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Zinc deficiency
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    Zinc is an essential micronutrient, and zinc deficiency affects gene expression, protein synthesis, and immune function as well as taste and appetite. Studies in developing countries on the effect of zinc supplementation have given conflicting results. Now a study in rural Ethiopia (Melaka Umeta and colleaguesLancet2000;355:2021–6) has shown that zinc supplementation improved growth in infants.

     The study included 100 apparently healthy breastfed 6–12 month old infants who were stunted (length for age Z score <−2) and 100 infants matched for age and sex who were not stunted. They were randomly assigned to zinc sulphate 10 mg or placebo daily for six days a week for six months. Over the six months the mean growth in length of stunted infants was 7.0 cm with zinc and 2.8 cm with placebo. Growth of the non-stunted group was 6.6 cm (zinc)v 5.0 cm (placebo). The corresponding increases in weight were: stunted infants 1.73 kg (zinc)v 0.95 kg (placebo); non-stunted 1.19 kgv 1.02 kg. Zinc supplementation reduced the incidences of anorexia, fever, diarrhoea, vomiting, and cough in stunted infants. At the end of the study, serum and hair zinc concentrations were lower in non-supplemented stunted infants than in non-supplemented non-stunted infants (they were not measured at the beginning of the study) and zinc concentrations in supplemented stunted infants correlated with growth in length.

     Zinc supplementation may improve growth in some children in developing countries. Whether the effect is a direct effect of zinc on growth or a result of improved appetite, fewer infections, and less diarrhoea is uncertain.

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