Rivera J A, González-Cossío T, Flores M, Romero M, Rivera M, Téllez-Rojo M M, Rosado J L, Brown K H
Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
Am J Clin Nutr. 2001 Nov;74(5):657-63. doi: 10.1093/ajcn/74.5.657.
The role of single micronutrient deficiencies in the etiology of growth retardation has recently gained attention. However, because multiple micronutrient deficiencies are common in children in developing countries, it is possible that more than one micronutrient may limit growth and, hence, the correction of a single deficiency may not be enough to improve growth substantially.
The objective was to evaluate the effect of multiple micronutrient supplementation on the growth of children aged 8-14 mo whose diets were poor in several micronutrients.
Children were randomly assigned to 1 of 2 groups. One group received a multiple micronutrient supplement containing the recommended dietary allowance (RDA) or 1.5 times the RDA of vitamins A, D, E, K, C, B-1, B-6, B-12, riboflavin, niacin, biotin, folic acid, and pantothenic acid, and iron, zinc, iodine, copper, manganese, and selenium. The other group received a placebo. Supplements were administered 6 d/wk for an average of 12.2 mo. Body length was measured at baseline and monthly thereafter until the end of supplementation.
Supplemented infants initially aged <12 mo had significantly greater length gains than did the placebo group, with a difference of 8.2 mm (length-for-age z score: 0.3) at the end of supplementation. In contrast, differences in length gains between the supplemented and placebo groups initially aged > or =12 mo were not significant.
Micronutrient deficiencies limited the growth of the Mexican infants studied. Improving micronutrient intakes should be a component of interventions to promote growth in infants living in settings where micronutrient intakes are inadequate.
单一微量营养素缺乏在生长发育迟缓病因中的作用最近受到关注。然而，由于发展中国家儿童中多种微量营养素缺乏很常见，可能不止一种微量营养素会限制生长，因此纠正单一缺乏可能不足以显著改善生长。
评估补充多种微量营养素对8至14月龄、多种微量营养素饮食较差儿童生长的影响。
将儿童随机分为两组。一组接受含有推荐膳食摄入量（RDA）或1.5倍RDA的多种微量营养素补充剂，其中包括维生素A、D、E、K、C、B-1、B-6、B-12、核黄素、烟酸、生物素、叶酸和泛酸，以及铁、锌、碘、铜、锰和硒。另一组接受安慰剂。补充剂每周服用6天，平均服用12.2个月。在基线时测量身长，此后每月测量一次，直至补充结束。
最初年龄小于12个月的补充微量营养素的婴儿身长增长明显高于安慰剂组，补充结束时相差8.2毫米（年龄别身长Z评分：0.3）。相比之下，最初年龄大于或等于12个月的补充组和安慰剂组之间的身长增长差异不显著。
微量营养素缺乏限制了所研究的墨西哥婴儿的生长。在微量营养素摄入不足的环境中，改善微量营养素摄入应成为促进婴儿生长的干预措施的一部分。
