Dietary Zinc Intake and the Underlying Factors of Serum Zinc Deficiency among Preschool Children in the Philippines

Abstract

Zinc deficiency is linked to linear growth and is considered as one of the risk factors of stunting. Stunting persists as a public health problem in the Philippines, affecting 30% of children below 5 yr old. This study assessed the adequacy of dietary zinc intake and the prevalence and associated factors of serum zinc deficiency among preschool-age children 6–71 mo old. Data from the 8th National Nutrition Survey (NNS) conducted in 2013, involving 2,892 preschool-age children, were analyzed. Zinc intake was collected using two non-consecutive 24-hr food recalls, while dietary zinc inadequacy was intake below 100% of the estimated average requirement (EAR) for zinc prescribed by the 2015 Philippine Dietary Reference Intakes (PDRI). Serum zinc level was analyzed using atomic absorption spectrophotometry. Factors associated with zinc deficiency such as micronutrient status, wealth status, food security, and dietary adequacy were identified using multivariate logistic regression analysis. Almost half (47.2%) of preschool-age children had inadequate zinc intake. The national prevalence of serum zinc deficiency was 17.9%, and it is highest among children 6–23 mo old and those from rural, poorest, and food-insecure households relative to other subgroups. Poor wealth status was found to be a strong predictor of zinc deficiency (OR 4.0; 95% CI = 2.22–6.00). Stunting (OR 1.37; 95% CI = 1.06–1.76) and serum vitamin A deficiency (OR 1.80; 95% CI = 1.43–2.26) were associated with higher odds of zinc deficiency. Adequate vitamin A intake was an important protective factor against zinc deficiency. The odds of a child being zinc deficient is significantly predicted by poor wealth status, stunting, and vitamin A deficiency, while adequate nutrient intake serves as a crucial protective factor. Strengthening programs on micronutrient supplementation (including zinc), food fortification, and dietary diversification – combined with micronutrient-dense food consumption among preschool-age children – could help achieve long-term nutrition and health outcomes.