Effects of iron and zinc supplementation in Indonesian infants on micronutrient status and growth

In this study the effects of supplementation of iron and zinc, alone or com bined, on iron status, zinc status and growth in Indonesian infants is inve stigated. Micronutrient deficiencies are prevalent in infants in developing countries, and deficiencies often coexist; thus, combined supplementation is an attractive strategy. However, little is known about interactions betw een micronutrients. In a randomized, double-blind, placebo-controlled suppl ementation trial, 478 infants, 4 mo of age, were supplemented for 6 mo with iron (10 mg/d), zinc (10 mg/d), iron + zinc (10 mg of each/d) or placebo. Anthropometry was assessed monthly, and micronutrient status was assessed a t the end of supplementation. Supplementation significantly reduced the pre valence of anemia, iron deficiency anemia and zinc deficiency. Iron supplem entation did not negatively affect plasma zinc concentrations, and zinc sup plementation did not increase the prevalence of anemia or iron deficiency a nemia. However, iron supplementation combined with zinc was less effective than iron supplementation alone in reducing the prevalence of anemia (20% v s. 38% reduction) and in increasing hemoglobin and plasma ferritin concentr ations. There were no differences among the groups in growth. The growth of all groups was insufficient to maintain the same Z-scores for height for a ge and weight for height. There is a high prevalence of deficiencies of iro n and zinc in these infants, which can be overcome safely and effectively b y supplementation of iron and zinc combined. However, overcoming these defi ciencies is not sufficient to improve growth performance in these infants.