Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: a meta-analysis of studies for input to the lives saved tool

Imdad, Aamer; Bhutta, Zulfiqar A.
January 2011
BMC Public Health;2011 Supplement 3, Vol. 11 Issue Suppl 3, p1
Academic Journal
Introduction: Zinc plays an important role in cellular growth, cellular differentiation and metabolism. The results of previous meta-analyses evaluating effect of zinc supplementation on linear growth are inconsistent. We have updated and evaluated the available evidence according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria and tried to explain the difference in results of the previous reviews. Methods: A literature search was done on PubMed, Cochrane Library, IZiNCG database and WHO regional data bases using different terms for zinc and linear growth (height). Data were abstracted in a standardized form. Data were analyzed in two ways i.e. weighted mean difference (effect size) and pooled mean difference for absolute increment in length in centimeters. Random effect models were used for these pooled estimates. We have given our recommendations for effectiveness of zinc supplementation in the form of absolute increment in length (cm) in zinc supplemented group compared to control for input to Live Saves Tool (LiST). Results: There were thirty six studies assessing the effect of zinc supplementation on linear growth in children < 5 years from developing countries. In eleven of these studies, zinc was given in combination with other micronutrients (iron, vitamin A, etc). The final effect size after pooling all the data sets (zinc ± iron etc) showed a significant positive effect of zinc supplementation on linear growth [Effect size: 0.13 (95% CI 0.04, 0.21), random model] in the developing countries. A subgroup analysis by excluding those data sets where zinc was supplemented in combination with iron showed a more pronounced effect of zinc supplementation on linear growth [Weighed mean difference 0.19 (95 % CI 0.08, 0.30), random model]. A subgroup analysis from studies that reported actual increase in length (cm) showed that a dose of 10 mg zinc/day for duration of 24 weeks led to a net a gain of 0.37 (±0.25) cm in zinc supplemented group compared to placebo. This estimate is recommended for inclusion in Lives Saved Tool (LiST) model. Conclusions: Zinc supplementation has a significant positive effect on linear growth, especially when administered alone, and should be included in national strategies to reduce stunting in children < 5 years of age in developing countries.


Related Articles

  • Treatment of severe and moderate acute malnutrition in low- and middle-income settings: a systematic review, meta-analysis and Delphi process. Lenters, Lindsey M.; Wazny, Kerri; Webb, Patrick; Tahmeed Ahmed; Zulfiqar A. Bhutta // BMC Public Health;2013, Vol. 13 Issue Suppl 3, p1 

    Background: Globally, moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) affect approximately 52 million children under five. This systematic review evaluates the effectiveness of interventions for SAM including the World Health Organization (WHO) protocol for inpatient...

  • The World Health Organization's Health Promoting Schools framework: a Cochrane systematic review and meta-analysis. Langford, Rebecca; Bonell, Christopher; Jones, Hayley; Pouliou, Theodora; Murphy, Simon; Waters, Elizabeth; Komro, Kelli; Gibbs, Lisa; Magnus, Daniel; Campbell, Rona // BMC Public Health;2015, Vol. 15 Issue 1, p1 

    Background: Healthy children achieve better educational outcomes which, in turn, are associated with improved health later in life. The World Health Organization's Health Promoting Schools (HPS) framework is a holistic approach to promoting health and educational attainment in school. The...

  • Smoking bans improve child health.  // Archives of Disease in Childhood;Jun2014, Vol. 99 Issue 6, p538 

    The article focuses on studies from Europe and the U.S. which examine the implications of smoking on child health concerning preterm birth, low birth weight and asthma. Topics discussed include a meta-analysis of low birth weight risk, aspects of passive smoking in stimulating premature labour...

  • 30 percent of world's kids malnourished.  // Nation's Health;Mar94, Vol. 24 Issue 3, p15 

    Reports on the health condition of the world's children by the World Health Organization. Percentage of the world's children under five years old who are malnourished and underweight; Geographical breakdown; Decline in the number of protein-energy malnourished children in other countries except...

  • Child and adolescent health and development.  // Weekly Epidemiological Record;2/25/2000, Vol. 75 Issue 8, p65 

    Reports global developments on child and adolescent health (CAH) as of February 2000. Administration of technical briefings in English by the World Health Organization department of CAH; Evolution of strategies for the control of major childhood diseases; Development of instruments to assist...

  • India Has Most Kids with Iron Deficiency: WHO.  // India -- West;3/25/2011, Vol. 36 Issue 18, pA31 

    The article reports on a statement by the World health Organization (WHO) on March 16, 2011 which identifies India as having the world's highest number of children with iron deficiency.

  • Taming the Burgeoning Stroke Epidemic in Africa: Stroke Quadrangle to the Rescue. Owolabi, M. O. // West Indian Medical Journal;Jul2011, Vol. 60 Issue 4, p412 

    Objectives: Globally, stroke is the second leading cause of death. This is a systematic review of the existing literature to examine the burden and profile of stroke in the World Health Organization (WHO) African region and proffer coordinated and responsive means to tackle the epidemic....

  • Obesity detection rate among primary school students in the People's Republic of China: a meta-analysis. Yue-long Jin; Ling-ling Ding; Ying-shui Yao; Xiu-li Song; Hui Tang; Lian-ping He; Yan Chen // Therapeutics & Clinical Risk Management;2013, Vol. 9, p383 

    Background: Obesity has become a major public health problem worldwide. The prevalence of obesity is rising alarmingly among children and adolescents in the People's Republic of China, with an estimated 120 million now in the obese range. It is estimated that 8% of children in the People's...

  • The Limits of Medical Interventions for the Elimination of Preventable Blindness. Goldschmidt, Pablo; Einterz, Ellen // Tropical Medicine & Health;2014, Vol. 42 Issue 1, p43 

    Back ground Health authorities are working toward the global elimination of trachoma by the year 2020 with actions focused on the World Health Organization SAFE strategy (surgery of trichiasis, antibiotics, face washing and environmental changes) with emphasis on hygienist approaches for...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics