Penny Mary E, Marin R Margot, Duran Augusto, Peerson Janet M, Lanata Claudio F, Lönnerdal Bo, Black Robert E, Brown Kenneth H
Instituto de Investigación Nutricional, Lima, Perú.
Am J Clin Nutr. 2004 Mar;79(3):457-65. doi: 10.1093/ajcn/79.3.457.
Zinc supplements reduce childhood morbidity in populations in whom zinc deficiency is common. In such populations, deficiencies in other micronutrients may also occur.
The objective was to determine whether the administration of other micronutrients with zinc modifies the effect of zinc supplementation on children's morbidity and physical growth.
Two hundred forty-six children aged 6-35 mo with persistent diarrhea were randomly assigned to 1 of 3 groups to receive a daily supplement of 10 mg Zn alone (Zn; n = 81), zinc plus vitamins and other minerals at 1-2 times recommended daily intakes (Zn+VM; n = 82), or placebo (n = 83) for approximately 6 mo after the diarrhea episode ended. Morbidity information was collected on weekdays. Weight, length, and other anthropometric indicators were measured monthly, and plasma zinc and other indicators of micronutrient status were measured at baseline and 6 mo.
Supplement consumption was high ( approximately 90%) in all groups, although slightly more vomiting was reported in the Zn+VM group (P < 0.0001, analysis of variance). The change in plasma zinc from baseline to 6 mo was greater in the 2 zinc groups (6.1, 27.3, and 16.2 micro g/dL in the placebo, Zn, and Zn+VM groups, respectively; P < 0.0001, analysis of variance). The Zn group had fewer episodes of diarrhea, dysentery, and respiratory illness and a lower prevalence of fever and cough than did the Zn+VM group and a lower prevalence of cough than did the placebo group (P = 0.05). No significant effects of supplementation on growth were observed.
Morbidity was greater after supplementation with zinc plus multivitamins and minerals than it was after supplementation with zinc alone.
在普遍存在锌缺乏的人群中，补充锌可降低儿童发病率。在这类人群中，其他微量营养素缺乏也可能出现。
确定锌与其他微量营养素同时补充是否会改变补充锌对儿童发病率和身体生长的影响。
246名6至35个月大的持续性腹泻儿童被随机分为3组，腹泻发作结束后，分别接受每日仅补充10毫克锌（锌组；n = 81）、锌加推荐每日摄入量1至2倍的维生素和其他矿物质（锌+维生素矿物质组；n = 82）或安慰剂（n = 83），为期约6个月。在工作日收集发病率信息。每月测量体重、身长和其他人体测量指标，在基线和6个月时测量血浆锌和其他微量营养素状况指标。
所有组的补充剂服用率都很高（约90%），尽管锌+维生素矿物质组报告的呕吐情况略多（方差分析，P < 0.0001）。从基线到6个月，两个锌组的血浆锌变化更大（安慰剂组、锌组和锌+维生素矿物质组分别为6.1、27.3和16.2微克/分升；方差分析，P < 0.0001）。与锌+维生素矿物质组相比，锌组的腹泻、痢疾和呼吸道疾病发作次数更少，发热和咳嗽患病率更低；与安慰剂组相比，咳嗽患病率更低（P = 0.05）。未观察到补充剂对生长有显著影响。
与单独补充锌相比，补充锌加多种维生素和矿物质后的发病率更高。
