Abstract
Objective
Zinc deficiency is very common in developing countries and is more pronounced during an episode of diarrhea. Supplementation with zinc improves diarrhea and might correct zinc deficiency in both the short and longer term.
Method.
We conducted a nested study within a cluster randomized treatment trial. Fifty children with diarrhea living in the zinc treated clusters, 50 children with diarrhea living in control clusters, and 50 healthy children living in the control clusters were enrolled. We assessed serum zinc at the start of the diarrhea episode, which was 1–3 days after supplementation began in zinc treated children, and again one week after the diarrhea ended and supplementation ceased. Baseline characteristics and serum zinc concentration were assessed.
Results.
Serum zinc was low in 44% of healthy children at the first blood draw. Compared to healthy controls, serum zinc was 3.1 mmol/L higher among children with diarrhea who were supplemented with zinc at first blood draw and 1.3mmol/L higher 3 weeks later.
Conclusion.
Zinc supplementation enhances serum zinc concentration when given as a treatment for diarrhea and helps children maintain a more adequate zinc status during the convalescent period.
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References
Brown, KHet al. Assessment of the risk of zinc deficiency in populations.Food and Nutrition Bulletin 2004; 25(1): S130-S162.
WHO, World Health Report 2002:Reducing risks, promoting healthy life. 2002, World Health Organization. Geneva.
Castillo-Duran C, Vial P. and R. Uauy. Trace mineral balance during acute diarrhea in infants.J Pediatr 1988; 113(3): 452–457.
Baqui, AHet al. Effect of zinc supplementation started during diarrhoea on morbidity and mortality in Bangladeshi children: community randomised trial.BMJ 2002; 325(7372): 1059.
Bhutta ZAet al. Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: pooled analysis of randomized controlled trials.Am J Clin Nutr 2000; 72(6): 1516–1522.
Bhutta ZAet al. Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: pooled analysis of randomized controlled trials. Zinc Investigators’ Collaborative Group.J Pediatr 1999; 135(6): 689–697.
WHO and UNICEF.WHO-UNICEF Joint statement on the clinical management of acute diarrhea. inWorld Health Assembly. 2004. Geneva.
Sandstead HH. Zinc deficiency. A public health problem?Am J Dis Child 1991; 145(8):853–859.
Ghishan FK. Transport of electrolytes, water, and glucose in zinc deficiency.J Pediatr Gastroenterol Nutr 1984; 3(4): 608–612.
Roy SK,et al. Impact of zinc supplementation on intestinal permeability in Bangladeshi children with acute diarrhoea and persistent diarrhoea syndrome.J Pediatr Gastroenterol Nutr 1992; 15(3): 289–296.
Jones PE and TJ Peters, Oral zinc supplements in nonresponsive coeliac syndrome: effect on jejunal morphology, enterocyte production, and brush border disaccharidase activities.Gut 1981; 22(3): 194–198.
Ibs, K.H. and L. Rink, Zinc-altered immune function.J. Nutr 2003; 133(5Suppl 1): 1452S-6S.
Bhatnagar Set al. Zinc with oral rehydration therapy reduces stool output and duration of diarrhea in hospitalized children: a randomized controlled trial.J Pediatr Gastroenterol Nutr 2004; 38(1): 34–40.
Bhutta ZA, S.Q. Nizami, and Z. Isani, Zinc supplementation in malnourished children with persistent diarrhea in Pakistan.Pediatrics 1999; 103(4): e42.
Roy SKet al. Impact of zinc supplementation on persistent diarrhoea in malnourished Bangladeshi children.Acta Paediatr 1998; 87(12): p. 1235–1239.
Roy SKet al. Randomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhoea.Arch Dis Child 1997; 77(3): 196–200.
Bhandari Net al. Substantial reduction in severe diarrheal morbidity by daily zinc supplementation in young north Indian children.Pediatrics 2002; 109(6): e86.
Brown, K.H., Effect of infections on plasma zinc concentration and implications for zinc status assessment in low-income countries.Am J Clin Nutr 1998; 68(2 Suppl): 425S-429S.
Raqib Ret al. Effect of zinc supplementation on immune and inflammatory responses in pediatric patients with shigellosis.Am J Clin Nutr 2004; 79(3): 444–450.
Strand TAet al. Predictors of plasma zinc concentrations in children with acute diarrhea.Am J Clin Nutr 2004; 79(3): 451–456.
Lowe, NMet al. Kinetic parameters and plasma zinc concentration correlate well with net loss and gain of zinc from men.J Nutr 2004; 134(9): 2178–2181.
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Baqui, A.H., Black, R.E., Fischer Walker, C.L. et al. Zinc supplementation and serum zinc during diarrhea. Indian J Pediatr 73, 493–497 (2006). https://doi.org/10.1007/BF02759893
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DOI: https://doi.org/10.1007/BF02759893