A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: Effects on growth and development

Torbjörn Lind, Bo Lönnerdal, Hans Stenlund, Indria L. Gamayanti, Djauhar Ismail, Rosadi Seswandhana, Lars Åke Persson

Research output: Contribution to journalArticle

133 Citations (Scopus)

Abstract

Background: Deficiencies of iron and zinc are associated with delayed development, growth faltering, and increased infectious-disease morbidity during infancy and childhood. Combined iron and zinc supplementation may therefore be a logical preventive strategy. Objective: The objective of the study was to compare the effects of combined iron and zinc supplementation in infancy with the effects of iron and zinc as single micronutrients on growth, psychomotor development, and incidence of infectious disease. Design: Indonesian infants (n = 680) were randomly assigned to daily supplementation with 10 mg Fe (Fe group), 10 mg Zn (Zn group), 10 mg Fe and 10 mg Zn (Fe+Zn group), or placebo from 6 to 12 mo of age. Anthropometric indexes, developmental indexes (Bayley Scales of Infant Development; BSID), and morbidity were recorded. Results: At 12 mo, two-factor analysis of variance showed a significant interaction between iron and zinc for weight-for-age z score, knee-heel length, and BSID psychomotor development. Weight-for-age z score was higher in the Zn group than in the placebo and Fe+Zn groups, knee-heel length was higher in the Zn and Fe groups than in the placebo group, and the BSID psychomotor development index was higher in the Fe group than in the placebo group. No significant effect on morbidity was found. Conclusions: Single supplementation with zinc significantly improved growth, and single supplementation with iron significantly improved growth and psychomotor development, but combined supplementation with iron and zinc had no significant effect on growth or development. Combined, simultaneous supplementation with iron and zinc to infants cannot be routinely recommended at the iron-to-zinc ratio used in this study.

Original languageEnglish (US)
Pages (from-to)729-736
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Volume80
Issue number3
StatePublished - Sep 2004

Fingerprint

Growth and Development
Zinc
growth and development
Iron
Randomized Controlled Trials
zinc
psychomotor development
iron
placebos
Placebos
morbidity
Heel
knees
infancy
Morbidity
infectious diseases
Communicable Diseases
Knee
infant development
Weights and Measures

Keywords

  • Development
  • Growth
  • Indonesia
  • Infants
  • Iron
  • Knee-heel length
  • Randomized controlled trial
  • Zinc

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Lind, T., Lönnerdal, B., Stenlund, H., Gamayanti, I. L., Ismail, D., Seswandhana, R., & Persson, L. Å. (2004). A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: Effects on growth and development. American Journal of Clinical Nutrition, 80(3), 729-736.

A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants : Effects on growth and development. / Lind, Torbjörn; Lönnerdal, Bo; Stenlund, Hans; Gamayanti, Indria L.; Ismail, Djauhar; Seswandhana, Rosadi; Persson, Lars Åke.

In: American Journal of Clinical Nutrition, Vol. 80, No. 3, 09.2004, p. 729-736.

Research output: Contribution to journalArticle

Lind, T, Lönnerdal, B, Stenlund, H, Gamayanti, IL, Ismail, D, Seswandhana, R & Persson, LÅ 2004, 'A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: Effects on growth and development', American Journal of Clinical Nutrition, vol. 80, no. 3, pp. 729-736.
Lind, Torbjörn ; Lönnerdal, Bo ; Stenlund, Hans ; Gamayanti, Indria L. ; Ismail, Djauhar ; Seswandhana, Rosadi ; Persson, Lars Åke. / A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants : Effects on growth and development. In: American Journal of Clinical Nutrition. 2004 ; Vol. 80, No. 3. pp. 729-736.
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abstract = "Background: Deficiencies of iron and zinc are associated with delayed development, growth faltering, and increased infectious-disease morbidity during infancy and childhood. Combined iron and zinc supplementation may therefore be a logical preventive strategy. Objective: The objective of the study was to compare the effects of combined iron and zinc supplementation in infancy with the effects of iron and zinc as single micronutrients on growth, psychomotor development, and incidence of infectious disease. Design: Indonesian infants (n = 680) were randomly assigned to daily supplementation with 10 mg Fe (Fe group), 10 mg Zn (Zn group), 10 mg Fe and 10 mg Zn (Fe+Zn group), or placebo from 6 to 12 mo of age. Anthropometric indexes, developmental indexes (Bayley Scales of Infant Development; BSID), and morbidity were recorded. Results: At 12 mo, two-factor analysis of variance showed a significant interaction between iron and zinc for weight-for-age z score, knee-heel length, and BSID psychomotor development. Weight-for-age z score was higher in the Zn group than in the placebo and Fe+Zn groups, knee-heel length was higher in the Zn and Fe groups than in the placebo group, and the BSID psychomotor development index was higher in the Fe group than in the placebo group. No significant effect on morbidity was found. Conclusions: Single supplementation with zinc significantly improved growth, and single supplementation with iron significantly improved growth and psychomotor development, but combined supplementation with iron and zinc had no significant effect on growth or development. Combined, simultaneous supplementation with iron and zinc to infants cannot be routinely recommended at the iron-to-zinc ratio used in this study.",
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AU - Lind, Torbjörn

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AU - Gamayanti, Indria L.

AU - Ismail, Djauhar

AU - Seswandhana, Rosadi

AU - Persson, Lars Åke

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N2 - Background: Deficiencies of iron and zinc are associated with delayed development, growth faltering, and increased infectious-disease morbidity during infancy and childhood. Combined iron and zinc supplementation may therefore be a logical preventive strategy. Objective: The objective of the study was to compare the effects of combined iron and zinc supplementation in infancy with the effects of iron and zinc as single micronutrients on growth, psychomotor development, and incidence of infectious disease. Design: Indonesian infants (n = 680) were randomly assigned to daily supplementation with 10 mg Fe (Fe group), 10 mg Zn (Zn group), 10 mg Fe and 10 mg Zn (Fe+Zn group), or placebo from 6 to 12 mo of age. Anthropometric indexes, developmental indexes (Bayley Scales of Infant Development; BSID), and morbidity were recorded. Results: At 12 mo, two-factor analysis of variance showed a significant interaction between iron and zinc for weight-for-age z score, knee-heel length, and BSID psychomotor development. Weight-for-age z score was higher in the Zn group than in the placebo and Fe+Zn groups, knee-heel length was higher in the Zn and Fe groups than in the placebo group, and the BSID psychomotor development index was higher in the Fe group than in the placebo group. No significant effect on morbidity was found. Conclusions: Single supplementation with zinc significantly improved growth, and single supplementation with iron significantly improved growth and psychomotor development, but combined supplementation with iron and zinc had no significant effect on growth or development. Combined, simultaneous supplementation with iron and zinc to infants cannot be routinely recommended at the iron-to-zinc ratio used in this study.

AB - Background: Deficiencies of iron and zinc are associated with delayed development, growth faltering, and increased infectious-disease morbidity during infancy and childhood. Combined iron and zinc supplementation may therefore be a logical preventive strategy. Objective: The objective of the study was to compare the effects of combined iron and zinc supplementation in infancy with the effects of iron and zinc as single micronutrients on growth, psychomotor development, and incidence of infectious disease. Design: Indonesian infants (n = 680) were randomly assigned to daily supplementation with 10 mg Fe (Fe group), 10 mg Zn (Zn group), 10 mg Fe and 10 mg Zn (Fe+Zn group), or placebo from 6 to 12 mo of age. Anthropometric indexes, developmental indexes (Bayley Scales of Infant Development; BSID), and morbidity were recorded. Results: At 12 mo, two-factor analysis of variance showed a significant interaction between iron and zinc for weight-for-age z score, knee-heel length, and BSID psychomotor development. Weight-for-age z score was higher in the Zn group than in the placebo and Fe+Zn groups, knee-heel length was higher in the Zn and Fe groups than in the placebo group, and the BSID psychomotor development index was higher in the Fe group than in the placebo group. No significant effect on morbidity was found. Conclusions: Single supplementation with zinc significantly improved growth, and single supplementation with iron significantly improved growth and psychomotor development, but combined supplementation with iron and zinc had no significant effect on growth or development. Combined, simultaneous supplementation with iron and zinc to infants cannot be routinely recommended at the iron-to-zinc ratio used in this study.

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