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Zinc Update: Predicting growth in zinc-deficient stunted infants with supplemental zinc in a dynamic model

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eMediNexus    20 September 2020

Deficiency of zinc can limit infant growth and increase their susceptibility to infections that can further affect their growth. Supplementation of zinc can improve the growth of zinc-deficient stunted infants. However, the frequency, amount and duration of zinc supplementation that is required to restore the growth in a child is unknown. A dynamic model of zinc metabolism that can predict the changes in weight and length of zinc-deficient, stunted infants with supplementation of dietary zinc can define the effective zinc supplementation treatments.

The objective of this study was to create a dynamic model for metabolism of zinc in stunted, zinc-deficient infants and to use this model to predict the response of growth in those infants who are given zinc supplements.

A model of zinc metabolism using data on zinc kinetics, growth requirements and tissue zinc, for healthy 9 months old infants was developed. The kinetic model was transformed to a dynamic model by substituting the rate constants for zinc absorption and excretion along with functions for these processes that alter with zinc intake. Estimates of the dynamic model, parameterized for zinc-deficient, stunted infants, were compared with the results of five published zinc intervention trials. The model was later used to predict the outcomes for zinc supplementation management, which varied in the amount, frequency and duration of zinc administration.

Predictions of the model did agree with available changes in plasma zinc after zinc supplementation. Predictions of weight and length also agreed with two studies, but overpredicted values from a third trial in which other nutrient deficiencies were growth limiting; the model had predicted that zinc absorption was weakened in that trial.

The study concluded that the model suggested that frequent and smaller doses (5-10 mg Zn/d) are more effective for increasing growth in stunted, zinc-deficient 9-month-old infants as compared to larger and less-frequent doses. The dose amount affects the length of dosing which is necessary to restore and maintain the plasma zinc concentration and growth.

Source: Wastney ME, McDonald CM, King JC. A dynamic model for predicting growth in zinc-deficient stunted infants given supplemental zinc. Am J Clin Nutr. 2018;107(5):808-816. doi:10.1093/ajcn/nqy020

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