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Nutrient Physiology, Metabolism, and Nutrient-Nutrient Interactions

Demonstrating Zinc and Iron Bioavailability from Intrinsically Labeled Microencapsulated Ferrous Fumarate and Zinc Gluconate Sprinkles in Young Children¹

Stanley H. Zlotkin^*,**,,,2,3, Claudia Schauer, Seth Owusu Agyei, Julian Wolfson, Melody C. Tondeur^,, Kwaku P. Asante, Samuel Newton, Robert E. Serfass^# and Waseem Sharieff^,

^* Departments of Paediatrics, Nutritional Sciences, and Health Policy, Management, and Evaluation and ^** Centre for International Health, University of Toronto, Toronto, Canada; Division of Gastroenterology and Nutrition, Programs in Metabolism and Integrative Biology, Research Institute, The Hospital for Sick Children, M5G 1X8 Toronto, Canada; Kintampo Health Research Centre Health Research Unit, Ghana Health Service, Kintampo, Brong Ahafo, Ghana; and ^# Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555

³ To whom correspondence and reprint requests should be addressed. E-mail: stanley.zlotkin{at}sickkids.ca.

Nutrient-nutrient interactions are an important consideration for any multiple-micronutrient formulation, including Sprinkles, a home-fortification strategy to control anemia. The objectives of this randomized controlled trial were as follows: 1) to compare the absorption of zinc at 2 doses given as Sprinkles; and 2) to examine the effect of zinc and ascorbic acid (AA) on iron absorption from Sprinkles. Seventy-five children aged 12–24 mo were randomly assigned to the following groups: 1) 5 mg of labeled zinc (⁶⁷Zn) with 50 mg AA (LoZn group); b) 10 mg of labeled zinc (⁶⁷Zn) with 50 mg AA (HiZn group); or 3) 5 mg zinc with no AA (control). All groups contained 30 mg of labeled iron (⁵⁷Fe). Intravenous infusions labeled with ⁷⁰Zn (LoZn and HiZn groups) and ⁵⁸Fe (control) were administered. Blood was drawn at baseline, 48 h and 14 d later. The percentage of zinc absorbed did not differ between LoZn (geometric mean = 6.4%; min-max: 1.7–14.6) and HiZn (geometric mean = 7.5%; min-max: 3.3–18.0) groups. However, total zinc absorbed was significantly different between the LoZn (geometric mean = 0.31 mg; min-max: 0.08–0.73) and HiZn (geometric mean = 0.82 mg; min-max: 0.33–1.82) groups (P = 0.0004). Geometric mean percentage iron absorption values did not differ between the LoZn (5.9%; min-max: 0.8–21) and HiZn (4.4%; min-max: 0.6–12.3) groups and between the LoZn and control groups (5.0%; min-max: 1.4–24). We conclude that zinc in the form of Sprinkles has a low bioavailability, yet provides adequate amounts of absorbed zinc in young children, and that there is no effect of zinc or AA on iron absorption from the given formulations of Sprinkles.

KEY WORDS: • home-fortification • stable isotopes • zinc absorption • iron absorption • Sprinkles