Abstract

BackgroundAdequate zinc nutrition is essential for adequate growth, immunocompetence and neurobehavioral development, but limited information on population zinc status hinders the expansion of interventions to control zinc deficiency. The present analyses were conducted to: (1) estimate the country-specific prevalence of inadequate zinc intake; and (2) investigate relationships between country-specific estimated prevalence of dietary zinc inadequacy and dietary patterns and stunting prevalence.Methodology and Principal FindingsNational food balance sheet data were obtained from the Food and Agriculture Organization of the United Nations. Country-specific estimated prevalence of inadequate zinc intake were calculated based on the estimated absorbable zinc content of the national food supply, International Zinc Nutrition Consultative Group estimated physiological requirements for absorbed zinc, and demographic data obtained from United Nations estimates. Stunting data were obtained from a recent systematic analysis based on World Health Organization growth standards. An estimated 17.3% of the world’s population is at risk of inadequate zinc intake. Country-specific estimated prevalence of inadequate zinc intake was negatively correlated with the total energy and zinc contents of the national food supply and the percent of zinc obtained from animal source foods, and positively correlated with the phytate: zinc molar ratio of the food supply. The estimated prevalence of inadequate zinc intake was correlated with the prevalence of stunting (low height-for-age) in children under five years of age (r = 0.48, P<0.001).Conclusions and SignificanceThese results, which indicate that inadequate dietary zinc intake may be fairly common, particularly in Sub-Saharan Africa and South Asia, allow inter-country comparisons regarding the relative likelihood of zinc deficiency as a public health problem. Data from these analyses should be used to determine the need for direct biochemical and dietary assessments of population zinc status, as part of nationally representative nutritional surveys targeting countries estimated to be at high risk.

Highlights

  • Adequate zinc nutrition is necessary for normal pregnancy outcome and child growth, immune function and neurobehavioral development [1]

  • These results, which indicate that inadequate dietary zinc intake may be fairly common, in Sub-Saharan Africa and South Asia, allow inter-country comparisons regarding the relative likelihood of zinc deficiency as a public health problem

  • Included are data on the daily per capita energy, zinc, phytate, absorbable zinc contents of the regional food supplies and the percent of energy and zinc derived from animal source foods

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Summary

Introduction

Adequate zinc nutrition is necessary for normal pregnancy outcome and child growth, immune function and neurobehavioral development [1]. Due to perceived high costs and logistical challenges, as well as the existence of a limited number of valid biomarkers, few nationally representative surveys have been conducted in low-income countries to assess population zinc status and the risk of zinc deficiency using the aforementioned recommended indicators. Until such data become more widely available, information on the amount of total and absorbable zinc in national food supplies may provide useful information on the risk of inadequate zinc intake in populations and help determine the need for more specific assessments of population zinc status. The present analyses were conducted to: (1) estimate the country-specific prevalence of inadequate zinc intake; and (2) investigate relationships between country-specific estimated prevalence of dietary zinc inadequacy and dietary patterns and stunting prevalence

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