TY - JOUR
T1 - Antenatal supplementation with folic acid + iron + zinc improves linear growth and reduces peripheral adiposity in school-age children in rural Nepal
AU - Stewart, Christine P.
AU - Christian, Parul
AU - LeClerq, Steven C.
AU - West, Keith P.
AU - Khatry, Subarna K.
PY - 2009/7/1
Y1 - 2009/7/1
N2 - Background: We previously reported that a randomized controlled trial of antenatal micronutrient supplements in rural Nepal decreased the risk of low birth weight by ≈15%. Objective: The objective was to examine the effects of micronutrient supplementation on growth and body composition in children of supplemented mothers through school age. Design: Mothers received 1 of 5 micronutrient supplements daily: folic acid, folic acid + iron, folic acid + iron + zinc, multiple micronutrients, or a control. All of the supplements contained vitamin A. Children born during this trial were revisited at age 6-8 y to measure height, weight, midupper arm circumference, waist circumference, and triceps and subscapular skinfold thicknesses. Arm fat and muscle area were estimated by using standard formulas, and height-for-age, weight-for-age, and body mass index-for-age z scores were calculated by using the World Health Organization growth standard. Results: Of the 3771 surviving children, 3324 were revisited and consented to anthropometric measurements. Maternal supplementation with folic acid + iron + zinc resulted in an increase in mean height (0.64 cm; 95% CI: 0.04, 1.25) and a reduction in mean triceps skinfold thickness (20.25 mm; 95% CI: 20.44, 20.06), subscapular skinfold thickness (20.20 mm; 95% CI: 20.33, 20.06), and arm fat area (20.18 cm2; -0.34, -0.01). No significant differences were found between groups in mean weight or body mass index-for-age z scores, waist circumference, or arm muscle area. Other micronutrient combinations including a multiple micronutrient formulation failed to show a growth benefit. Conclusion: Antenatal supplementation with zinc may benefit child growth, particularly in areas where a deficiency of this nutrient is common.
AB - Background: We previously reported that a randomized controlled trial of antenatal micronutrient supplements in rural Nepal decreased the risk of low birth weight by ≈15%. Objective: The objective was to examine the effects of micronutrient supplementation on growth and body composition in children of supplemented mothers through school age. Design: Mothers received 1 of 5 micronutrient supplements daily: folic acid, folic acid + iron, folic acid + iron + zinc, multiple micronutrients, or a control. All of the supplements contained vitamin A. Children born during this trial were revisited at age 6-8 y to measure height, weight, midupper arm circumference, waist circumference, and triceps and subscapular skinfold thicknesses. Arm fat and muscle area were estimated by using standard formulas, and height-for-age, weight-for-age, and body mass index-for-age z scores were calculated by using the World Health Organization growth standard. Results: Of the 3771 surviving children, 3324 were revisited and consented to anthropometric measurements. Maternal supplementation with folic acid + iron + zinc resulted in an increase in mean height (0.64 cm; 95% CI: 0.04, 1.25) and a reduction in mean triceps skinfold thickness (20.25 mm; 95% CI: 20.44, 20.06), subscapular skinfold thickness (20.20 mm; 95% CI: 20.33, 20.06), and arm fat area (20.18 cm2; -0.34, -0.01). No significant differences were found between groups in mean weight or body mass index-for-age z scores, waist circumference, or arm muscle area. Other micronutrient combinations including a multiple micronutrient formulation failed to show a growth benefit. Conclusion: Antenatal supplementation with zinc may benefit child growth, particularly in areas where a deficiency of this nutrient is common.
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U2 - 10.3945/ajcn.2008.27368
DO - 10.3945/ajcn.2008.27368
M3 - Article
C2 - 19474130
AN - SCOPUS:67649846461
SN - 0002-9165
VL - 90
SP - 132
EP - 140
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 1
ER -