Effect of zinc intake on serum/plasma zinc status in infants: A meta-analysis

Abstract

A systematic review and meta-analysis of available RCTs was conducted to evaluate the effect of zinc (Zn) intake on serum/plasma Zn status in infants. Out of 5500 studies identified through electronic searches and reference lists, 9 RCTs were selected after applying the exclusion/inclusion criteria. The influence of zinc intake on serum/plasma Zn concentration was considered in the overall meta-analysis. Other variables were also taken into account as possible effect modifiers: doses of zinc intake, intervention duration, nutritional status and risk of bias. From each selected study, final measures of serum/plasma Zn were assessed.

RESULTS: The pooled β of status was 0.09 (95%CI 0.06 to 0.12). However, a substantial heterogeneity was present in the analyses (I2=95%; p=0.00001). When we performed a meta-regression, the effect of Zn intake on serum/plasma Zn status changed depending on the duration of the intervention, the dose of supplementation and the nutritional situation (p ANCOVA= 0.005; <0.001 and <0.001 respectively). After stratifying the sample according to the effect modifiers the results by duration of intervention showed a positive effect when Zn intake was provided during medium and long period of time (from 4 to 20 and >20 weeks). A positive effect was seen also when doses ranged from 8.1 to 12 mg/day. In all cases, the pooled β showed high evidence of heterogeneity.

CONCLUSION: Zinc supplementation increases serum/plasma Zn status in infants, although high evidence of heterogeneity was found. Further standardized research is urgently needed to reach evidence-based conclusions to clarify the role of zinc supplementation upon infant serum/plasma Zn status, particularly in Europe.