Evidence map›Paper›PMID 28876332›Full record

Trial reportEuropean journal of clinical nutrition2018

Zinc and multivitamin supplementation have contrasting effects on infant iron status: a randomized, double-blind, placebo-controlled clinical trial.

R C Carter, R Kupka, K Manji, C M McDonald, S Aboud, J G Erhardt, K Gosselin, R Kisenge, E Liu, W Fawzi and 1 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of clinical nutrition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 4 pooled it
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

R C CarterDivision of Pediatric Emergency Medicine and the Institute for Human Nutrition, Columbia and the Institute for Human Nutrition, Columbia, Columbia University Medical Center, New York, NY, USA.
R KupkaDepartment of Nutrition, UNICEF, New York, NY, USA.
K ManjiDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
C M McDonaldDivision of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, USA.
S AboudDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
J G ErhardtVitMin Laboratory, Willstaett, Germany.
K GosselinDivision of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, USA.
R KisengeDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
E LiuDivision of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, USA.
W FawziDepartment of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
C P DugganDivision of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, USA.
Boston Children's Hospital · USMuhimbili University of Health and Allied Sciences · TZColumbia University Irving Medical Center · USHarvard University · USUnited Nations Children's Fund · US

Funding

ROLE OF DIETARY CONSTITUENTS ON GENE EXPRESSION IN INTESTINAL EPITHELIUMP30DK040561 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI MARTIN TORRIANI · 1994 to 2026
$31.6M
A Trial of Zinc and Micronutrients in Tanzanian ChildrenR01HD048969 · NICHD · HARVARD SCHOOL OF PUBLIC HEALTH · PI DUGGAN, CHRISTOPHER P · 2006 to 2010
$2.0M
Patient-oriented Research in Pediatric Diarrheal DiseasesK24DK104676 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI DUGGAN, CHRISTOPHER P · 2015 to 2019
$903k
The Role of Maternal Nutrition in the Teratogenesis of Alcohol in HumansK23AA020516 · NIAAA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI CARTER, ROBERT COLIN · 2011 to 2015
$891k
NIAAA NIH HHS K23 AA020516NICHD NIH HHS R01 HD048969NIDDK NIH HHS K24 DK104676NIDDK NIH HHS P30 DK040561
6 · The paper itself

Abstract

BACKGROUND/

objectivesZinc (Zn) supplementation adversely affects iron status in animal and adult human studies, but few trials have included young infants. The objective of this study was to determine the effects of Zn and multivitamin (MV) supplementation on infant hematologic and iron status. SUBJECTS/

methodsIn a double-blind RCT, Tanzanian infants were randomized to daily, oral Zn, MV, Zn and MV or placebo treatment arms at the age of 6 weeks of life. Hemoglobin concentration (Hb) and red blood cell indices were measured at baseline and at 6, 12 and 18 months of age. Plasma samples from 589 infants were examined for iron deficiency (ID) at 6 months.

resultsIn logistic regression models, Zn treatment was associated with greater odds of ID (odds ratio (OR) 1.8 (95% confidence interval (CI) 1.0-3.3)) and MV treatment was associated with lower odds (OR 0.49 (95% CI 0.3-0.9)). In Cox models, MV was associated with a 28% reduction in risk of severe anemia (hazard ratio (HR)=0.72 (95% CI 0.56-0.94)) and a 26% reduction in the risk of severe microcytic anemia (HR=0.74 (0.56-0.96)) through 18 months. No effects of Zn on risk of anemia were seen. Infants treated with MV alone had higher mean Hb (9.9 g/dl (95% CI 9.7-10.1)) than those given placebo (9.6 g/dl (9.4-9.8)) or Zn alone (9.6 g/dl (9.4-9.7)).

conclusionsMV treatment improved iron status in infancy, whereas Zn worsened iron status but without an associated increase in risk for anemia. Infants in long-term Zn supplementation programs at risk for ID may benefit from screening and/or the addition of a MV supplement.

Indexed as

Iron DeficienciesAnemia, Iron-DeficiencyDietary SupplementsDouble-Blind MethodFerritinsHemoglobinsHumansInfantInfant Nutritional Physiological PhenomenaIronNutritional StatusPlacebosRecommended Dietary AllowancesRisk FactorsTanzaniaVitaminsFerritinsHemoglobinsIronPlacebosVitaminsZinc

Identifiers

PMID28876332
PMCPMC5762262
OpenAlexW2752655676

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.