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Table 4 Summary of results for zinc fortification in children

From: Micronutrient fortification of food and its impact on woman and child health: a systematic review

Outcome/
quality of evidence
Combined effect Age groups Zinc compound used for fortification Food vehicle Duration
Newborns with very low birth weight Full term healthy infants Infants at risk of stunting Malnourished infants School-going children School-going children with asymptomatic zinc deficiency Zinc sulfate Zinc chloride Zinc acetate Milk products Cereal products Less than 6 months 6 months or more
Serum zinc levels SMD: 1.28 (95% CI: 0.56, 2.01) SMD: 0.51 (95% CI: -0.32, 1.34) SMD: 3.49 (95% CI: -0.36, 7.33) SMD: 0.09 (95% CI: -0.24, 0.41) SMD: 0.12 (95% CI: -0.55, 0.78) SMD: 1.12 (95% CI: -0.21, 2.46) SMD: 2.77 (95% CI: 1.43, 4.11) No studies identified No studies identified No studies identified SMD: 1.46 (95% CI: 0.26, 2.66) SMD: 1.16 (95% CI: 0.08, 2.24) SMD: 1.48 (95% CI: 0.57, 2.39) SMD: 1.51 (95% CI: 0.13, 2.89)
Quality of evidence: Moderate   2 studies 64 participants 2 studies 71 infants 1 study 147 infants 1 study 35 infants 2 studies 347 participants 1 study 19 children     5 studies 176 participants 4 studies 513 participants 4 studies 381 participants 4 studies 155 participants
Hemoglobin level SMD: -0.11 (95% CI: -0.52, 0.31) No studies identified No studies identified No studies identified f No studies identified No studies identified No studies identified SMD: 0.00 (95% CI: -0.67, 0.67) SMD: -0.39 (95% CI: -1.03, 0.24) SMD: 0.28 (95% CI: -0.62, 1.19) SMD: -0.21 (95% CI: -0.67, 0.25) SMD: 0.28 (95% CI: -0.62, 1.19) No studies identified No studies identified
Quality of evidence: Low         1 study 34 children 1 study 39 children 1 study 19 children 2 studies 73 participants 1 study 19 participants   
Serum copper levels SMD: 0.57 (95% CI: -0.91, 2.06) No studies identified SMD: 0.75 (95% CI: -1.65, 3.16) No studies identified SMD: 0.21 (95% CI: -0.46, 0.87) No studies identified No studies identified No studies identified No studies identified No studies identified SMD: 0.57 (95% CI: -0.91, 2.06) SMD: -0.61 (95% CI: -1.54, 0.31) No studies identified No studies identified
Quality of evidence: Very low    3 studies 126 infants   1 study 35 infants       3 studies 142 participants 1 study 19 participants   
Serum alkaline phosphatase levels SMD: 0.94 (95% CI: -0.29, 2.17) No studies identified SMD: 0.68 (95% CI: -0.90, 2.25) No studies identified No studies identified No studies identified SMD: 1.56 (95% CI: 0.50, 2.62) No studies identified No studies identified No studies identified SMD: 0.68 (95% CI: -0.90, 2.25) SMD: 1.56 (95% CI: 0.50, 2.62) No studies identified No studies identified
Quality of evidence: Low    2 studies 100 infants     1 study 19 children     2 studies 100 participants 1 study 19 participants   
Weight gain SMD: 0.50 (95% CI: -0.12, 1.11) SMD: 0.33 (95% CI: -0.33, 0.99) SMD: 1.48 (95% CI: -1.49, 4.45) SMD: 0.00 (95% CI: -0.30, 0.30) SMD: -0.10 (95% CI: -0.73, 0.52) SMD: 0.25 (95% CI: -0.17, 0.67) No studies identified No studies identified No studies identified No studies identified SMD: 0.77 (95% CI: -0.43, 1.96) SMD: 0.08 (95% CI:-0.16, 0.33) No studies identified No studies identified
Quality of evidence: Moderate   1 study 36 infants 2 studies 80 infants 1 study 176 infants 1 study 39 infants 1 study 88 children      4 studies 155 participants 2 studies 264 participants   
Height growth SMD: 0.52 (95% CI: 0.01, 1.04) SMD: 0.70 (95% CI: 0.02, 1.37) SMD: -0.48 (95% CI: -2.45, 1.48) SMD: 0.05 (95% CI: -0.25, 0.35) SMD: 0.16 (95% CI: -0.47, 0.79) SMD: 0.31 (95% CI: -0.11, 0.74) No studies identified No studies identified No studies identified No studies identified SMD: -0.09 (95% CI: -1.17, 0.99) SMD: 0.14 (95% CI: -0.11, 0.38) No studies identified No studies identified
Quality of evidence: Moderate   1 study 36 infants 2 studies 80 infants 1 study 176 infants 1 study 39 infants 1 study 88 children      5 studies 187 participants 2 studies 264 participants   
  1. CI, confidence interval; SMD: Standard mean difference. Estimates in bold show significant impacts.