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

European Journal of Clinical Nutrition volume 63, pages 1176–1184 (2009)Cite this article

Abstract

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 ⩽; 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.

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Acknowledgements

This project was supported by the Instituto de Nutricion Danone, CONACYT (National Council of Science and Technology of Mexico) and by the National Institutes of Health Grant no. K01 DK06142-02. We thank Cristina Barrgan and Matilde Juárez of the Clinical Microbiological Laboratory, Hospital La Perla, Cda Netzahuaycoytl, México for their assistance in the laboratory.

Author information

Authors and Affiliations

  1. School of Natural Sciences, Universidad Autónoma de Querétaro, Mexico

    J L Rosado & M C Caamaño

  2. Centro de Salud para Infancia y Adolescencia, Secretaría de Salud, Mexico City, Mexico

    Y A Montoya

  3. Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubiran, Mexico City, México

    M de Lourdes Solano

  4. Department of Experimental Medicine, School of Medicine, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico

    J I Santos

  5. Nutrition, Disease Control and Injury Unit, School of Population Health, University of Queensland, Australia

    K Z Long

  6. Nutrition, CINDETEC, Queretaro, Mexico

    K Z Long

Authors
  1. J L Rosado
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  2. M C Caamaño
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  3. Y A Montoya
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  4. M de Lourdes Solano
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  5. J I Santos
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  6. K Z Long
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Corresponding author

Correspondence to J L Rosado.

Additional information

Presented in part: Impact of vitamin A and zinc supplementation on growth among Mexican infants. Rosado JL, Caamaño MC, Montoya YA, Frongillo E, Santos JI, Long KZ. Experimental Biology Meetings, San Franciso CA 2006.

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Rosado, J., Caamaño, M., Montoya, Y. et al. Interaction of zinc or vitamin A supplementation and specific parasite infections on Mexican infants' growth: a randomized clinical trial. Eur J Clin Nutr 63, 1176–1184 (2009). https://doi.org/10.1038/ejcn.2009.53

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