Nutrition intervention strategies to combat zinc deficiency in developing countries

Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Nutrition Research Reviews (Impact Factor: 3.91). 07/1998; 11(1):115-31. DOI: 10.1079/NRR19980008
Source: PubMed


Widespread zinc deficiency is likely to exist in developing countries where staple diets are predominantly plant based and intakes of animal tissues are low. The severe negative consequences of zinc deficiency on human health in developing countries, however, have only recently been recognized. An integrated approach employing targeted supplementation, fortification and dietary strategies must be used to maximize the likelihood of eliminating zinc deficiency at a national level in developing countries. Supplementation is appropriate only for populations whose zinc status must be improved over a relatively short time period, and when requirements cannot be met from habitual dietary sources. As well, the health system must be capable of providing consistent supply, distribution, delivery and consumption of the zinc supplement to the targeted groups. Uncertainties still exist about the type, frequency, and level of supplemental zinc required for prevention and treatment of zinc deficiency. Salts that are readily absorbed and at levels that will not induce antagonistic nutrient interactions must be used. At a national level, fortification with multiple micronutrients could be a cost effective method for improving micronutrient status, including zinc, provided that a suitable food vehicle which is centrally processed is available. Alternatively, fortification could be targeted for certain high risk groups (e.g. complementary foods for infants). Efforts should be made to develop protected fortificants for zinc, so that potent inhibitors of zinc absorption (e.g. phytate) present either in the food vehicle and/or indigenous meals do not compromise zinc absorption. Fortification does not require any changes in the existing food beliefs and practices for the consumer and, unlike supplementation, does not impose a burden on the health sector. A quality assurance programme is required, however, to ensure the quality of the fortified food product from production to consumption. In the future, dietary modification/diversification, although long term, may be the preferred strategy because it is more sustainable, economically feasible, culturally acceptable, and equitable, and can be used to alleviate several micronutrient deficiencies simultaneously, without danger of inducing antagonistic micronutrient interactions. Appropriate dietary strategies include consumption of zinc-dense foods and those known to enhance zinc absorption, reducing the phytic acid content of plant based staples via enzymic hydrolysis induced by germination/fermentation or nonenzymic hydrolysis by soaking or thermal processing. All the strategies outlined above should be integrated with ongoing national food, nutrition and health education programmes, to enhance their effectiveness and sustainability, and implemented using nutrition education and social marketing techniques. Ultimately the success of any approach for combating zinc deficiency depends on strong advocacy, top level commitment, a stable infrastructure, long term financial support and the capacity to control quality and monitor and enforce compliance at the national or regional level. To be cost effective, costs for these strategies must be shared by industry, government, donors and consumers.

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    • "Zinc deficiency is prevalent in children of developing countries where food is often vegetable-based and rarely includes animal products. Zinc is easily absorbed with animal proteins, while excess plant meals lead to decreased zinc absorption due to its binding to phytates [9] [10]. In such countries, Zn deficiency results in growth retardation, hypogonadism, and increased mortality and morbidly from infection-related diarrhea and pneumonia due to compromised immune function [4] [9]. "
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    ABSTRACT: Zinc (Zn) is essential for appropriate growth and proper immune function, both of whichmay be impaired in thalassemia children. Factors that can affect serumZn levels in these patientsmay be related to their disease or treatment or nutritional causes.We assessed the serum Zn levels of children with thalassemia paired with a sibling. Zn levels were obtained from 30 children in Islamabad, Pakistan. Serum Zn levels and anthropometric data measures were compared among siblings. Thalassemia patients’ median age was 4.5 years (range 1–10.6 years) and siblings was 7.8 years (range 1.1–17 years).The median serum Zn levels for both groups were within normal range: 100 𝜇g/dL (10 𝜇g/dL–297 𝜇g/dL) for patients and 92 𝜇g/dL (13 𝜇g/dL–212 𝜇g/dL) for siblings. There was no significant difference between the two groups. Patients’ serum Zn values correlated positively with their corresponding siblings (𝑟 = 0.635, 𝑃 < 0.001). There were no correlations between patients’ Zn levels, height for age Z-scores, serum ferritin levels, chelation, or blood counts (including both total leukocyte and absolute lymphocyte counts). Patients’ serum Zn values correlated with their siblings’ values. In this study, patients with thalassemia do not seem to have disease-related Zn deficiency.
    Anemia 08/2014; 2014. DOI:10.1155/2014/125452
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    • "Mean daily dietary zinc intake of populations from several countries range from 4.7 to 18.6 mg.100 g−1. International studies have found that zinc deficiency can also be a common health concern in developing countries where the consumption of animal protein is low (20). "
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    ABSTRACT: Because iron deficiency anemia is prevalent in developing countries, determining the levels of iron and zinc in beans, the second most consumed staple food in Brazil, is essential, especially for the low-income people who experience a deficiency of these minerals in their diet. This study aimed to evaluate the effect of cooking methods by measuring the iron and zinc contents in cowpea cultivars before and after soaking to determine the retention of these minerals. The samples were cooked in both regular pans and pressure cookers with and without previous soaking. Mineral analyses were carried out by Spectrometry of Inductively Coupled Plasma (ICP). The results showed high contents of iron and zinc in raw samples as well as in cooked ones, with the use of regular pan resulting in greater percentage of iron retention and the use of pressure cooker ensuring higher retention of zinc. The best retention of iron was found in the BRS Aracê cultivar prepared in a regular pan with previous soaking. This cultivar may be indicated for cultivation and human consumption. The best retention of zinc was found for the BRS Tumucumaque cultivar prepared in a pressure cooker without previous soaking.
    Food & Nutrition Research 02/2014; 58. DOI:10.3402/fnr.v58.20694 · 1.79 Impact Factor
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    • "Foods with a high content of absorbable micronutrients are considered the best means for preventing MNDs ( Gibson and Ferguson , 1998 ; IZiNCG , 2004 ) . In countries like Africa where supplies of such foods a ++ re unavailable , specific preventive and healing interventions are needed ( Adamson , 2003 ; Holmes and Toole , 2005 ) . "
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    ABSTRACT: This paper reviews research published in recent years concerning the effects of zinc deficiency, its consequences, and possible solutions. Zinc is an essential trace element necessary for over 300 zinc metalloenzymes and required for normal nucleic acid, protein, and membrane metabolism. Zinc deficiency is one of the ten biggest factors contributing to burden of disease in developing countries. Populations in South Asia, South East Asia, and sub-Saharan Africa are at greatest risk of zinc deficiency. Zinc intakes are inadequate for about a third of the population and stunting affects 40% of preschool children. In Pakistan, zinc deficiency is an emerging health problem as about 20.6% children are found in the levels of zinc, below 60 μg/dL. Signs and symptoms caused by zinc deficiency are poor appetite, weight loss, and poor growth in childhood, delayed healing of wounds, taste abnormalities, and mental lethargy. As body stores of zinc decline, these symptoms worsen and are accompanied by diarrhea, recurrent infection, and dermatitis. Daily zinc requirements for an adult are 12-16 mg/day. Iron, calcium and phytates inhibit the absorption of zinc therefore simultaneous administration should not be prescribed. Zinc deficiency and its effects are well known but the ways it can help in treatment of different diseases is yet to be discovered. Improving zinc intakes through dietary improvements is a complex task that requires considerable time and effort. The use of zinc supplements, dietary modification, and fortifying foods with zinc are the best techniques to combat its deficiency.
    Critical reviews in food science and nutrition 02/2014; 54(9):1222-40. DOI:10.1080/10408398.2011.630541 · 5.18 Impact Factor
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