc status in infants. However, the positive effect of zinc alone on SZn and weight would indicate a negative interaction of iron when added to zinc supplements.

Sponsorship:

UNICEF New York.

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Acknowledgements

We are grateful to all the infants and their parents who participated in this study and to field workers and other personnel at the National Institute of Nutrition (Hanoi) for their collaboration. The technical assistance of V Bianco of IRD during the statistical evaluation is gratefully acknowledged. The financial contribution by UNICEF and the constant support of M Tolvanen from UNICEF to this study are greatly acknowledged.

Author information

Authors and Affiliations

  1. Institut de Recherche pour le Développement (IRD), UR 106 ‘Nutrition, Alimentation, Sociétés’, Montpellier, Cedex, France

    J Berger

  2. National Institute of Nutrition, Hanoi, Vietnam

    N X Ninh, N C Khan, N V Nhien, D K Lien, N Q Trung & H H Khoi

Authors
  1. J Berger
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  2. N X Ninh
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  3. N C Khan
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  4. N V Nhien
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  5. D K Lien
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  6. N Q Trung
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  7. H H Khoi
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Corresponding author

Correspondence to J Berger.

Additional information

Guarantor: J Berger.

Contributors: JB and NXN were the principal investigators of the study. They were responsible for the design and the implementation of the study. JB was responsible for data management and analysis. JB and NXN were responsible for the preparation of the manuscript. NXN was responsible for day-to-day supervision of the field staff and development of the study. NCK, HHK and NQT contributed to the development of the study protocol. NVN and DKL were responsible for the analysis of hemoglobin, plasma ferritin and zinc analysis under supervision of NXN and JB.

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Berger, J., Ninh, N., Khan, N. et al. Efficacy of combined iron and zinc supplementation on micronutrient status and growth in Vietnamese infants. Eur J Clin Nutr 60, 443–454 (2006). https://doi.org/10.1038/sj.ejcn.1602336

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602336

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