Copper, iron, and zinc status in children with moderate and severe acute malnutrition recovered following WHO protocols

The prevalence of copper, iron, and zinc deficiencies in malnutrition and the amounts of micronutrients that should be provided for nutritional recovery are unclear.

This study aims to measure (1) the frequency of Cu, Fe, and Zn deficiencies in children with acute malnutrition on day 1 and after 15- and 30-day treatments with F100 plus vitamins/minerals mix, and (2) anthropometric recovery after 30 d feeding ad libitum.

In Cochabamba, Bolivia, 12 hospitalized children with severe acute malnutrition (HSM) and 17 (hospitalized) with moderate acute malnutrition (HMM), 3-33 months, received F100 ad libitum for 1 month. Children received FeSO4 after infection subsided. On days 1, 15, and 30 weight, length, hemoglobin, serum ferritin, iron, copper, zinc, and ceruloplasmin were measured. Comparison group were 17 ambulatory moderately malnourished (AMM) and 34 well-nourished children, measured once.

Deficiencies were highly prevalent in hospitalized groups. Serum copper and zinc became normal on D15 and D30, respectively. Mean daily energy intake of 160 kcal and 4 g prot//kg/d/1 mo led children to gain (mean) 5 g/kg/day, both on D15 and D30.

Micronutrient deficiencies were highly prevalent in HSM and HMM and recovered similarly. Application of WHO protocols induced satisfactory copper status recovery, but improvement of zinc was slower.