Effect of zinc on efficacy of iron supplementation in improving iron and zinc status in women.

Phuong Nguyen,Usha Ramakrishnan,Paul Melgar,Reynaldo Martorell,Jessica Marcinkevage,Ruben Grajeda,Rafael Flores

doi:10.1155/2012/216179

Abstract

Iron and zinc may interact in micronutrient supplements and thereby decrease efficacy. We investigated interactive effects of combined zinc and iron supplementation in a randomized controlled trial conducted in 459 Guatemalan women. Four groups were supplemented for 12 weeks: (1) weekly iron and folic acid (IFA); (2) weekly IFA and 30 mg zinc; (3) daily IFA; (4) daily IFA and 15 mg zinc. Effects were assessed by generalized linear regression. Baseline hemoglobin (Hb) concentration was 137.4 ± 15.5 g/L, 13% were anemic and 54% had zinc deficiency. Hb cconcentrations were similar by supplement type, but Hb concentrations improved significantly in anemic women at baseline (increase of 21.8 g/L). Mean percentage changes in serum ferritin were significantly higher in daily compared to weekly supplemented groups (86% versus 32%). The addition of zinc to IFA supplements had no significant impact on iron or zinc status. In conclusion, adding zinc to IFA supplements did not modify efficacy on iron status or improve zinc status, but daily supplementation was more efficacious than weekly in improving iron stores.

Highlights

Women of reproductive age (WRA) in poor countries are at high risk for micronutrient deficiencies, iron and zinc
Four groups were supplemented for 12 weeks: (1) weekly iron and folic acid (IFA); (2) weekly IFA and 30 mg zinc; (3) daily IFA; (4) daily IFA and 15 mg zinc
The objective of this study is to investigate the efficacy of IFA supplements provided daily or weekly with and without zinc on iron and zinc status in a randomized control trial (RCT) carried out in Guatemalan WRA

Summary

Introduction

Women of reproductive age (WRA) in poor countries are at high risk for micronutrient deficiencies, iron and zinc. Some 1.2 billion people worldwide are at risk of inadequate zinc intake and presumably many are zinc deficient [4]. Both iron and zinc deficiencies have adverse consequences for human health. Iron deficiency results in anemia, impaired psychomotor development, reduced physical and work capacity, impaired immunity, and adverse pregnancy outcomes [5]. Zinc deficiency is associated with fertility reduction [6], poor pregnancy outcomes [7], mental and behavioral changes [8], impaired immunity, increased morbidity and mortality [9], and perhaps linear growth retardation [10, 11]

Objectives

Methods

Results