Effect of micronutrient supplementation on height velocity of underprivileged girls in comparison with un-supplemented healthy controls
-
Anuradha V. Khadilkar
,
Nidhi S. Kadam
Abstract
The aim of this study was to investigate the effect of 1-year micronutrient supplementation on the height velocity of underprivileged premenarchal girls in comparison with the natural growth of apparently healthy girls from an affluent class. A 1-year cluster-randomisation intervention trial was conducted in 119 premenarchal girls (8–12 years) from two schools catering to the lower socioeconomic strata (LSES) in Pune, India. Three classes of age-matched girls were randomly allocated to any one of the three intervention groups: (i) Ca+MZn+D group (C1: zinc, 15 mg/day+multivitaminscalcium, 500 mg/day; vitamin D, 30,000 IU/3 months); (ii) Ca+D group (C2: calcium, 500 mg/day; vitamin D, 30,000 IU/3 months); and (iii) M+D group (C3: multivitamins; vitamin D, 30,000 IU/3 months). Height, weight, and Tanner stage were assessed at baseline and endline. A total of 119 age-matched, apparently healthy school girls from a higher socioeconomic group (HSES) were assessed for their growth after 1 year without any supplementation. At baseline, mean height-for-age Z-scores and weight-for-age Z-scores by Indian references were >–2 in 99% of HSES girls and 28% of LSES girls had height-for-age Z-scores <–2. Post-intervention, increase in height-for-age Z-scores adjusted for Tanner stage was significantly higher in the Ca+MZn+D group (0.32±0.06) than in the respective age-matched controls (C1 group) (–0.02±0.05) (p<0.05) as well as in both the Ca+D group (0.18±0.06) and the M+D group (0.14±0.04) (p<0.05). After adjusting for Tanner stage, height velocity was significantly higher for the Ca+MZn+D group (6.7±0.4 cm/year) than for the M+D group (6.1±0.2), Ca+D group (5.6±0.5) as well as age-matched controls (C1 group) (5.0±0.3) (p<0.05). Supplementation with calcium+vitamin D, zinc and multivitamins may be effective in improving stature in underprivileged Indian premenarchal girls.
Acknowledgments
The authors wish to thank the director of Agharkar Research Institute for providing the necessary facilities for carrying out this work as a part of the research work for Ph.D. of the second author. The authors also acknowledge the funding from University Grants Commission (UGC), Government of India, to the second author. They also thank the participating schoolgirls, their parents and staff at two participating schools. The authors are grateful to Mrs. Shamim Momin, Ms. Shobha Davare, Mrs. Kalpana Shinde, Mrs. Mangal Gaikwad, Ms. Deepa Pillay and Ms. Deepa Pandit for their help with the trial. They also extend their gratitude to the Hirabai Cowasji Jehangir Medical Research Institute, Pune, India, for data collection.
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