Effects of iron and zinc supplementation during the preschool years on school-age child behavior

Open Access
Author:
Bahnfleth, Charlotte Lena
Area of Honors:
Nutritional Sciences
Degree:
Bachelor of Science
Document Type:
Thesis
Thesis Supervisors:
  • Laura E Murray Kolb, Thesis Supervisor
  • Jill Patterson, Honors Advisor
Keywords:
  • Iron
  • Zinc
  • Micronutrient supplementation
  • Behavior
  • Children
  • Nepal
Abstract:
Data on the long-term effects of preschool micronutrient supplementation on behavior are sparse. We examined behavior in seven to nine year old Nepali children (n=694) who received micronutrient supplements from 12 to 35 months of age in a double-masked randomized controlled trial. Children were randomized to daily iron plus folic acid (IFA), zinc (Zn), iron plus folic acid and zinc (IFAZn) or control. Behavior was assessed on six dimensions (positive mood, negative mood, lively/active, sociability, attention and demandingness) during two home visits. Differences in behavioral rating scores were assessed using logistic regression, comparing the control group to each of the three supplementation groups. Additionally, groups who received any iron plus folic acid (IFA or IFAZn) or any zinc (Zn or IFAZn) were compared to groups who received no iron plus folic acid or no zinc, respectively. Overall, those who received IFA were 2.90 times more likely to receive higher ratings of demandingness than controls (p=0.005) and those who received IFAZn were 1.43 times more likely to receive higher ratings of sociability than controls (p=0.048). After adjusting for confounders, those who received IFA were 3.13 times more likely to receive higher ratings of demandingness than controls (p=0.007); the greater likelihood of children supplemented with IFAZn to receive higher ratings of sociability than controls lost significance. Additionally, those who received any iron plus folic acid were 1.81 times more likely to receive higher ratings of demandingness than those who received none (p=0.03) and those who received any zinc were 1.58 times more likely to receive higher ratings of sociability than those who received none (p=0.0005). After adjusting for confounders, those who received any iron plus folic acid were 2.10 times more likely to receive higher ratings of demandingness than those who received none (p=0.01) and those who received any zinc were 1.49 times more likely to receive higher ratings of sociability than those who received none (p=0.004).