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A trial of zinc supplementation in young rural Gambian children

Published online by Cambridge University Press:  09 March 2007

C. J. Bates ,
P. H. Bates ,
M. Dardenne ,
A. Prentice ,
P. G. Lunn ,
C. A. Northrop-Clewes ,
S. Hoare ,
T. J. Cole ,
S. J. Horan  and
S. C. Longman
...Show all authors
C. J. Bates
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
P. H. Bates
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
M. Dardenne
Affiliation:
Immunologie Clinique, Hôpital Necker, 161 Rue de Sèvres, 75743, Paris, Cedex 15, France
A. Prentice
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
P. G. Lunn
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
C. A. Northrop-Clewes
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
S. Hoare
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
T. J. Cole
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
S. J. Horan
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
S. C. Longman
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
D. Stirling
Affiliation:
MRC Dunn Nutrition Unit, Milton Road, Cambridge CB4 1XJ and Keneba, The Gambia, W. Africa
P. J. Aggett
Affiliation:
AFRC Institute of Food Research, Norwich Laboratory, Colney Lane, Norwich NR4 7UA
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Abstract

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The present study tested the hypothesis that inadequate Zn intake might be responsible for failure to thrive and impaired catch-up growth in young rural Gambian children, and that Zn supplements might be beneficial. Gambian children might be deprived of Zn because of its poor availability from their predominantly plant-based diet. Rural Gambian children (110; fifty boys, sixty girls) aged between 0.57 and 2.30 years were divided into two matched groups, one to receive 70 mg Zn twice weekly for 1.25 years, and the other a placebo. Growth and mid-upper-arm circumference were measured at weekly intervals throughout the study and illnesses were monitored. Capillary blood and urine samples were collected at 0, 2 and 8 weeks. Body weights and arm circumferences showed a linear increase, plus a seasonal effect (rainy season faltering). For body weight there was no significant overall effect of the supplement. For arm circumference, a very small (2 %) but significant (P < 0.01) difference favoured the supplemented group. Plasma thymulin was much lower at the first clinic than at the second and third clinics, and in vitro Zn stimulation was greater at the first clinic. There was, however, no effect of Zn in vivo. Likewise, Zn did not significantly benefit T-cell numbers or ratios, secretory IgA in urine, circulating hormone levels or biochemical indices of Zn status. One index of intestinal permeability, i.e. lactulose: creatinine, was improved (P < 0.02) by the supplement, but the lactulose: mannitol value was not; this requires further investigation. Dietary Zn deficiency is, thus, unlikely to be of major overall importance for rural Gambian children's ability to thrive, and blanket Zn supplementation is not justified. There may, however, be vulnerable sub-groups who would benefit from Zn supplements.

Keywords

ZincInfantsSupplementationGrowthThymulin
Type
Micronutrient Supplementation and the Incidence of Deficiency
Information
British Journal of Nutrition , Volume 69 , Issue 1 , January 1993 , pp. 243 - 255
Copyright
Copyright © The Nutrition Society 1993

References

REFERENCES

Aggett, P. J. (1990). Malnutrition and trace element metabolism. In The Malnourished Child. Nestlé Nurrition Workshop Series no. 18, pp. 155–176 [Suskind, R. M. and Lewinter-Suskind, L., editors]. New York: Vevey/Raven Press Ltd.Google Scholar
Anderson, M. G. & Kelly, A. M. (1981). Serum ferritin by a rapid and inexpensive ELISA method. Clinica Chimica Acta 116, 405–408.CrossRefGoogle ScholarPubMed
Bates, C. J. & Tsuchiya, H. (1990). Zinc in breast milk during prolonged lactation: comparison between the UK and The Gambia. European Journal of Clinical Nutrition 44, 61–69.Google ScholarPubMed
Behrens, R. H., Tomkins, A. M. & Roy, S. K. (1990). Zinc supplementation during diarrhoea, a fortification during malnutrition? Lancet ii, 442–443.CrossRefGoogle Scholar
Bray, T. M. & Bettger, W. J. (1990). The physiological role of zinc as an antioxidant. Free Radicals in Biology and Medicine 8, 281–291.CrossRefGoogle ScholarPubMed
Brinchmann, J. E., Vartdal, F., Gaudernack, G., Markussen, G., Funderud, S., Ugelstad, J. & Thorsby, E. (1988). Direct immunomagnetic quantification of lymphocyte subsets in blood. Clinical and Experimental Immunology 71, 182–186.Google ScholarPubMed
Calvin, J. & Price, C. P. (1986). Measurement of serum a1-antichymotrypsin by immunoturbidimetry. Annals of Clinical Biochemistry 23, 206–209.CrossRefGoogle Scholar
Castillo-Duran, C., Heresi, G., Fisberg, M. & Uauy, R. (1987). Controlled trial of zinc supplementation during recovery from malnutrition: effects on growth and immune function. American Journal of Clinical Nutrition 45, 602–608.CrossRefGoogle ScholarPubMed
Dardenne, M. & Bach, J. F. (1975). The sheep cell rosette assay for the evaluation of thymic hormones. In Biological Activity of Thymic Hormones, pp. 235–243 [Van Bekkum, D., editor]. Rotterdam: Kooyer Scientific Publications.Google Scholar
Dardenne, M., Pleau, J. M. & Nabarra, P. (1982 a). Contribution of zinc and other metals to the biological activity of the serum thymic factor. Proceedings of the National Academy of Sciences, USA 79, 5370–5373.CrossRefGoogle Scholar
Dardenne, M., Pleau, J. M. & Savino, W. (1982 b). Monoclonal antibody against the serum thymic factor (FTS). Immunology Letters 48, 61–64.Google Scholar
Department of Health (1991). Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy. London: H.M. Stationery Office.Google Scholar
Ferguson, E. L., Gibson, R. S., Thompson, L. U. & Ounpuu, S. (1989). Dietary calcium, phytate and zinc intakes and the calcium, phytate and zinc molar ratios of the diets of a selected group of East African children. American Journal of Clinical Nutrition 50, 1450–1456.CrossRefGoogle ScholarPubMed
Fraker, P. J., Gershwin, M. E., Good, R. A. & Prasad, A. S. (1986). Interrelationship between zinc and immune function. Federation Proceedings 45, 1474–1479.Google ScholarPubMed
Gatheru, Z., Kinoti, S., Alwar, J. & Mwita, M. (1988). Serum zinc levels in children with kwashiorkor aged one to three years at Kenyatta National Hospital and the effect of zinc supplementation during recovery. East African Medical Journal 65, 670–679.Google ScholarPubMed
Ghavami-Maibodi, S. Z., Collipp, P. J., Castro-Magana, M. C., Stewart, C. & Chen, Y. (1983). Effect of oral zinc supplements on growth, hormonal levels and zinc in healthy short children. Annals of Nutrition and Metabolism 27, 214–219.CrossRefGoogle ScholarPubMed
Golden, B. E. (1988). Zinc in cell division and tissue growth: physiological aspects. In Zinc in Human Biology, pp. 119–128 [Mills, C. F., editor]. Berlin: Springer-Verlag.Google Scholar
Golden, M. H. N. & Golden, B. E. (1981). Effect of zinc supplementation on the dietary intake, rate of weight gain, and energy cost of tissue disposition in children recovering from severe malnutrition. American Journal of Clinical Nutrition 34, 906–908.Google Scholar
Hambidge, K. M. (1988). Mild zinc deficiency in human subjects. In Zinc in Human Biology, pp. 281–296 [Mills, C. F., editor]. Berlin: Springer-Verlag.Google Scholar
Ho, K.-C. & Pang, C. P. (1989). Automated analysis of urinary hydroxyproline. Clinica Chimica Acta 185, 191–196.CrossRefGoogle ScholarPubMed
Kruse-Jarres, J. D. (1989). The significance of zinc for humoral and cellular immunity. Journal of Trace Elements and Electrolytes in Health and Disease 3, 1–8.Google ScholarPubMed
Levine, J. B. (1974). Determination in blood with automated analyzers. In Methods of Enzymatic Analysis, 2nd ed., vol. 2. pp. 856–870 [Bergmeyer, H. U., editor]. New York: Academic Press.Google Scholar
Lunn, P. G., Northrop-Clewes, C. A. & Downes, R. M. (1991). Recent developments in the nutritional management of diarrhoea. 2. Chronic diarrhoea and malnutrition in The Gambia: studies on intestinal permeability. Transactions of the Royal Society of Tropical Medicine & Hygiene 85, 8–11.CrossRefGoogle ScholarPubMed
McClain, C. J., Kasarskis, E. J. & Allen, J. J. (1985). Functional consequences of zinc deficiency. Progress in Food and Nutrition Science 9, 185–226.Google ScholarPubMed
Northrop, C. A., Lunn, P. G. & Behrens, R. H. (1990). Automated enzymatic assays for the determination of intestinal permeability probes in urine. 1. Lactulose and lactose. Clinica Chimica Acta 187, 79–88.CrossRefGoogle ScholarPubMed
Prasad, A. S. (1991). Discovery of human zinc deficiency and studies in an experimental human model. American Journal of Clinical Nutrition 53, 403–412.CrossRefGoogle Scholar
Prasad, A. S., Meftah, S. & Abdallah, J. (1988). Serum thymulin in human zinc deficiency. Journal of Clinical Investigation 82, 1202–1210.CrossRefGoogle ScholarPubMed
Prentice, A., Prentice, A. M., Cole, T. J., Paul, A. A. & Whitehead, R. G. (1984). Breast-milk antimicrobial factors of rural Gambian mothers. 1. Influence of stage of lactation and maternal plane of nutrition. Acta Paediatrica Scandinavica 73, 796–802.CrossRefGoogle ScholarPubMed
Prentice, A., Stirling, D. M., Sullivan, P. B., Northrop-Clewes, C. A. & Lunn, P. G. (1991). Raised urinary secretory IgA in chronic diarrhoea. Archives of Disease in Childhood 66, 223–226.CrossRefGoogle ScholarPubMed
Rowland, M. G. M., Cole, T. J. & Whitehead, R. G. (1977). A quantitative study into the role of infection in determining nutritional status in Gambian village children. British Journal of Nutrition 37, 441–450.CrossRefGoogle ScholarPubMed
Roy, S. K., Behrens, R. H., Haider, R., Akramuzzaman, S. M., Mahalanabis, D., Wahed, M. A. & Tomkins, A. M. (1992). Impact of zinc supplementation on intestinal permeability in Bangladeshi children with acute diarrhoea and persistent diarrhoea syndrome. Journal of Pediatric Gastroenterology and Nutrition 15, 289–296.Google ScholarPubMed
Sachdev, H. P. S., Mittal, N. K., Mittal, S. K. & Yadav, H. S. (1988). A controlled trial on utility of oral zinc supplementation on acute dehydrating diarrhea in infants. Journal of Pediatric Gastroenterology and Nutrition 7, 877–881.Google ScholarPubMed
Shaw, J. C. L., Bury, A. J., Barber, A., Mann, L. & Taylor, A. (1982). A micromethod for the analysis of zinc in plasma or serum by atomic absorption spectrophotometry using graphite furnace. Clinica Chimica Acta 118, 229–239.CrossRefGoogle ScholarPubMed
Simmer, K.. Khanum, S., Carlsson, L. & Thompson, R. P. H. (1988). Nutritional rehabilitation in Bangladesh – the importance of zinc. American Journal of Clinical Nutrition 41, 1036–1040.CrossRefGoogle Scholar
Tanner, J. M., Whitehouse, R. H. & Takaishi, M. (1966). Standards from birth to maturity for height, weight, height velocity and weight velocity: British children, 1965, part II. Archives of Disease in Childhood 41, 613–635.CrossRefGoogle ScholarPubMed
Walravens, P. A., Hambidge, K. M. & Koepfer, D. M. (1989). Zinc supplementation in infants with a nutritional pattern of failure to thrive: a double-blind controlled study. Pediatrics 83, 532–538.CrossRefGoogle ScholarPubMed
Watkinson, M., Aggett, P. J. & Cole, T. J. (1985). Zinc and acute tropical ulcers in Gambian children and adolescents. American Journal of Clinical Nutrition 41, 43–51.CrossRefGoogle ScholarPubMed
Weismann, K. & Hoyer, H. (1985). Serum alkaline phosphatase and serum zinc levels in the diagnosis and exclusion of zinc deficiency in man. American Journal of Clinical Nutrition 41, 1214–1219.CrossRefGoogle ScholarPubMed
Wheeler, C. R., Salzman, J. A., El-Sayed, N. M., Omaye, S. T. & Korte, D. W. (1990). Automated assays for superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase activity. Analytical Biochemistry 184, 193–199.CrossRefGoogle ScholarPubMed
Yardrick, M. K., Kenney, M. A. & Winterfeldt, E. A. (1989). Iron, copper and zinc status: response to supplementation with zinc and iron in adult females. American Journal of Clinical Nutrition 49, 145–150.CrossRefGoogle Scholar