Micronutrients and child health: Studies in international nutrition and HIV infection

Increasing data link micronutrient deficiencies to excess childhood morbidi ty and mortality, and similar relationships have been noted in the study of nutrition and HIV infection. We review epidemiologic studies that have exa mined the relationship between micronutrient deficiencies and health outcom es in childhood and HIV infection, as well as clinical trials of micronutri ent supplementation. Vitamin A supplementation among communities at risk of deficiency effectively reduces mortality and morbidity in children younger than age 5, and vitamin A may be especially effective in HIV-infected chil dren. Vertical transmission of HIV has not to date been affected by materna l micronutrient supplementation. In children with poor dietary zinc intake and/or bioavailability, zinc supplementation reduces the incidence and seve rity of diarrheal diseases, as well as the occurrence of pneumonia. Vitamin A therapy has not been associated with improved growth, whereas some trial s have shown that zinc supplementation is associated with greater increment s in height. Further trials of micronutrient supplementation are warranted.