OBJECTIVE: To determine the efficacy of iron and zinc supplementation on behavior ratings of lead-exposed children. STUDY DESIGN: In this double-blind, randomized trial, 602 first-grade children received30 mg ferrous fumarate, 30 mg zinc oxide, both, or placebo daily for 6 months. Lead, iron, and zinc status were determined at baseline and follow-up. Parents and teachers provided ratings of child behavior using the Conners Rating Scales. RESULTS: The baseline mean (SD) blood lead concentration was 11.5 (6.1) mug/dL, with 51% of children > or = 10 microg/dL. The prevalence of attention deficit hyperactivity disorder, estimated by combined parent and teacher ratings, was 6%. At follow-up, parent ratings of oppositional, hyperactive, cognitive problems, and attention deficit hyperactivity disorder decreased by 1.5, 1.2, 2.5, and 3.4 points, respectively (P < .05). Teacher ratings of hyperactivity increased by 1.1 points (P = .008), and the mean cognitive problem score declined by 0.7 points (P = .038). There were no treatment effects on mean change in scores, but children receiving any zinc had a higher likelihood of no longer receiving clinically-significant teacher ratings of oppositional behaviors. CONCLUSIONS: This regimen of supplementation did not result in consistent improvements in ratings of behavior in lead-exposed children over 6 months.
RCT Entities:
OBJECTIVE: To determine the efficacy of iron and zinc supplementation on behavior ratings of lead-exposed children. STUDY DESIGN: In this double-blind, randomized trial, 602 first-grade children received 30 mg ferrous fumarate, 30 mg zinc oxide, both, or placebo daily for 6 months. Lead, iron, and zinc status were determined at baseline and follow-up. Parents and teachers provided ratings of child behavior using the Conners Rating Scales. RESULTS: The baseline mean (SD) blood lead concentration was 11.5 (6.1) mug/dL, with 51% of children > or = 10 microg/dL. The prevalence of attention deficit hyperactivity disorder, estimated by combined parent and teacher ratings, was 6%. At follow-up, parent ratings of oppositional, hyperactive, cognitive problems, and attention deficit hyperactivity disorder decreased by 1.5, 1.2, 2.5, and 3.4 points, respectively (P < .05). Teacher ratings of hyperactivity increased by 1.1 points (P = .008), and the mean cognitive problem score declined by 0.7 points (P = .038). There were no treatment effects on mean change in scores, but children receiving any zinc had a higher likelihood of no longer receiving clinically-significant teacher ratings of oppositional behaviors. CONCLUSIONS: This regimen of supplementation did not result in consistent improvements in ratings of behavior in lead-exposed children over 6 months.
Authors: Ann M DiGirolamo; Manuel Ramirez-Zea; Meng Wang; Rafael Flores-Ayala; Reynaldo Martorell; Lynnette M Neufeld; Usha Ramakrishnan; Daniel Sellen; Maureen M Black; Aryeh D Stein Journal: Am J Clin Nutr Date: 2010-09-29 Impact factor: 7.045
Authors: Katarzyna Kordas; Adrienne S Ettinger; David C Bellinger; Lourdes Schnaas; Martha María Téllez Rojo; Mauricio Hernández-Avila; Howard Hu; Robert O Wright Journal: J Pediatr Date: 2011-05-17 Impact factor: 4.406
Authors: Martin Falkingham; Asmaa Abdelhamid; Peter Curtis; Susan Fairweather-Tait; Louise Dye; Lee Hooper Journal: Nutr J Date: 2010-01-25 Impact factor: 3.271