Respiratory infections reduce the growth response to vitamin A supplementation in a randomized controlled trial.

ABSTRACT

PIP: This randomized, double-masked, placebo-controlled trial study examined the role of respiratory infections and diarrhea in modifying the growth response to vitamin A supplementation. A total of 1405 children aged 6-48 months were given a single high dose of vitamin A or placebo every 4 months, and 4430 child treatment cycles were used in this analysis. The study was conducted in two rural subdistricts located on the southern coast of central Java, Indonesia. Analytic findings indicate that vitamin A supplementation resulted in a modest improvement in the linear and not in the ponderal growth of children. Those who had an adequate intake of 400 RE/day and were free of respiratory infection grew 0.22 cm/4 months (95% CI: 0.08, 0.37) more in height. Conversely, there were no significant growth responses to vitamin A supplementation among children with 21.5% of days or higher of respiratory infection. In addition, children who experienced no respiratory infection and had vitamin A intake below the normative requirement (400 RE/day) gained 0.31 cm/4 months (95% CI: 0.10, 0.52) more in height than the placebo group. Moreover, diarrhea was associated with poorer growth but did not modify the effect of vitamin A supplementation on growth. In conclusion, vitamin A supplementation improves linear growth in children but not among those with a high prevalence of respiratory infections.