Long-term effects of iron and zinc supplementation during infancy on cognitive performance and growth 8 years later: a follow-up study Pubblico
Pongcharoen, Tippawan (2010)
Abstract
ABSTRACT
Long-term effects of iron and zinc supplementation during
infancy
on cognitive performance and growth 8 years later: a follow-up
study
By
Tippawan Pongcharoen
Iron and zinc are important micronutrients for child cognitive
development and
growth, particularly during infancy when brain development and
physical growth are
rapid. Many studies have investigated the effects of iron and zinc
interventions in
infancy, but the benefits of these interventions have been assessed
only in terms of
outcomes in infancy. None of the intervention studies during the
critical phase of infancy
have reported effects measured in school-aged children and
beyond.
A randomized, placebo controlled trial of iron and zinc
supplementation was
conducted in 4-6 month-old breastfed infants in Khon Kaen, Thailand
from 1998-1999.
Infants were randomly divided into 4 groups receiving 1) 10 mg
iron, 2) 10 mg zinc, 3)
10 mg iron+10 mg zinc, or 4) a placebo for 6 months. Improvements
in iron and zinc
status and weight were found; no measures of cognitive development
in infancy were
assessed in this study. These children were followed-up at 9 years
of age in order to
assess long-term effects of iron and/or zinc supplementation on
intellectual functioning
and physical growth (n=560). Results showed no differences in
intelligence quotient (IQ),
Raven's CPM scores, or school performance among the 4 groups. There
were no
differences in physical growth among these 4 groups. We also
investigated the influence
of prenatal and postnatal growth on IQ and Raven's CPM scores at 9
years of age.
Results showed that early infancy growth that included a gain in
weight, length, and head
circumference was correlated positively with measured IQ at 9 years
of age. In addition,
solely a gain in length at late infancy was also positively
correlated with measured IQ.
In summary, we found no long-term benefits of iron and/or zinc
supplementation
during infancy on cognitive performance and growth at 9 years of
age. However, we
found a significant relationship between early to late infancy
growth and intellectual
functioning at 9 years of age. These findings suggest that
nutrition intervention programs
should emphasize the importance of early childhood
nutrition.
Table of Contents
TABLE OF CONTENTS
ACKNOWLEDGEMENTS………………………………………………………....
i
TABLE OF
CONTENTS……...………………………………………………….....
ii
LIST OF
TABLES……..……...………………………………………………….....
iv
LIST OF
FIGURES...…..……...………………………………………………….....
v
CHAPTER 1:
INTRODUCTION………………………………………..…….……
1
CHAPTER 2: LITERATURE
REVIEW………………………………..…….….....
6
2.1 Overview of iron and zinc
deficiencies…………………………..……….…
6
2.2 Roles of iron and zinc in cognitive development and growth
during
childhood
…………………………………………………………………....
9
2.3 Benefits of iron supplementation on cognitive development and
growth
during childhood
………………………………………………………..…...
13
2.4 Benefits of zinc supplementation on cognitive development and
growth
during
childhood………………………………………………………...……
29
2.5 Iron and zinc
interaction………………………………………………...…....
39
2.6 Effects of combined iron and zinc
supplementation…………………..……..
41
2.7 Long-term effects of nutrition intervention during early
childhood on
cogntive development and
growth…………………………………………...
46
2.8 Thailand: country overview and description of intervention
trial in infancy...
58
2.9 Window of vulneralility during
infancy…………………………...…………
52
2.10 Influence of early growth on later cognitive
development………..………….
52
2.11 Chapter
summary…………………………………………………..………....
54
CHAPTER 3:
METHODS………………………………………………..…………
56
3.1 Objectives and
hypotheses…………………………………………..…………
56
3.2 Study
design……………………………………………………………..…….
57
3.3 Study
setting……………………………………………………………..…….
57
3.4 Study
participants………………………………………………………..…….
58
3.5 Data
collection…………………………………………………………..……..
59
3.6 Statistical
analysis……………………………………………………………...
64
CHAPTER 4: LONG-TERM EFFECTS OF IRON AND ZINC
SUPPLEMENTATION DURING INFANCY ON COGNITIVE FUNCTION AT 9
YEARS OF AGE AMONG NORTHEAST THAI CHILDREN: A FOLLOW-UP
STUDY………………………………………………………………….…………...
74
Abstract……………………………………………………………………………
77
Introduction……………………………………………………………………….
78
Methods……………………………………………………………………..…….
80
Results……………………………………………………………...……………..
86
Discussion.………………………………………………………..….……………
89
Literature
cited…………………………………………………………………….
94
ii
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