Effects of iron-zinc supplementation on the iron, zinc, and vitamin A status of anaemic pre-school children in Indonesia

The effects of iron-zinc versus iron supplementation on iron, zinc, and vitamin A status were investigated in a double-blind trial. The subjects were 67 pre-school children from among 85 initially enrolled; all had haemoglobin <110 g/L and a height-for-age Z score below -1.5. They were allocated at random to two groups: 33 children received supplementary iron-zinc (30 mg iron and 15 mg zinc per day), and 34 children received supplementary iron (30 mg iron per day) for eight weeks. All subjects initially were dewormed with mebendazole and pyrantel pamoate. The chronically malnourished anaemic children had a low vitamin A status, although 46 had received vitamin A capsules through the government programme three to nine months before the study. At the start of the study, 81/8% of the children had serum retinol values below 0.70 μmol/L. Only 3.2% of the children had serum zinc values below 10.7 μmol/L, and the zinc status appeared to be sufficient. The iron status improved more in the iron-supplemented group than in the iron-zinc supplemented group (p<0.01). A combined iron-zinc supplement was not effective in improving iron status. The change in serum zinc in the iron-zinc-supplemented group was 1.8μmol/L higher (p=0.37) than in the iron-supplemented group. Serum retinol increased significantly in both groups by about 0.16 μmol/L (p<0.001). The changes in retinol status were probably due to the deworming treatment.