Abstract
This review addresses the prevalence of zinc deficiency in Low- and Middle-income Countries (LMICs) and assesses the available strategies for its alleviation. The paucity of national-level data on the zinc deficiency in LMICs is partially a result of the lack of a reliable biomarker. Zinc deficiency appears to be a public health problem in almost all the LMICs, irrespective of the recommended indicators (plasma zinc concentration, dietary zinc adequacy and stunting prevalence) used. Based on plasma/serum zinc concentration (PZC), which is the most appropriate indicator at present, the prevalence of zinc deficiency in LMICs is of concern. Among the 25 countries for which national PZC data were available, 23 had a zinc deficiency prevalence of >20% for at least one physiological group. Zinc supplementation is largely restricted as an adjunct therapy for diarrhoea management in children, and the best platform and the most effective way of preventive zinc supplementation delivery remains to be established. Impact assessment for current zinc fortification programmes in LMICs and the effectiveness of zinc supplementation as part of a multi-micronutrient powder is to be determined. Dietary diversification, though promising for LMICs, is in the nascent stages of development at present. Inclusion of meat and animal products can be an important way of improving zinc status. Programmatic experience with the promotion of home processing techniques to increase absorbable zinc in the diet is lacking. Conventional biofortification techniques are gaining recognition in LMICs; however, transgenic biofortification as a strategy remains controversial.
Highlights
Zinc is ubiquitous to all biological systems and plays an exceptionally versatile role
This review further examines various ongoing as well as possible intervention strategies to address zinc deficiency in low- and middle-income countries (LMICs)
There is paucity of information on zinc deficiency for various physiological groups at a national level in LMICs and the lack of a reliable biomarker is one of the underlying factors that has impeded the assessment of zinc status in national monitoring and surveillance
Summary
INVITED REVIEW Zinc deficiency in low- and middle-income countries: prevalence and approaches for mitigation. Lancashire Research Centre for Global Development, University of Central Lancashire, Preston, UK. Received January 2020; revised April 2020; accepted 3 June 2020. How to cite this article Gupta S., Brazier A.K.M. (2020) Zinc deficiency in low- and middle-income countries: prevalence and approaches for mitigation.
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