The impact of vitamin A supplementation on physical growth of children is dependent on season

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Abstract
OBJECTIVE: To determine the impact of vitamin A supplementation on physical growth in young children. DESIGN: Randomized, double blind, placebo controlled trial. SETTING: Urban slum community clinic. SUBJECTS: 900 children, aged 12–59 months, attending the community clinic with diarrhea of ≤7 d were included in the trial. INTERVENTION: Each child was given a single dose capsule containing 200 000 IU vitamin A or placebo at enrollment. MAIN OUTCOME MEASURES: Mean increments in weight and height during the 90 d period post supplementation. RESULTS: In all children, the mean increments in weight following supplementation were 0.66 kg (s.d. 0.5) and 0.64 kg (s.d. 0.6) in the vitamin A and placebo groups (P=0.5). The mean increments in height were also similar in the two treatment groups (P=0.5). Serum vitamin A was measured in 40 randomly selected children in each group; the proportion of subclinical deficiency (serum retinol P=0.02). In the children supplemented with vitamin A during summer, the mean increment in weight was 140 g more than those who received placebo (95% confidence interval CI 30–250); there was also a significant reduction in the proportion of children who were wasted (<−2 weight-for-height Z-score) at end study (Odds Ratio 0.53, 95% CI 0.28–1.0, P=0.03). There was no significant impact of vitamin A on height increments in children supplemented during summer. CONCLUSION: Vitamin A supplementation in 12–59 month old children improves weight gain in the subsequent three months only in the summer season, but not during the rest of the year. SPONSORSHIP: The study was supported by CDR, World Health Organization and Indian Council of Medical Research.

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