Determination of glomerular filtration rate (GFR) with 99mTc-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) is a validated method to assess renal function, but there are no well-established pediatric reference ranges for GFR. The aim of this study was to establish reference GFRs in children and young adults. Methods: GFR was calculated for 235 reference subjects (median age, 4.86 y; range, 20 d to 24.8 y) using 99mTc-DTPA at Boston Children's Hospital between 2000 and 2020. This included 220 patients for prechemotherapy evaluation and 15 potential kidney donors. GFR was determined using a single-compartment model after a single intravenous injection technique and serial blood sampling at 2, 3, and 4 h. Data were analyzed by age, corrected for body surface area, and normalized to a body surface area of 1.73 m2 The 95% reference ranges were calculated as mean ± 1.96 SD. Results: GFR increased with age, likely reflecting increased functional renal mass. Lower normalized GFR in children younger than 1 y may reflect renal immaturity. Conclusion: The use of a single injection of 99mTc-DTPA revealed that GFR increases with age, likely reflecting increased renal mass. Further, in patients younger than 1 y, GFR rapidly increases initially, with a subsequent more gradual increase, reaching the adult level by approximately 2 y of age. Between 2 and 10 y of age, the GFR slightly exceeds the adult level, stabilizing at a slightly lower adult level by 10 y of age.

Poor dietary quality, particularly inadequate fruit and vegetable (F&V) intake, remains a significant public health challenge globally. This article synthesizes findings from scoping reviews examining diet and F&V intake, and interventions to increase F&V consumption among population groups in five countries: Benin, Fiji, the Philippines, Sri Lanka and Tanzania. Our analysis confirms previous findings of inadequate F&V intake across all five countries, with most adults consuming well below the WHO recommendations of 400 g per day. Across the five countries, the identified scientific evidence is limited due to heterogeneous dietary assessment methods, limited coverage of population groups in national surveys and smaller studies, and limited data from rigorous evaluations of interventions aiming to increase F&V intake. Although all five countries have developed food-based dietary guidelines promoting F&V intake, research on their implementation and effectiveness remains limited. To build evidence for effective programmes and policies to improve both quantity and diversity of F&V intake, we identify three priority areas for future research: standardizing dietary assessment methods for use in surveys and evaluations, understanding context-specific drivers and determinants of F&V intake and strengthening intervention research in low-resource settings.

BackgroundIn regions facing chronic stress such as the arid and semi-arid lands (ASALs) of Kenya, there is poor quality of diet among women and children in humanitarian situations, mainly due to multiple climatic shocks that exacerbate local food systems. The objective of this study was to assess the effect of household participation in climate smart nutrition-sensitive agriculture (NSA) interventions on maternal and young child nutrition outcomes in Makueni, Garissa and Tana River counties.MethodsFrom March 2020 to October 2023, the International Potato Center and partners (World Food Program, Ministries of Agriculture and Health) implemented an NSA intervention in Makueni, Garissa and Tana River counties. The intervention comprised of household participating in three main activities: (1) access to orange fleshed sweetpotato (OFSP) vines; (2) participation in nutrition education activities and (3) receiving and utilizing infant feeding toolkits (Healthy Baby Toolkit/HBT). Approximately 3 months after intervention activities, we conducted a cross-sectional survey in intervention communities to assess effect of particpation in the interventions on maternal and child nutrition outcomes. The study utilized the doubly robust inverse probability weighting regression adjustment (IPWRA) estimator to evaluate the impact of participation in the project intervention on nutrition outcomes. Caregivers’ knowledge of nutrition, health and childcare, women (MDD-W) and young child dietary diversity (MDD-C), vitamin A (VA) intakes, minimum meal frequency (MMF), and minimum acceptable diet (MAD) for children 6–23 months were analyzed. The comparison of means and proportions was assessed using Student’s t-test and the Chi-square test, respectively, between the caregivers participating in NSA interventions and non-participants. The impact of the level of participation in NSA interventions and information on how to utilize these to improve infant and maternal feeding in the household on caregiver knowledge and practices scores was examined using regression analysis.ResultsOf 494 caregivers surveyed, 72% indicated to have participated in at least one study intervention. In adjusted analyses, participation in at least one of the study interventions was significantly associated with improved caregiver nutrition [β: 0.943, p < 0.05], and VA [0.613, p < 0.05] knowledge scores and young child MMF [0.202, p < 0.05] and MAD [0.111, p < 0.05]. Participation in all three interventions (nutrition training, use of infant feeding toolkit and access to OFSP vines) significantly increased VA knowledge among caregivers (p ≤ 0.05) and infant MMF (p ≤ 0.05). While the use of infant feeding toolkit and access to OFSP vines alone had a significant positive effect on MDD-W and MDD-C (p ≤ 0.05).ConclusionThe findings show the need to integrate climate-smart NSA interventions in humanitarian settings to improve nutrition among women and young children. Such interventions can potentially build resilience among populations in these fragile environments to better withstand various shocks.

BackgroundAdequate fruit and vegetable (F&V) intake is important for health, yet populations globally are failing to meet recommendations.ObjectiveA scoping review to summarize available evidence of evaluations of interventions to increase F&V intake globally, focusing on target populations, intervention strategies, research methods, and summarizing their evaluated impacts.MethodsWe searched PubMed and Web of Science in February 2023 for intervention studies in which dietary intake of fruit and/or vegetables were documented. Eligible studies included all age groups, excluding those targeting populations with specific disease-related conditions, such as cancer patients/survivors. Only articles published in English since 2012 were included in the review.ResultsWe identified 6338 articles, with 226 meeting inclusion criteria, comprising 223 unique studies and 284 intervention comparisons. Most comparisons occurred in high-income countries (n = 192) compared to low- and middle-income countries (n = 92). Randomized controlled trials (RCTs; 37.3%) and cluster RCTs (52.5%) were predominant. Interventions primarily targeted adults (31.7%), school-aged children (18.0%), children under-five (14.4%), and adolescents (13.7%), lasting an average of 24 weeks (range: 2 weeks to 20 years). Food-frequency questionnaires (59.2%) and 24-h recalls (26.8%) were the most used dietary assessment method. Health and nutrition communication (75.9%) was the most common intervention, utilizing interpersonal communication, mass media, and information-communication technology, often in combinations. Positive impacts on fruit (43.9%), vegetable (40.2%), and combined F&V intake (53.0%) were observed in nearly half the intervention comparisons.ConclusionsThese findings highlight the predominance of health and nutrition communication interventions, predominantly in high-income countries, showing mixed success in improving F&V intake, emphasizing the need for context-specific strategies and standardized methodologies to design sustainable, cost-effective interventions for better diet quality and health outcomes.Plain language titleA literature review assessing what we know and do not know about efforts to improve fruit and vegetable intake across the world.

Globally, the intake of fruit and vegetables (F&V) is far below the recommended levels, contributing to various health challenges including micronutrient deficiencies and non-communicable diseases. In Tanzania, where the triple burden of malnutrition persists, there is a need to identify gaps in evidence, better understand diets and F&V intake and identify promising interventions for improved intake. We conducted a scoping review to summarize the evidence on dietary intake, F&V intake and nutritional status in Tanzania. This included three separate literature searches in PubMed covering the years 2012-2023. A total of 62, 37 and 15 articles met predefined eligibility criteria for the review of overall diet, dietary intake of F&V and nutritional status, respectively. Identified studies suggest that overall dietary practices among all population groups were primarily based on carbohydrate-rich foods, complementary feeding practices were suboptimal among young children and a low proportion of women of reproductive age (WRA) and pregnant and lactating women achieved minimum dietary diversity for women (MDD-W). Across all population groups, F&V intake was below the recommended 400 g per day. Analysis of nutritional status in Tanzania in population representative surveys showed high stunting prevalence in children below 5 years of age, and a high prevalence of overweight and obesity among WRA, particularly in urban areas. Additional research is needed to understand better the complex interactions between diet and nutrition and health outcomes, and to identify efficient and cost-effective strategies to improve overall dietary quality, including increasing F&V intake.

ObjectiveVitamin A deficiency (VAD) has serious public health consequences including morbidity and mortality for populations in low and middle-income countries (LMICs), especially for children under 5 years and pregnant women. LMICs are at greater risk of VAD, in part due to low levels of consumption of vitamin A-rich foods most of which are plant-based, such as orange-fleshed sweet potatoes (OFSP), with lower bioavailability than animal sources of the vitamin A. Food-based approaches such as biofortification of OFSP, including promoting the consumption of vitamin A-rich biofortified staple crops, has been shown to be potentially effective in improving the status of vitamin A and other micronutrients. This study examined vitamin A-rich food consumption and its predictors among women of reproductive age from OFSP-growing households in two regions of Uganda.MethodsA cross-sectional survey was conducted among 617 OFSP growing households, focusing on women in the reproductive age group from the northern and eastern regions of Uganda. Households were not receiving any VAD-related intervention at the time of the survey. Quantitative data included vitamin A-rich food consumption, knowledge on vitamin A, and rich food sources dietary intake, using a 7-day food frequency questionnaire. Vitamin A consumption and risk of deficiency were estimated using the Hellen Keller International guide.ResultsThe majority of women in this study were either pregnant (80%) or lactating (17%). More than 70% of the study population had a weighted vitamin A rich food consumption mean score of <6 days per week, indicating a high risk of VAD. Knowledge about vitamin A [b (SE) = −0.18 (0.50), p < 0.001] was significantly and inversely associated with vitamin A rich food consumption.ConclusionComponents of food insecurity such as availability, affordability, utilization, and changing food preferences may contribute to the unexpected inverse relationship between knowledge and consumption of vitamin A rich foods. Scaling up biofortified food initiatives, including OFSP, can improve consumption of vitamin A rich foods with effective strategies to comprehensively address consumption barriers such as lack of nutrition education, cooking skills, and storage facilities, as well as low production levels and perceived contamination of biofortified foods.

Vitamin A deficiency (VAD) increases risk for morbidity and mortality. Food-based approaches offer one strategy to improve vitamin A status. This systematic review assessed evidence of the effects of food-based approaches on the vitamin A status of women and children under 5 y. VAD was defined as clinical ocular symptoms, such as loss of vision, and/or retinol plasma or serum concentration <0.70 μmol/L. Searches on food-based approaches to improve vitamin A status were conducted for the period 2011-2022 on PubMed, CINHAL, Web of Science, and Google Scholar using PRISMA guidelines. English-language publications were included. Case studies, unpublished dissertations, and non-peer-reviewed studies were excluded. This review comprises 24 of 27,322 identified studies; 23 included studies focused on provitamin A carotenoids. There were 17,214 participants across the 24 studies with sample sizes ranging from 8 to 3571 individuals. Intervention studies spanned from 3 wk to 2 y. Fifteen (63%) studies were randomized control trials, 7 were cross-sectional, and 2 were longitudinal studies. Most studies (N = 21) used biochemical measurements, for example, serum retinol, to assess vitamin A status; other studies used clinical symptoms (for example, xerophtalmia) or dietary intake. Thirteen (54%) studies reported a statistically significant effect of food-based interventions (N = 8) or an association of diet (N = 5) on vitamin A status. This systematic review indicated that some food-based interventions improved vitamin A status, thus offering a safe and effective delivery mechanism for vitamin A. There appeared to be significant association between vitamin A status and consumption of foods with high concentrations of preformed vitamin A and provitamin A carotenoids. Differences across studies in regard to the period of evaluation, food approaches used, and statistical power may explain the lack of effectiveness of food-based approaches on vitamin A status in some studies.

Background Efforts to improve infant and young child feeding practices include the use of nutrition behavior change communication among caregivers of children under 5 years. We assessed the association between monthly participation in community-level nutrition group meetings on caregiver health and nutrition knowledge and practices (KPs). Methods Data from a community-based cross-sectional survey conducted in the Eastern and Southern Highland Zones of Tanzania were used. Indices were developed for caregivers' knowledge of nutrition, health and childcare, household (HDD) and young child dietary diversity (CDD), and vitamin A (VA) intakes. The comparison of means and proportions was assessed using Student's t -test and the Chi-square test, respectively, between the caregivers participating in nutrition group meetings and non-participants. The impact of the number of nutrition meeting attendance on caregiver KPs scores was examined using multiple regression. Results Of 547 caregivers surveyed, 49.7% attended nutrition group meetings and received information on nutrition social behavior change communication (SBCC). Overall, 28% of participating women had a moderate level of nutrition knowledge, 62% had a high level of VA knowledge, and 57% had a high level of health and childcare knowledge. Participation in nutrition group meetings was significantly associated with the health and childcare knowledge score (HKS), HDD and CDD scores, and household and young child VA intake; the magnitude of the associations was greater for caregivers who attended at least four meetings. Conclusion The findings emphasize the need for programs that seek to address the issues present in the use of nutrition SBCC at the community level to improve maternal or caregiver KPs and subsequently the nutrition status of infants and young children.

Traditionally, sweetpotato is a woman's crop grown primarily for food in Mozambique. With the introduction of Vitamin A rich varieties, efforts were made to commercialize the crop. This study assessed the effects of this commercialization on women producers. Findings indicate that though women devoted more land to sweetpotato, men got higher yields, sold more and obtained better prices. Nonetheless, women dominated the roots value chain and increased their participation in markets. The more lucrative sweetpotato vine chain was dominated by men (75% men), as the resources and skills required to engage in this activity were a significant challenge for women. Women perceived that sweetpotato commercialization increased their ability to make production decisions, though it has not resulted in any changes in ownership of resources. Women and men both noted a subtle change in norms. Men for example perceived that their ability to make decisions had reduced, while women noted that they had taken on more leadership positions locally. These changes might be attributed to the role played by project implementors who encouraged men to allow their spouses to engage more in commercial activities. Whilst women faced challenges related to literacy, market entry and access to resources, they valued the experience obtained in improving their entrepreneurial skills. Future commercialization initiatives should work on linking women to business services and building stronger farmer-processer linkages. Efforts to sensitize men about the benefits of women's engagement in business showed some impact and should be included in further work on crop commercialization.

AbstractReplacing some of the wheat flour in breads and pastries with OFSP (orange-fleshed sweetpotato) puree can increase the market demand for these nutritious varieties and would offer economic opportunities for smallholders, including women and youths. The technology to make sweetpotato puree has been well developed in industrialized countries since the 1960s. Techniques fine-tuned by RTB allow OFSP puree to be stored in plastic bags for 6 months, without refrigeration. Private companies in Malawi and Kenya are now manufacturing the puree and selling it to bakeries that substitute OFSP puree for up to 40% of the white wheat flour in bread and other baked goods. Consumers like the bread that is sold in supermarkets and bakeries. Food safety protocols ensure that the puree is part of safe, healthy products. The OFSP seed is available to smallholder farmers, who are linked with processors who buy the roots. Business models suggest that processing puree is profitable. The Scaling Readiness approach is helping to ensure that more farmers, processors, and consumers benefit from OFSP.

Background:Infection is associated with impaired nutritional status, especially for infants younger than 5 years.Objectives:We assessed the impact of infection indicated by both acute phase proteins (APP), C-reactive protein (CRP), and α-1-acid-glycoprotein (AGP), and as reported by maternal recall on the nutritional status of infants.Materials and methods:A total of 505 pregnant women were enrolled in a nested longitudinal cohort study of vitamin A (VA). Data from 385 children are reported here. The incidence and severity of respiratory infection and diarrhea (previous 14 days) were assessed by maternal recall; infant/child feeding practices were collected. Infant weight, recumbent length, and heel-prick capillary blood were taken at 9 months postpartum. Indicators of the VA status [retinol binding protein (RBP)], iron status (Hb, ferritin), and subclinical inflammation APP, CRP (>5 mg/L), and AGP (>1 g/L) were determined. Impacts of infection on the infant nutritional status were estimated using logistic regression models.Results:Infection prevalence, based on elevated CRP and AGP levels, was 36.7%. For diarrhea reported symptoms, 42.4% of infants at 9 months had no indication of infection as indicated by CRP and AGP; for acute respiratory reported symptoms, 42.6% had no indication of infection. There was a significant positive association with infection among VA-deficient (RBP < 0.83 μmol/L) infants based on maternal reported symptoms but not with iron deficiency (ferritin < 12 μg/L). The odds of having infection, based on increased CRP and AGP, in underweight infants was 3.7 times higher (OR: 3.7; 95% CI: 2.3, 4.5; P = 0.019). Infants with iron deficiency were less likely (OR: 0.40; 95% CI: 0.1, 0.7; P = 0.001) to have infection based on CRP and AGP, while infants with VA deficiency were five times more likely (OR: 5.06; 95% CI: 3.2, 7.1; P = 0.0001) to have infection.Conclusion:Acute phase proteins are more useful in defining infection in a population than reported symptoms of illness. Not controlling for inflammation in a population while assessing the nutritional status might result in inaccurate prevalence estimation.

This study examined mother-child differences in vitamin A-rich food consumption and conduct a comparative analysis of three food security indicators on household vitamin A-rich food consumption for 375 mother-child dyads from selected sweet potato growing households in Uganda. This study examined baseline data collected by the International Potato Centre (IPC) for an initiative on the development and delivery of biofortified crops in Uganda. Dietary intake and livelihoods data was collected from women residing in households that grew sweet potatoes in selected regions in Uganda. Eligibility criteria included women who were pregnant or lactating and/or had children 6–24 months. The analytical dataset had 375 woman-child dyads. An adjusted Hellen Keller International (HKI) guide was used to examine data on vitamin A consumption. Scores were weighted for animal- and plant-based sources of vitamin A. Data were stratified by woman or child to allow for within- and between-person variances in vitamin A-rich food consumption. Dependent sample Student's t-tests, Pearson's correlation analysis and a repeated measure analysis of covariance (ANCOVA) tested for differences in the vitamin A-rich food consumption mother-child dyads. There was a statistically significant difference in the mean consumption of vitamin A-rich foods for women and children (F (1,370) = 6.51, p = .011). Women had a higher vitamin A consumption (M = 2.08, SD = 2.11) than children in the same household (M = 1.39, SD = 2.17). This was qualified by a significant interaction with the household wealth index (F (1,370) = 4.31, p = .039), however not with household dietary diversity (F (1,370) = 3.16, p = .07), and household food insecurity access (F (1,370) = 0.32, p = .57). HDDS and the wealth index were associated with the mother's consumption of vitamin A-rich food but not with the children's. Initiatives that target mother-child dyads should be aware of factors such as intrahousehold food distribution and cultural practices that may differentially impact child consumption of vitamin A-rich and other micronutrient-rich foods. Child-friendly initiatives are recommended to maximize nutritional benefits for children under five years. International Potato Center and the University of Massachusetts Amherst.

Despite their proven effectiveness in addressing micronutrient deficiencies, adoption of biofortified crops among smallholder farmers remains low. Using a cross-sectional survey dataset of 1538 households randomly selected from 15 districts in Nampula and Zambezia provinces of Mozambique, this study examined the factors influencing farmers' dis-adoption and retention decisions for biofortified OFSP varieties. Data on household socio-demographic characteristics; knowledge, attitudes, perceptions and practices on OFSP production and nutrition were fitted to a Heckman bivariate probit model with sample selection to empirically assess the determinants of sequential adoption and dis-adoption decisions. The results showed that adoption and dis-adoption of OFSP is significantly influenced by a combination of farmers' socio-economic characteristics (age, gender, nutrition knowledge, education, access to planting material), consumption (taste, dry matter content) and agronomic (yield, early maturity, drought tolerance) traits. However, the agronomic traits and access to planting material are particularly key for the retention of OFSP varieties. These results suggest the need for breeding efforts to improve the agronomic traits of biofortified OFSP to match or better local non-biofortified varieties and establish seed delivery systems for sustainable adoption of biofortified OFSP.

Background: The American Thyroid Association (ATA), the European Association of Nuclear Medicine, the European Thyroid Association, and the Society of Nuclear Medicine and Molecular Imaging have established an intersocietal working group to address the current controversies and evolving concepts in thyroid cancer management and therapy. The working group annually identifies topics that may significantly impact clinical practice and publishes expert opinion articles reflecting intersocietal collaboration, consensus, and suggestions for further research to address these important management issues. Summary: In 2019, the intersocietal working group identified the following topics for review and interdisciplinary discussion: (i) perioperative risk stratification, (ii) the role of diagnostic radioactive iodine (RAI) imaging in initial staging, and (iii) indicators of response to RAI therapy. Conclusions: The intersocietal working group agreed that (i) initial patient management decisions should be guided by perioperative risk stratification that should include the eighth edition American Joint Committee on Cancer staging system to predict disease specific mortality, the modified 2009 ATA risk stratification system to estimate structural disease recurrence, with judicious incorporation of molecular theranostics to further refine management recommendations; (ii) diagnostic RAI scanning in ATA intermediate risk patients should be utilized selectively rather than being considered mandatory or not necessary for all patients in this category; and (iii) a consistent semiquantitative reporting system should be used for response evaluations after RAI therapy until a reproducible and clinically practical quantitative system is validated.

Against a worsening backdrop of climate stress and population growth, drought-resistant, highly adaptable, nutritious orange-fleshed sweetpotato (OFSP) stands out as a sustainable food crop that supports household resiliency, food security, and health. Recognized as one of the cheapest sources of vitamin A (VA), OFSP holds promise as a food-based approach to combat VA deficiency, a significant public health concern in sub-Saharan Africa. Because the dominant white-fleshed varieties have no beta-carotene, research initiated in the mid-1990s set out to adapt, develop, and promote VA-rich OFSP as a more nutritious alternative to non-OFSP types. Multisectorial strategies that integrate agriculture with health or education sectors hold promise as effective strategies to ensure OFSP reaches and meets the needs of those populations at greatest risk of VA deficiency – pregnant and lactating women, infants, and children. In this article, we share experiences, findings, implementation challenges, and lessons learned from four integrated programs in Kenya, Tanzania, Mozambique, and Ethiopia that aimed to improve the nutrition and health of women and children with production and promotion of OFSP. Across these projects, households significantly increased OFSP production. In all but one, changes in OFSP production were accompanied by improved food security and maternal and child diets.

Adequate zinc nutrition is important for child growth, neurodevelopment, immune function, and normal pregnancy outcomes. Seventeen percent of the global population is estimated to be at risk for inadequate zinc intake. However, zinc is not included in the fortification standards of several low- and middle-income countries with mandatory fortification programs, despite data suggesting a zinc deficiency public health problem. To guide policy decisions, we investigated the factors enabling and impeding the inclusion of zinc as a fortificant by conducting in-depth interviews with 17 key informants from 10 countries. Findings revealed the decision to include zinc was influenced by guidance from international development partners and enabled by the assessment of zinc deficiency, mandatory regional food fortification standards which included zinc, the World Health Organization (WHO) guidelines for zinc fortification, and the low cost of zinc compound commonly used. Barriers included the absence of zinc from regional fortification standards, limited available data on the efficacy and effectiveness of zinc fortification, and the absence of national objectives related to the prevention of zinc deficiency. To promote zinc fortification there is a need to put the prevention of zinc deficiency higher on the international nutrition agenda and to promote large-scale food fortification as a key deficiency mitigation strategy.

This study assessed effects and drivers of mother-child pair participation in agriculture-nutrition-health linkage projects. Data were collected from 2,271 households in Kenya. Three categories of participation regime were defined: none, partial and full participation. Bivariate analyses and multinomial-logit regression were used to assess the effects and drivers of participation, respectively. Results found higher diet quality and consumption of vitamin A foods, and more frequent visits to ante-natal clinics, among full participants. Regression results showed that partial and full participation decreased with the caregivers' age, de-incentivisation of community health workers and health facility linkage, but increased with dependency ratio and wealth.

Abstract Seventeen per cent of the world's population is estimated to be at risk of inadequate zinc intake, which could in part be addressed by zinc fortification of widely consumed foods. We conducted a review of efficacy and effectiveness studies to ascertain the effect of zinc fortification [postharvest fortification of an industrially produced food or beverage; alone or with multiple micronutrients (MMN)] on a range of health outcomes. Previous reviews have required that the effect of zinc be isolated; because zinc is always cofortified with MMN in existing fortification programs, we did not impose this condition. Outcomes assessed were zinc-related biomarkers (plasma or serum, hair or urine zinc concentrations, comet assay, plasma fatty acid concentrations, and the proportion of and total zinc absorbed in the intestine from the diet), child anthropometry, morbidity, mortality, cognition, plasma or serum iron and copper concentrations, and for observational studies, a change in consumption of the food vehicle. Fifty-nine studies were included in the review; 54 in meta-analyses, totaling 73 comparisons. Zinc fortification with and without MMN increased plasma zinc concentrations (efficacy, n = 27: 4.68 μg/dL; 95% CI: 2.62–6.75; effectiveness, n = 13: 6.28 μg/dL; 95% CI: 5.03–7.77 μg/dL) and reduced the prevalence of zinc deficiency (efficacy, n = 11: OR: 0.76, 95% CI: 0.60–0.96; effectiveness, n = 10: OR: 0.45, 95% CI: 0.31–0.64). There were statistically significant increases in child weight (efficacy, n = 11: 0.43 kg, 95% CI: 0.11–0.75 kg), improvements in short-term auditory memory (efficacy, n = 3: 0.32 point, 95% CI: 0.13–0.50 point), and decreased incidence of diarrhea (efficacy, n = 3: RR: 0.79, 95% CI: 0.68–0.92) and fever (efficacy, n = 2: RR: 0.85, 95% CI: 0.74–0.97). However, these effects cannot be solely attributed to zinc. Our review found that zinc fortification with or without MMN reduced the prevalence of zinc deficiency and may provide health and functional benefits, including a reduced incidence of diarrhea.