Publications Scientifiques

[ Article ] Efficacy of highly bioavailable zinc from fortified water: a randomized controlled trial in rural Beninese children

Date de soumission: 14-03-2018
Année de Publication: 2015
Entité/Laboratoire Laboratoire de Nutrition Humaine (LNH)
Document type : Article
Discipline(s) : Nutrition et Sciences de la Santé
Titre Efficacy of highly bioavailable zinc from fortified water: a randomized controlled trial in rural Beninese children
Auteurs Galetti Valeria [1], Kujinga Prosper [2], MITCHIKPE COMLAN EVARISTE SIMON [3], Zeder Christophe [4], Tay Fabian [5], Tossou FÉLICIEN [6], HOUNHOUIGAN DJIDJOHO JOSEPH [6], Zimmermann Michael B [6], Moretti Diego [6],
Journal: American Journal of Clinical Nutrition
Catégorie Journal: Internationale
Impact factor: 6.926
Volume Journal: 102
DOI: 10.3945/ajcn.115.117028
Resume Background: Zinc deficiency and contaminated water are major contributors to diarrhea in developing countries. Food fortification with zinc has not shown clear benefits, possibly because of low zinc absorption from inhibitory food matrices. We used a novel pointof-use water ultrafiltration device configured with glass zinc plates to produce zinc-fortified, potable water. Objective: The objective was to determine zinc bioavailability from filtered water and the efficacy of zinc-fortified water in improving zinc status. Design: In a crossover balanced study, we measured fractional zinc absorption (FAZ) from the zinc-fortified water in 18 healthy Swiss adults using zinc stable isotopes and compared it with zinc-fortified maize porridge. We conducted a 20-wk double-blind randomized controlled trial (RCT) in 277 Beninese school children from rural settings who were randomly assigned to receive a daily portion of zinc-fortified filtered water delivering 2.8 mg Zn (Zn+filter), nonfortified filtered water (Filter), or nonfortified nonfiltered water (Pump) from the local improved supply, acting as the control group. The main outcome was plasma zinc concentration (PZn), and the 3 groups were compared by using mixed-effects models. Secondary outcomes were prevalence of zinc deficiency, diarrhea prevalence, and growth. Results: Geometric mean (2SD, +SD) FAZ was 7-fold higher from fortified water (65.9%; 42.2, 102.4) than from fortified maize (9.1%; 6.0, 13.7; P , 0.001). In the RCT, a significant time-by-treatment effect on PZn (P = 0.026) and on zinc deficiency (P = 0.032) was found; PZn in the Zn+filter group was significantly higher than in the Filter (P = 0.006) and Pump (P = 0.025) groups. We detected no effect on diarrhea or growth, but our study did not have the duration and power to detect such effects. Conclusions: Consumption of filtered water fortified with a low dose of highly bioavailable zinc is an effective intervention in children from rural African settings. Large community-based trials are needed to assess the effectiveness of zinc-fortified filtered water on diarrhea and growth.
Mots clés Benin, school-age children, water fortification, zinc absorption, zinc fortification
Pages 1238 - 1248
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