Zinc for Diarrhea Pediatric
Verdict: Published with Warning
Across 6 PubMed studies, the evidence for Zinc in Diarrhea Pediatric grades Tier A — moderate evidence. Effective, but with safety or population caveats.
A 🔵 A Moderate Evidence Published with Warning
Why this grade7-layer evidence engine
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Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditableRaw score 0.73
D
C
B
A
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← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
A · Published with Warning
Confidence
89%
Highly consistent evidence
Evidence level
E1
Cochrane high-quality SR/MA
▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.727
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 positive (5 篇 > 0 negative)
- tier_strict_requirement_check — A 級條件未達 (需 E1-E3 + L5≥2 supportive + L4 無 against；實際 E1 / L5=1 / L4_against=0)
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
PubMed studies (6)L2 · primary research & systematic reviews
Oral zinc for treating diarrhoea in children (Cochrane Review, Lazzerini M & Wanzira H)
Finding: In children >6 months, zinc shortened acute diarrhoea by ~half a day (MD -11.46 h, 95% CI -19.72 to -3.19; 9 trials) and reduced diarrhoea persisting to day 7 (RR 0.73, 95% CI 0.61-0.88), with the largest effect in malnourished children (MD -26.39 h, high certainty); but it had NO effect in children <6 months (MD +5.23 h, 95% CI -4.00 to 14.45, NS) and increased vomiting (RR 1.57, 95% CI 1.32-1.86).
View on PubMed Zinc supplementation for acute and persistent watery diarrhoea in children: A systematic review and meta-analysis (WHO-commissioned)
Finding: Across 38 RCTs, zinc increased recovery from acute diarrhoea (RR 1.07, 95% CI 1.03-1.10) and reduced duration (MD -13.27 h, 95% CI -17.66 to -8.89; moderate certainty) and improved persistent-diarrhoea recovery (RR 1.75, 95% CI 1.34-2.30; low certainty), but increased vomiting (RR 1.46, 95% CI 1.22-1.76), which was lower with low-dose vs high-dose zinc (RR 0.80).
View on PubMed Zinc supplementation for treating diarrhea in children: a systematic review and meta-analysis (PAHO/Pan American Journal)
Finding: Across 18 RCTs (n=7,314), zinc reduced diarrhoea duration by ~20 hours (MD -20.12 h, 95% CI -29.15 to -11.09, I2=91%), with a markedly greater effect in malnourished children (MD -33.17 h, 95% CI -33.55 to -27.79, I2=0%); vomiting incidence was significantly higher with zinc.
View on PubMed Oral zinc supplementation for the treatment of acute diarrhea in children: a systematic review and meta-analysis (incl. Chinese literature)
Finding: Pooling 104 studies (18,822 cases; 9,469 zinc / 9,353 control), zinc produced a 26% relative reduction in diarrhoea lasting beyond 3 days (RR reduction 26%, 95% CI 20%-32%) plus reductions in stool output/frequency and hospitalization duration.
View on PubMed Zinc supplementation in acute diarrhea (Zou TT et al., Indian J Pediatr; DARE quality-assessed)
Finding: Pooling 8 RCTs, zinc significantly reduced acute diarrhoea duration (WMD -14.47 h, 95% CI -25.06 to -3.89; P=0.007), but with significant unresolved heterogeneity that subgroup/sensitivity analyses could not eliminate.
View on PubMed Effect of Zinc Supplementation in Children with Acute Diarrhea: Randomized Double Blind Controlled Trial (Trivedi SS et al., India)
Finding: In 117 children (zinc n=60 / placebo n=57), stool-frequency reduction from day 1 to days 3-5 was 62% with zinc vs 26% with placebo (36% absolute between-group difference, reported as highly statistically significant) plus a 45% greater reduction in stool output and shorter hospital stay; abstract gives no exact p-value or CI.
View on PubMed Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …
L4b EU EFSA
Supportive
contributes to normal function of the immune system source↗
L4c UK NHS
Cautious
You should be able to get all the zinc you need from your daily diet source↗
L4d TW TFDA / 衛福部
Supportive
鋅之每日最高攝食量不得超過30 mg source↗
L4e WHO
Supportive
zinc has been recommended by WHO and UNICEF as the only treatment to be coupled with oral rehydration salts for the treatment of all diarrhoea episodes source↗
L5a NIH Office of Dietary Supplements
Supportive
Zinc is an essential mineral involved in numerous aspects of cellular metabolism source↗
L5b Mayo Clinic
Cautious
Zinc supplements can ease symptoms of diarrhea in children who have low levels of zinc, which may happen in children who have malnutrition. However, there isn't enough research to recommend use of zinc supplements for children with diarrhea who eat a healthy, varied diet. source↗
L5e Specialty Society (condition-mapped)
Supportive
Routine use of zinc supplementation, at a dosage of 20 milligrams per day for children older than six months or 10 mg per day in those younger than six months, for 10–14 days, is recommended for children with diarrhoea. source↗