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 | Â | 2 studies 64 participants | 2 studies 71 infants | 1 study 147 infants | 1 study 35 infants | 2 studies 347 participants | 1 study 19 children | Â | Â | Â | 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 | Â | Â | Â | Â | Â | Â | Â | 1 study 34 children | 1 study 39 children | 1 study 19 children | 2 studies 73 participants | 1 study 19 participants | Â | Â |
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 | Â | Â | 3 studies 126 infants | Â | 1 study 35 infants | Â | Â | Â | Â | Â | 3 studies 142 participants | 1 study 19 participants | Â | Â |
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 | Â | Â | 2 studies 100 infants | Â | Â | Â | 1 study 19 children | Â | Â | Â | 2 studies 100 participants | 1 study 19 participants | Â | Â |
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 | Â | 1 study 36 infants | 2 studies 80 infants | 1 study 176 infants | 1 study 39 infants | 1 study 88 children | Â | Â | Â | Â | 4 studies 155 participants | 2 studies 264 participants | Â | Â |
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 | Â | 1 study 36 infants | 2 studies 80 infants | 1 study 176 infants | 1 study 39 infants | 1 study 88 children | Â | Â | Â | Â | 5 studies 187 participants | 2 studies 264 participants | Â | Â |