Effect of Zinc Supplementation on Growth and Body Composition in Children with Sickle Cell Disease

Effect of Zinc Supplementation on Growth
and Body Composition in Children
with Sickle Cell Disease

This section is compiled by Frank M. Painter, D.C.
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FROM: Amer J Clin Nutrit 2002 (Feb);   75 (2):   300–307 ~ FULL TEXT

Babette S Zemel, Deborah A Kawchak, Ellen B Fung,
Kwaku Ohene-Frempong and Virginia A Stallings

From the Divisions of Gastroenterology and Nutrition
and Hematology (KO-F),
The Children's Hospital of Philadelphia,
the University of Pennsylvania School of Medicine,
Philadelphia, and the Division of Hematology,
Oakland Children's Medical Center,
Oakland, CA (EBF).

Background:   Poor growth and delayed maturation in children with sickle cell disease (SCD) may be due, in part, to mild zinc deficiency.

Objective:   The objective was to determine the effects of zinc supplementation on growth and body composition in children with SCD.

Design:   Forty-two prepubertal children (20 girls and 22 boys) aged 4–10 y with SCD-SS were randomly assigned to receive 10 mg elemental Zn/d in cherry syrup (zinc group) or cherry syrup alone (control group). The 2 groups were stratified by sex and initial height status. Dietary intakes were evaluated and anthropometric, high-precision knee-height, and plasma zinc measurements were made at baseline and at 3, 6, and 12 mo. Body composition was determined every 6 mo with dual-energy X-ray absorptiometry, and z scores for anthropometric variables were computed from national reference data. Longitudinal-mixed-effects analysis was used to test for differences between the groups over the 12-mo observation period.

Results:   Thirty-eight children completed the study. No significant differences were observed at baseline. After 12 mo, the zinc group had significantly greater mean (±SE) increases in height (0.66 ± 0.29 cm/y), sitting height (0.97 ± 0.40 cm/y), knee height (3.8 ± 1.2 mm/y), and arm circumference z scores (0.27 ± 0.12 cm/y). Height-for-age and weight-for-age z scores decreased significantly by 0.11 ± 0.04 and 0.13 ± 0.05, respectively, in the control group but did not change significantly in the zinc group.

Conclusions:   Prepubertal children with SCD-SS may have zinc deficiency and may benefit from zinc supplementation to improve linear growth and weight gain.

Key Words:   Sickle cell disease • zinc supplementation • growth • body composition • children

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