The article on ‘Effect of Iron and Zinc deficiency on short term memory in children’ [1] is an eye opener, as micronutrient malnutrition and its ill effects are rampant in our country. Iron deficiency anemia is the most common nutritional disorder, even in the current era. Iron is essential for oxygen carrying, muscle functions, immune function and brain myelination, neurotransmission and cognitive functions [2]. Even mild to moderate anemia in infancy and early childhood are known to leave a permanent signature on the growing brain. Iron has effects on the neurotransmitters like dopamine and probably serotonin [2]. Iron deficiency reduces dopaminergic receptors and the reduction in dopaminergic receptors leads to increase in opiate receptors and resultant defective learning ability and cognition. The role of iron deficiency on aggravating breath holding spell, febrile seizure, and hypercyanotic blue spell are also being increasingly observed in clinical practice. Similarly, zinc is essential for enzyme function, metabolism, immune function, taste sensation, reproduction, cognition and retinal function [3]. The findings of the above study prove robust evidence in this context.

However, data regarding how many children had malnutrition, how many had anemia, the distribution according to hemoglobin level, severity of iron and zinc deficiency are lacking in the presentation [1]. Serum protein level, that may be a confounder while interpreting serum zinc level, is to be evaluated in such a study. It is also interesting to know whether deworming was given prior to iron therapy, as the role of parasitic infestation in deficiency is discussed in the presentation. Deworming is essential to break the negative spiral of worm infestation, malnutrition and altered immunity [4].

The dose of iron 2 mg/kg/day and zinc 5 mg/day is suboptimum to treat deficiency state. The authors have not given any explanation for choosing prophylactic dose for treatment. The reference endorsing the selection of 6-8 years and 9-11 years as the age for cultivating inspiration and wisdom and for formative process and reasoning, respectively, as cited in the concluding paragraph is also missing.