Bhandari N, Bahl R, Taneja S
All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Br J Nutr. 2001 May;85 Suppl 2:S131-7.
This review summarizes the results of published, randomized clinical trials that have examined the impact of administration of micronutrients, singly or in combination to infants, preschool and school children on linear growth. Supplementation of single micronutrients resulted in small or no benefits on linear growth. A meta-analysis of zinc supplementation trials confirmed that zinc has a significant but small impact (0.22 sd units) on length gain in children 0-13 years of age. However, a recent study reported a substantially greater benefit (>1 sd) in stunted and non-stunted breast-fed infants 6-12 months of age. With iron supplementation, a beneficial effect was found only in anemic children. Vitamin A supplementation trials have reported little or no benefit on linear growth. Data currently available suggest some impact in children with clinical or biochemical vitamin A deficiency, but this issue needs confirmation. Few studies could be identified where a combination of micronutrients was given as a supplement or as fortified food; in the latter set of studies energy availability was assured. The impact on length without multiple micronutrient supplementation was no greater than that observed with single micronutrients. In conclusion, zinc and iron seem to have a modest effect on linear growth in deficient populations. Vitamin A is unlikely to have an important effect on linear growth. Limited available evidence does not allow us to conclude whether a combination of micronutrients, with or without additional food, would have a greater impact than that seen with zinc alone.
本综述总结了已发表的随机临床试验结果，这些试验研究了单独或联合给婴儿、学龄前儿童和学龄儿童补充微量营养素对线性生长的影响。补充单一微量营养素对线性生长的益处很小或没有益处。一项锌补充试验的荟萃分析证实，锌对0至13岁儿童的身长增加有显著但较小的影响（0.22标准差单位）。然而，最近一项研究报告称，在6至12个月大的发育迟缓及未发育迟缓的母乳喂养婴儿中，益处要大得多（>1标准差）。补充铁剂仅在贫血儿童中发现有益效果。维生素A补充试验报告称，对线性生长几乎没有益处或没有益处。目前可得的数据表明，对临床或生化维生素A缺乏的儿童有一定影响，但这一问题需要证实。很少有研究确定将微量营养素组合作为补充剂或强化食品给予；在后者的研究中，能量供应有保障。不补充多种微量营养素时对身长的影响不大于补充单一微量营养素时观察到的影响。总之，锌和铁似乎对缺乏人群的线性生长有适度影响。维生素A不太可能对线性生长有重要影响。现有有限的证据无法让我们得出结论，即无论是否添加额外食物，微量营养素组合是否会比单独补充锌有更大影响。
