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The relationship between zinc intake and growth in children aged 1–8 years: a systematic review and meta-analysis



It is estimated that zinc deficiency affects 17% of the world's population, and because of periods of rapid growth children are at an increased risk of deficiency, which may lead to stunting. This paper presents a systematic review and meta-analysis of the randomised controlled trials (RCTs) that assess zinc intake and growth in children aged 1–8 years. This review is part of a larger systematic review by the European Micronutrient Recommendations Aligned Network of Excellence that aims to harmonise the approach to setting micronutrient requirements for optimal health in European populations (


Searches were performed of literature published up to and including December 2013 using MEDLINE, Embase and the Cochrane Library databases. Included studies were RCTs in apparently healthy child populations aged from 1 to 8 years that supplied zinc supplements either as capsules or as part of a fortified meal. Pooled meta-analyses were performed when appropriate.


Nine studies met the inclusion criteria. We found no significant effect of zinc supplementation of between 2 weeks and 12 months duration on weight gain, height for age, weight for age, length for age, weight for height (WHZ) or WHZ scores in children aged 1–8 years.


Many of the children in the included studies were already stunted and may have been suffering from multiple micronutrient deficiencies, and therefore zinc supplementation alone may have only a limited effect on growth.

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The work reported herein has been carried out within the EURRECA Network of Excellence (, which is financially supported by the Commission of the European Communities, specific Research, Technology and Development Programme Quality of Life and Management of Living Resources, within the Sixth Framework Programme, contract no. 036196. This report does not necessarily reflect the Commission’s views or its future policy in this area. The original conception of the systematic review was undertaken by the EURRECA Network and coordinated by partners based at Wageningen University (WU), the Netherlands and the University of East Anglia (UEA), United Kingdom. Susan Fairweather-Tait (UEA), Lisette de Groot (WU), Pieter van’ t Veer (WU), Kate Ashton (UEA), Amélie Casgrain (UEA), Adriënne Cavelaars (WU), Rachel Collings (UEA), Rosalie Dhonukshe-Rutten (WU), Esmée Doets (WU), Linda Harvey (UEA) and Lee Hooper (UEA) designed and developed the review protocol and search strategy. The authors thank Nick Kenworthy, Sarah Richardson-Owen, Hannah Eichmann, Joseph Saavedra and Christine Cockburn for assistance with data extraction and Olga W Souverein (WU) and Carla Dullemeijer (WU) for calculating the estimated intake-growth regression coefficient (β̂).

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Correspondence to V H Moran.

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Stammers, AL., Lowe, N., Medina, M. et al. The relationship between zinc intake and growth in children aged 1–8 years: a systematic review and meta-analysis. Eur J Clin Nutr 69, 147–153 (2015).

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