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Zinc Deficiency and Stunting

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Handbook of Famine, Starvation, and Nutrient Deprivation

Abstract

This chapter reviews key aspects of human zinc nutrition providing an insight on the etiology of zinc deficiency and current policies on the assessment of the risk of zinc deficiency in populations using stunting rates and other indicators. Zinc is an essential trace element in human nutrition, and it is critical to various basic molecular functions. Zinc depletion of the organism thus virtually affects any organ system in the human body, and it encompasses a number of diverse biochemical changes resulting in a generalized metabolic dysfunctions. Marginal zinc deficiency mainly occurs when zinc intakes from the diet are inadequate to provide for increased requirements, increased losses, decreased absorption, or decreased utilization. This form of zinc deficiency carries most of the public health significance of zinc deficiency. Marginal zinc deficiency adversely affects physiological, biochemical, and immunological functions. Typical signs are growth retardation, hypogonadism in male adolescents, rough skin, poor appetite, mental lethargy, abnormal dark adaptation, abnormal neurosensory changes, and delayed wound healing. A more severe form of zinc deficiency can be inherited or acquired due to iatrogenic-induced zinc-free diet or severely impaired intestinal uptake. Acrodermatitis enteropathica is a rare autosomal recessive genetic disorder that results in impaired zinc absorption. In population surveys, the risk of zinc deficiency is considered to be elevated and of public health concern when the prevalence of low serum zinc concentrations is greater than 20%, the prevalence of inadequate intakes is greater than 25%, or the prevalence of stunting is at least 20%. In such cases, an intervention to improve population zinc status or increase dietary zinc intake is recommended. Approximately 17.3% of the world’s population are at risk of inadequate intake of absorbable zinc, with the highest risk carried by countries in South and Southeast Asia, sub-Saharan Africa, and Central America. The global mortality burden due to zinc deficiency is of 116,000 deaths per year, the second most important cause of mortality due to micronutrient deficiency after vitamin A deficiency.

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Abbreviations

AE:

Acrodermatitis enteropathica

CI:

Confidence interval

DALY:

Disability-adjusted life year

EAR:

Estimated average requirement

EDTA:

Ethylenediaminetetraacetic acid

EFZ:

Endogenous fecal zinc

FAO:

Food and Agriculture Organization

HAZ:

Height-for-age z-score

IAEA:

International Atomic Energy Association

IL:

Interleukin

IOM:

Institute of Medicine

IZiNCG:

International Zinc Nutrition Consultative Group

PZn:

Plasma/serum zinc

RCT:

Randomized controlled trial

RDA:

Recommended dietary allowance

RR:

Relative risk or rate ratio

SD:

Standard deviation

UFZ:

Unabsorbed fecal zinc

UL:

Tolerable upper level of intake

UNICEF:

United Nations Children’s Emergency Fund

WAZ:

Weight-for-age z-score

WHO:

World Health Organization

WHZ:

Weight-for-height z-score

ZIP:

Gene expressing for a Zip transporter

Zip:

Zinc transporter, transports zinc into the cytoplasm

ZnT:

Zinc transporter, transports zinc out of the cytoplasm

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Authors and Affiliations

  1. ETH Zurich, Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, Zurich, Switzerland

    Valeria Galetti

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  1. Valeria Galetti
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Correspondence to Valeria Galetti .

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Editors and Affiliations

  1. Diabetes and Nutritional Sciences Research Division, Faculty of Life Science and Medicine, King’s College London, London, UK

    Victor R. Preedy

  2. School of Life Sciences, University of Westminster, London, UK

    Vinood B. Patel

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Galetti, V. (2019). Zinc Deficiency and Stunting. In: Preedy, V., Patel, V. (eds) Handbook of Famine, Starvation, and Nutrient Deprivation. Springer, Cham. https://doi.org/10.1007/978-3-319-55387-0_93

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  • DOI: https://doi.org/10.1007/978-3-319-55387-0_93

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