|De Romana, Daniel|
|Van Loan, Marta|
Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/3/2007
Publication Date: 11/20/2008
Publication URL: http://jn.nutrition.org/content/138/1/108.long
Citation: Arsenault, J., De Romana, D.L., Penny, M., Van Loan, M.D., Brown, K. 2008. Effect of additional zinc, delivered in a fortified food or liquid supplement, on energy intake, appetite and body composition of Young Peruvian children. Journal of Nutrition. 85(2):538-47. Interpretive Summary: Improved zinc status has been associated with improved immune function, a reduction in inflammation, improved appetite and other conditions. However, the way in which zinc works to enhance these systems is not clear. We examined a group of infants in Peru with limited zinc nutrition and followed them through the course of a zinc fortification program. Zinc was given to the infants either as a liquid supplement or in cooked cereal. After 2-3 months of intervention there was no improvement in food intake, appetite or measures of growth in the total group. However, in infants who were mild to moderately growth stunted zinc fortification did increase food intake, appetite and lean body mass. Perhaps the majority of the infants were not severely zinc deficient and, therefore, did not respond to the fortification program. Another possibility is that the zinc fortification was not high enough to result in any improvement. But it was clear that for infants with growth stunting zinc fortification was beneficial.
Technical Abstract: The exact mechanism whereby zinc influences growth is unknown, although it has been postulated that zinc may stimulate appetite and energy intake or enhance lean mass accrual directly. We compared energy intake, reported appetite, and body composition of 6-8 mo old Peruvian children with initial length-for-age Z-score < -0.5 SD who were randomly assigned to receive daily for 6 mo: 1) 3 mg/d zinc in a liquid supplement (ZnSuppl); 2) 3 mg/d of zinc in a porridge (ZnFort); or 3) no extra zinc in either the porridge or supplement (Control). There were no group-wise differences in changes in dietary energy intakes (at 2-3 mo) or body composition (at 6 mo), nor in the prevalence of reported poor appetite during the 6 mo. Children with an initial length-for-age Z-score < -1 SD who received zinc in the liquid form had a greater increase in lean body mass than children not receiving zinc. In conclusion, daily provision of 3 mg of supplemental zinc did not result in greater increases in energy intake or reported appetite except among children with initial mild-to-moderate stunting, those who received the zinc supplement had a greater increase in lean body mass than those not receiving zinc. It is possible that the majority of this population was not zinc deficient or the dose provided was inadequate. Further research is needed on the optimal level of zinc fortification that will result in improved health outcomes in populations with high rates of zinc deficiency.