Effect of Zinc and Iron Supplementation on Appetite, Nutritional Status and Intelligence Quotient in Young Children

Aryu Candra Kusumastuti, Martha Ardiaria, Meita Hendrianingtyas

Abstract


BACKGROUND: Lack of appetite in young children leads to growing incidences of physical and mental growth disorders. Supplementation of certain micronutrients can increase appetite and improve nutritional status. This study aims to analyze the effects of zinc and iron supplementation on appetite, nutritional status and intelligence quotient (IQ) in young children.

METHODS: An experimental study withrandomized control group pre/post-test design was conducted in Semarang, Indonesia. A total of 68 children were divided into four groups. The first group was the control group, which was given a placebo; the second group was given a zinc supplement at 10 mg/day; the third group was given an iron supplement at 7.5 mg/day; andthe fourth group was given zinc and iron for three months. Appetite was assessed based on eating frequency and energy intake. Nutritional status was assessed by weight per age (W/A) and height per age (H/A) z score. IQ score was assessed based on Wechsler Preschool and Primary Scale of Intelligence (WPPSI).

RESULTS: Before intervention, low zinc intake was observed in 27.7% of the subjects and low iron intake was observed in 58.5% of them. After intervention, appetite in the second and fourth groups increased. W/A z score increased in the second and third groups. IQ score increased in the third group. No significant effect on H/A z score was observed in all groups.

CONCLUSION: Supplementation of zinc and iron for three months had a positive effect on appetite, body weight and IQ score but no significant effect on body height.

KEYWORDS: appetite, zinc, iron, growth


Full Text:

PDF

References


Kirsty, Hendricks CD. Manual of pediatric nutrition, 4th edition. Ontario: BC Decker; 2005, NLMID.

Lind T, Lönnerdal B, Stenlund H, Gamayanti IL, Ismail D, Seswandhana R, et al. A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: effects on growth and development. Am J Clin Nutr. 2004; 80: 729-36, CrossRef.

Dewi A. Gambaran asupan zat gizi mikro pada balita di Kota Semarang. Journal of Nutrition and Health. 2015; 3(2): n.p.

Eichler K, Wieser S, Rüthemann I, Brugger U. Effects of micronutrient fortified milk and cereal food for infants and children: a systematic review. BMC Public Health. 2012; 12: 506, CrossRef.

Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan RI. Riset Kesehatan Dasar Tahun 2013. Jakarta: Kementrian Kesehatan RI; 2013, article.

Kim SH, Keen CL. Vitamin and mineral supplement use among children attending elementary schools in Korea: a survey of eating habits and dietary consequences. Nutr Res. 2002; 22: 433-48, CrossRef.

Arsenault JE, Romaña DL, Penny ME, Loan MDV, Brown KH. Additional zinc delivered in a liquid supplement, but not in a fortified porridge, increased fat-free mass accrual among young peruvian children with mild-to-moderate stunting. J Nutr. 2008; 138: 108-14, CrossRef.

Gropper SS, Smith JL. Advanced Nutrition and Human Metabolism. 6th edition. Belmont: Wadsworth; 2013, NLMID.

Roche AF, Sun SS. Human Growth: Assessment and Interpretation. New York: Cambridge University Press; 2003, NLMID.

Hoffbrand AV, Moss PAH. Kapita Selekta Hematologi. 6th edition. Jakarta: Penerbit Buku Kedokteran EGC; 2013.

Provan D, Baglin T, Dokal I, Vos JD. Oxford Handbook of Clinical Haematology. 4th edition. Oxford: Oxford University Press; 2015, NLMID.

Hackett M, Melgar-Quiñonez H, Álvarez MC. Household food insecurity associated with stunting and underweight among preschool children in Antioquia, Colombia. Rev Panam Salud Publica. 2009; 25: 506-10, CrossRef.

Pudjiadi S. Ilmu Gizi Klinis Pada Anak. 2nd edition. Jakarta: Fakultas Kedokteran Universitas Indonesia; 1993.

Bryant-Waugh R, Markham L, Kreipe RE, Walsh BT. Feeding and eating disorders in childhood. Int J Eat Disord. 2010; 43: 98-111, CrossRef.

Almatsier S. Prinsip Dasar Ilmu Gizi. Jakarta: Gramedia Pustaka Utama; 2009.

DeSocio JE, O'Toole JK, Nemirow SJ, Lukach ME, Magee MG. Screening for childhood eating disorders in primary care. Prim Care Companion J Clin Psychiatry. 2007; 9: 16-20, CrossRef.

Anisa C. Status gizi dan gambaran hematologi balita. Journal of Nutrition and Health. 2016; 4(1): n.p.

Kelishadi R, Khademian M, Farhangpajouh N, Shahsanaee A, Bahreynian M, Mirshamsi M,. Effects of zinc supplementation on subscales of anorexia in children: A randomized controlled trial. Pak J Med Sci. 2014; 30: 1213-7, CrossRef.

Hidayat A. Seng (zinc) : esensial bagi kesehatan. J Kedokter Trisakti. 1999; 18: 19-26, article.

Suzuki H, Asakawa A, Li JB, Tsai M, Amitani H, Ohinata K, et al. Zinc as an appetite stimulator - the possible role of zinc in the progression of diseases such as cachexia and sarcopenia. Recent Pat Food Nutr Agric. 2011; 3: 226-31, CrossRef.

Yagi T, Asakawa A, Ueda H, Ikeda S, Inui SMA. The role of zinc in the treatment of taste disorders. Recent Pat Food Nutr Agric. 2013; 5: 44-51, CrossRef.

Wasantwisut E, Winichagoon P, Chitchumroonchokchai C, Yamborisut U, Boonpraderm A, Pongcharoen T, et al. Iron and zinc supplementation improved iron and zinc status, but not physical growth, of apparently healthy, breast-fed infants in rural communities of Northeast Thailand. J Nutr. 2006; 136: 2405-11, CrossRef.

Berger J, Ninh N, Khan N, Nhien N, Lien D, Trung NQ, et al. Efficacy of combined iron and zinc supplementation on micronutrient status and growth in Vietnamese infants. Eur J Clin Nutr. 2006; 60: 443-54, CrossRef.

Silva APR, Vitolo MR, Zara LF, Castro CFS. Effects of zinc supplementation on 1- to 5-year old children. J Pediatr (Rio J). 2006; 82: 227-31, CrossRef.

Shakur S, Bano N, Malek MA, Kundu SK, Ahmed AU. Effect of zinc supplementation on appetite, growth & body composition in children suffering from non-specific etiology of feeding refusal with failure to thrive. Orion Med J. 2009; 32: 612-5, article.

Surkan PJ, Charles MK, Katz J, Siegel EH, Khatry SK, LeClerq SC, et al. The role of zinc and iron-folic acid supplementation on early child temperament and eating behaviors in rural Nepal: a randomized controlled trial. PLoS One. 2015; 10: e0114266, CrossRef.

Rerksuppaphol S, Rerksuppaphol L. Effect of zinc plus multivitamin supplementation on growth in school children. Pediatr Int. 2016; 58: 1193-9, CrossRef.

Hasan MI, Hossain SJ, Braat S, Dibley MJ, Fisher J, Grantham-McGregor S, et al. Benefits and risks of Iron interventions in children (BRISC): protocol for a three-arm parallel-group randomised controlled field trial in Bangladesh. BMJ Open. 2017; 7: e018325, CrossRef.

Dijkhuizen MA, Wieringa FT, West CE, Martuti S, Muhilal. Effects of iron and zinc supplementation in Indonesian infants on micronutrient status and growth. J Nutr. 2001; 131: 2860-5, CrossRef.

Moran VH, Lowe NM. Nutrition and the Developing Brain. New York: CRC Press; 2017, NLMID.

Olney DK, Pollitt E, Kariger PK, Khalfan SS, Ali NS, Tielsch JM, et al. Young Zanzibari children with iron deficiency, iron deficiency anemia, stunting, or malaria have lower motor activity scores and spend less time in locomotion. J Nutr. 2007; 137: 2756-62, CrossRef.

Heller S. Get Smart: Samantha Heller's Nutrition Prescription for Boosting Brain Power and Optimizing Total Body Health. Baltimore, Maryland: Johns Hopkins University Press; 2010.

Low M, Farrell A, Biggs BA, Pasricha SR. Effects of daily iron supplementation in primary-school-aged children: systematic review and meta-analysis of randomized controlled trials. CMAJ 2013; 185: E791-802, CrossRef.

Cusick SE, Georgieff MK. The role of nutrition in brain development: the golden opportunity of the “first 1000 days”. J Pediatr. 2016; 175: 16-21, CrossRef.

Georgieff MK. Nutrition and the developing brain: nutrient priorities and measurement. Am J Clin Nutr. 2007; 85: 614S-20S, CrossRef.




DOI: https://doi.org/10.18585/inabj.v10i2.365

Indexed by:

                 

                

                

  

 

The Prodia Education and Research Institute