Zinc Sulfate and Omega-3: Do They Have a Role in Environmental Enteric Dysfunction?
Maged A. El Wakeel1 , Ghada M. El-Kassas1 , Shaimaa A. Hashem1, Mones M Abushady1, Alyaa H Kamhawy1, Ahmed F. Amer1, Salwa Refat El-Zayat2 and Nevein N. Fadl2

1Department of Child Health, National Research Centre, Giza, Egypt.

2Department of Medical Physiology, National Research Centre, Giza, Egypt.

Corresponding Author E-mail: sho_hashem@yahoo.com

Abstract: Introduction: Environmental enteric dysfunction (EED) is a subclinical, chronic inflammatory condition of the gut.  The purpose of the study: The purpose of this study is to evaluate the effects of zinc sulphate and omega-3 supplementation on anthropometric measurements and faecal EED biomarkers (α-1-antitrypsin (AAT), Neopterin (NEO), and Myeloperoxidase (MPO) in underweight and stunted children as an intervention for EED. Subjects and Methods: An interventional study included 105 underweight and stunted children, divided into two subgroups: one subjected to intervention with zinc supplementation (55 children) and the other subjected to intervention with omega-3 supplementation (50 children) for 6 months. Assessment of anthropometric measurements and faecal EED biomarkers: AAT, NEO, and MPO.  Results: Regarding the zinc intervention group, post-intervention weight, weight z score, height, height z score, and BMI z score were highly significantly improved after 6 months of zinc supplementation (p value ≤ 0.001). Serum zinc level was highly significant increased after supplementation (p value ≤ 0.001), while AAT and NEO were highly significant and significant decreased (p value ≤ 0.001) (p value  ≤ 0.05) respectively. Regarding the omega-3 intervention group, post-intervention weight, weight z score, height, and height z score were highly significantly improved after 6 months of omega-3 supplementation (p value ≤ 0.001). Meanwhile, no significant change was observed for serum iron and zinc level (p value  ≥ 0.05) or EED faecal markers except for AAT, which was highly significant for decreasing after supplementation (p value ≤ 0.001). A significant increase in weight, height, and serum zinc level was observed in the zinc supplementation group more than in the omega-3 supplementation group (p value  ≤ 0.05). Alongside no significant difference post intervention in EED fecal markers between the two groups (p value  ≥ 0.05). Conclusion: No definite drug intervention or supplementation is documented as appropriate management. Zinc sulphate supplementation is thought to be more beneficial than omega-3 supplementation, as evidenced by the improvement of anthropometric measurements and decrease of EED faecal markers.

Keywords: Environmental Enteric Dysfunction; Omega-3 Fatty Acids; Malnutrition; Stunting; Zinc

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