Zinc Supplementation Improves the Growth of Stunted Rural Guatemalan Infants

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Abstract
The impact of zinc supplementation on the growth and body composition of Guatemalan infants was assessed in a community-based, double-blind intervention trial. Infants aged 6–9 mo were assigned randomly to receive 4 mL of a beverage containing 10 mg of zinc as zinc sulfate (n = 45) or a placebo (n = 44) daily (7 d/wk) for an average of 6.9 mo. The children's weight, length, mid-upper arm and head circumferences, and triceps skinfolds were measured at baseline and at 1–2 mo intervals until the end of supplementation. Midarm muscle area (MMA) was derived from the mid-upper arm circumference and triceps skinfolds measurements. Maternal anthropometry and family socioeconomic and demographic characteristics also were obtained. Zinc supplementation was associated with an overall increase of 0.61 cm2 in MMA (P = 0.02). Children who received zinc supplements had a mean length increment that was 0.75 cm greater than those who did not (P = 0.12). However, there was a significant interaction between treatment group and initial length-for-age status (P = 0.04), such that supplemented children who were stunted at baseline (length-for-age Z score less than −2) gained 1.40 cm more than stunted children who received the placebo. We conclude that zinc supplementation of these rural Guatemalan infants during 6.9 mo increased accretion of fat-free mass and enhanced the linear growth of those who were stunted at baseline. Further research is required to determine whether zinc supplementation during longer periods of time may achieve larger and more generalized effects on physical growth.