DIARRHEA

ZINC
(1 microgram = 0.001 milligrams)

1. Compared to placebo, daily doses of elemental zinc (10 mg /infants and 20 mg /older children) decreased the incidence of severe and persistent diarrhea, recurrent diarrhea and mortality in Indian urban slum children.

Pediatrics. 2002 Jun;109(6):e86. 
Substantial reduction in severe diarrheal morbidity by daily zinc supplementation in young north Indian children.
Bhandari N, Bahl R, Taneja S, Strand T, Molbak K, Ulvik RJ, Sommerfelt H, Bhan MK.
PMID: 12042580

2. Compared to placebo, doses of zinc (20 mg/twice/day for 7 days) reduced prolonged diarrhea, weight loss and facilitated recovery in children 6 – 24 months old. Vitamin A had no significant impact.

Acta Paediatr. 2001 Apr;90(4):376-80. 
A randomized controlled clinical trial of zinc, vitamin A or both in undernourished children with persistent diarrhea in Bangladesh.
Khatun UH, Malek MA, Black RE, Sarkar NR, Wahed MA, Fuchs G, Roy SK.
PMID: 11332926

3. Compared to placebo, doses of zinc (20 mg/day for 14 days) reduced prolonged diarrhea (of 14 or more days) in children 6 – 36 months old.

J Pediatr. 1999 Aug;135(2 Pt 1):208-17. 
Randomized, community-based trial of the effect of zinc supplementation, with and without other micronutrients, on the duration of persistent childhood diarrhea in Lima, Peru.
Penny ME, Peerson JM, Marin RM, Duran A, Lanata CF, Lonnerdal B, Black RE, Brown KH.
PMID: 10431116

4. Doses of zinc (20 mg/day for 14 days) reduced prolonged diarrhea, improved respiratory tract infection and promoted growth and weight gain in children 3 – 24 months old.

Eur J Clin Nutr. 1999 Jul;53(7):529-34. 
Impact of zinc supplementation on subsequent growth and morbidity in Bangladeshi children with acute diarrhoea.
Roy SK, Tomkins AM, Haider R, Behren RH, Akramuzzaman SM, Mahalanabis D, Fuchs GJ.
PMID: 10452407

5. Compared to placebo, doses of zinc (14.2 - 40 mg/day for 15 days) and ascorbic acid (30 mg) reduced the rate and duration of diarrhea in children 6 – 24 months old.

Acta Paediatr. 1999 Feb;88(2):154-60. 
Double-blind, randomized, controlled trial of zinc or vitamin A supplementation in young children with acute diarrhoea.
Faruque AS, Mahalanabis D, Haque SS, Fuchs GJ, Habte D.
PMID: 10102147

6. Doses of zinc (20 mg in 3 doses/day for 14 days) reduced prolonged diarrhea in undernourished children 3 – 24 months old.

Arch Dis Child. 1997 Sep;77(3):196-200. 
Randomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhoea.
Roy SK, Tomkins AM, Akramuzzaman SM, Behrens RH, Haider R, Mahalanabis D, Fuchs G.
PMID: 9370894

7. Doses of zinc (10 mg/day and 20 mg/day during diarrhea for 120 days) reduced diarrhea-related morbidity and improved cellular immune status.

Indian Pediatr. 1997 Jul;34(7):589-97. 
Effect of zinc supplementation on cell-mediated immunity and lymphocyte subsets in preschool children.
Sazawal S, Jalla S, Mazumder S, Sinha A, Black RE, Bhan MK.
PMID: 9401251

8. Compared to placebo, doses of zinc (10 mg/day for 7 months) reduced the number of children aged 6 – 9 months with persistent diarrhea (by 67%).

Pediatrics. 1997 Jun;99(6):808-13. 
Impact of zinc supplementation on morbidity from diarrhea and respiratory infections among rural Guatemalan children.
Ruel MT, Rivera JA, Santizo MC, Lonnerdal B, Brown KH.
PMID: 9164774

9. Doses of zinc (20 mg/day) reduced the incidence of severe and persistent diarrhea in children 6 – 35 months old.

N Engl J Med. 1995 Sep 28;333(13):839-44. 
Comment in:
    N Engl J Med. 1995 Sep 28;333(13):873-4.
Zinc supplementation in young children with acute diarrhea in India.
Sazawal S, Black RE, Bhan MK, Bhandari N, Sinha A, Jalla S.
PMID: 7651474

10. Compared to placebo, doses of zinc (20 mg/twice/day) reduced duration and frequency of diarrhea and promoted weight gain in children 6 – 18 months old.

Ann Trop Paediatr. 1990 Mar;10(1):63-9. 
Oral zinc supplementation in persistent diarrhoea in infants.
Sachdev HP, Mittal NK, Yadav HS.
PMID: 1694647

11. Compared to placebo, doses of zinc (20 mg/twice/day) reduced the duration and frequency of diarrhea in infants.

J Pediatr Gastroenterol Nutr. 1988 Nov-Dec;7(6):877-81. 
A controlled trial on utility of oral zinc supplementation in acute dehydrating diarrhea in infants.
Sachdev HP, Mittal NK, Mittal SK, Yadav HS.
PMID: 3058919

12. Doses of zinc (200 – 300 micrograms per kilogram body weight/day) reduced incidence of diarrhea and healed skin rash associated with zinc deficiency in infants.

Am J Clin Nutr. 1982 Mar;35(3):595-8. 
Serum alkaline phosphatase and zinc undernutrition in infants with chronic diarrhea.
Rothbaum RJ, Maur PR, Farrell MK.
PMID: 6801964

VITAMIN A

13. Compared to placebo, supplementation with vitamin A (200,000, 100,000, and 500,000 IU) every 4 to 6 months over 15 months reduced incidence of diarrhea and measles in children under 10.

Indian J Med Sci. 2002 Jun;56(6):259-64.
Effect of vitamin A supplementation on childhood morbidity and mortality.
Chowdhury S, Kumar R, Ganguly NK, Kumar L, Walia BN.