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.
    Full-text · Article · Aug 2014 · Anemia
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    • "Studies of inhibition of spermatogenesis and different abnormalities of sperm production in human have shown Zn deficiency (Prasad 2008a). It is estimated that globally two billion people are at threat of zinc deficiency (Gibson and Ferguson 1998). Additionally 37 % of children less than five years of age are at risk of zinc deficiency in Pakistan (Harvest Plus 2012). "
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    ABSTRACT: Introduction Zinc (Zn) is an essential element necessary for plants, humans, and microorganisms (Broadley et al. 2007; Prasad 2008b; Cakmak 2008). Humans and other living things require Zn throughout life in little quantities to orchestrate a complete array of physiological functions (Canadian UNICEF Committee 2006). Zinc is a vital mineral of “exceptional biological and public health importance” (Hambidge and Krebs 2007). Furthermore 100 specific enzymes are found in which zinc serves as structural ions in transcription factors and is stored and transferred in metallothionein (Silvera and Ronan 2001; United States National Research Council 2000). It is typically “the second most abundant transition metal in organisms” after iron, and it is the only metal which appears in all enzyme classes (King 2006; Broadley et al. 2007). Biofortification is a current approach aimed at increasing the bioavailability of micronutrients such as Zn and Fe in the staple crops of specific region (Stein 2010). In this regard beneficial free-living soil bacteria which have been shown to improve plant health or increase yield can also mobilize micronutrients. In this chapter, the collective results highlight the importance of Zn with comparison of various strategies to meet its required quantity in major food crops. The next technological revolution to eradicate Zn malnutrition would be the plant growth-promoting microorganisms enabling better availability of Zn and other micronutrients through their economical, beneficial, and eco-friendly nature.
    Full-text · Article · Mar 2014
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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.
    Full-text · Article · Feb 2014 · Food & Nutrition Research
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