1. Introduction
PDR, ~39.0–39.2, multiple micronutrient deficiencies, anemia
POOR NUTRITION, ANEMIA
Objectives: To assess (a) the impact of daily preventive zinc tablets (7 mg; PZ), zinc-containing multiple micronutrient powder (10 mg zinc, and 13 other micronutrients; MNP) or placebo, delivered for 9 months, on Insulin-like Growth Factor 1 (IGF1) and IGF Binding Protein 3 (IGFBP3) among Laotian children 6–23 months, and (b) whether the effects of PZ and MNP on length-for-age z-scores (LAZ) and weight-for-age z-scores (WAZ) are modified by baseline IGF1 and IGFBP3. Design: A double-blind, placebo-controlled trial (N = 419). Methods: Plasma IGF1 and IGFBP3 concentrations at baseline and 36 weeks were analyzed by automated chemiluminescent assay. Anthropometry was assessed at baseline, at 18 and 36 weeks. Intervention effects were estimated using ANCOVA. Results: At 36 weeks, geometric mean IGF1 (~39.0–39.2 ng/mL; Growth faltering, including both linear and ponderal growth restriction, is a major public health problem among children in settings with poor nutrition [Furthermore, because of the coexistence of multiple micronutrient deficiencies among children presenting with growth stunting, there is a growing interest in interventions delivering multiple micronutrients concurrently, such as multiple micronutrient powder (MNP) recommended to improve iron status and anemia among infants and young children 6–23 mo of age by the World Health Organization (WHO) and UNICEF [Growth hormone (GH), produced by the anterior pituitary gland, is the primary regulator of anabolism and growth [The majority of IGF1 in circulation is found in ternary complexes of IGF1, IGF binding protein 3 (IGFBP-3) and an acid-labile subunit, which together influences the bioavailability of IGF1, and therefore, its effects on growth [To expand understanding of the role of the GH-IGF1 axis in mediating the growth effects of zinc, the present study was implemented in the context of a community-based randomized controlled trial designed to assess, among other things, the effects of different zinc supplementation strategies on physical growth among young children in rural Lao People’s Democratic Republic (Lao PDR). The main study outcomes were presented elsewhere [