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Supplementation of Vitamin E, Vitamin C, and Zinc Attenuates Oxidative Stress in Burned Children: A Randomized, Double-Blind, Placebo-Controlled Pilot Study

Barbosa, Eliana RD, MS*†; Faintuch, Joel MD, PhD‡; Machado Moreira, Emilia Addison RD, PhD*; Gonçalves da Silva, Viviane Rodrigues RD*; Lopes Pereima, Maurício José MD, PhD†§; Martins Fagundes, Regina Lúcia RD, PhD*; Filho, Danilo Wilhelm PhD¶

doi: 10.1097/BCR.0b013e3181b487a8
Original Articles

The aim of this study was to investigate the effect of supplementation of vitamin E, vitamin C, and zinc on the oxidative stress in burned children. In a prospective double-blind placebo-controlled pilot study, 32 patients were randomized as no supplementation (n = 15) or antioxidant supplementation (n = 17) groups. Supplementation consisted of the antioxidant mixture of vitamin C (1.5 times upper intake level), vitamin E (1.35 times upper intake level), and zinc (2.0 times recommended dietary allowance) administered during 7 days starting on the second day of admittance into the hospital. Energy requirement was calculated by the Curreri equation, and protein input was 3.0 g/kg of ideal body mass index (percentile 50°). Total antioxidant capacity of plasma and malondialdehyde were used to monitor oxidative stress. The time of wound healing was evaluated as the main clinical feature. Patients (age 54.2 ± 48.9 months, 65.6% males), who exhibited 15.5 ± 6.7% of total burn area, showed no differences in age and sex, when compared with controls. Intake of the administered antioxidants was obviously higher in treated subjects (P = .005), and serum differences were confirmed for vitamin E and C, but not for zinc (P = .180). There was a decrease in lipid peroxidation (malondialdehyde level) (P = .006) and an increase in vitamin E concentrations in the antioxidant supplementation group (P = .016). The time of wound healing was lower in the supplemented group (P < .001). The antioxidant supplementation through vitamin E and C and the mineral zinc apparently enhanced antioxidant protection against oxidative stress and allowed less time for wound healing.

From the *Postgraduate Program in Nutrition, Federal University of Santa Catarina, Florianopolis, Brazil; †Burn Unit, Joana de Gusmão Children’s Hospital, Florianopolis, Brazil; ‡Department of Gastroenterology, São Paulo University Medical School, São Paulo, Brazil; §Department of Pediatrics, Federal University of Santa Catarina, Florianopolis, Brazil; and ¶Department of Ecology and Zoology, Federal University of Santa Catarina, Florianopolis, Brazil.

This study was supported by grants from the Secretary of Health of the State of Santa Catarina, Dermus Pharmacy, Roche Laboratories, Galena Quimica and Farmaceutica Ltda, and Support Produtos Nutricionais Ltda, and fellowship from the National Council for Research and Scientific Development (CNPq).

Address correspondence to Emília Addison Machado Moreira, RD, PhD, Departamento de Nutrição/Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Campus Universitário, S/N, Trindade, Florianópolis, Brazil.

© 2009 The American Burn Association