Plant and Soil

, Volume 361, Issue 1–2, pp 291–299 | Cite as

Zinc deficiency and human health: etiology, health consequences, and future solutions

  • Rosalind S GibsonEmail author
Regular Article



Multiple functions in the human body are affected by zinc deficiency. Here the etiology, assessment, health consequences, and intervention strategies for human zinc deficiency are discussed.


A literature review was conducted to identify papers on the topics itemized using electronic databases.


A major factor in the etiology of zinc deficiency is inadequate intakes, followed by physiological states increasing requirements, and pathological conditions resulting in poor absorption, excessive losses, or impaired utilization. High risk groups comprise infants, preschoolers, pregnant and lactating women, and the elderly. Zinc deficiency can result in impairments in growth, immune competence, and reproductive function, leading to increased risk of stunting, diarrhea, respiratory diseases, and mortality during childhood, and preterm births in pregnancy. Intervention strategies include supplementation, fortification, dietary diversification/modification, and biofortification, the choice depending on the magnitude of risk, life-stage group, and setting.


Zinc supplementation is recommended for treating acute diarrhea, and for preventing stunting, diarrhea, pneumonia, and mortality in high risk children. Zinc fortified cereals are appropriate for urban households, whereas dietary diversification/modification and biofortification are suitable for the rural poor. For maximum impact, interventions should be integrated with effective public health programs that address underlying causes of zinc deficiency.


Supplementation Fortification Dietary diversification Biofortification Diarrhea Respiratory diseases Children pregnancy Etiological factors 


  1. Andree KB, Kim J, Kirschke CP, Gregg JP, Paik HY, Joung H, Woodhouse L, King JC, Huang L (2004) Investigation of lymphocyte gene expression for use as biomarkers for zinc status in humans. J Nutr 134:1716–1723PubMedGoogle Scholar
  2. Arsenault JE, Yakes EA, Hossain MB, Islam MM, Ahmed T, Hotz C, Lewis B, Rahman AS, Jamil KM, Brown KH (2010) The current high prevalence of dietary zinc inadequacy among children and women in rural Bangladesh could be substantially ameliorated by zinc biofortification of rice. J Nutr 140:1683–1690PubMedCrossRefGoogle Scholar
  3. Ba Lo N, Aaron GJ, Hess SY, Dossou NI, Guiro AT, Wade S, Brown KH (2011) Plasma zinc concentration responds to short-term zinc supplementation, but not zinc fortification, in young children in Senegal. Am J Clin Nutr 93:1348–1355CrossRefGoogle Scholar
  4. Bindra GS, Gibson RS, Thompson LU (1986) [Phytate][calcium]/[zinc] ratios in Asian immigrant lacto-ovo vegetarian diets and their relationship to zinc nutriture. Nutr Res 6:475–483CrossRefGoogle Scholar
  5. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Masthers C, Riveria J for the Maternal and Child Undernutrition Study Group (2008) Maternal and child health consequences. Lancet 371:243–260PubMedCrossRefGoogle Scholar
  6. Brown KM, Rivera JA, Bhutta ZA, Gibson RS, King JC, Lönnerdal B et al (2004) International zinc nutrition consultative group (IZiNCG) technical document #1. Assessment of the risk of zinc deficiency in populations and options for its control. Food Nutr Bull 25:S99–S199PubMedGoogle Scholar
  7. Brown KH, de Romaňa L, Arsenault JE, Peerson JM, Penny ME (2007) Comparison of the effects of zinc delivered in a fortified food or a liquid supplement on the growth, morbidity, and plasma zinc concentrations of young Peruvian children. Am J Clin Nutr 85:538–547PubMedGoogle Scholar
  8. Brown KH, Peerson JM, Baker SK, Hess SY (2009a) Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Food Nutr Bull 30:S12–S40PubMedGoogle Scholar
  9. Brown KM, Baker SK, and the IZiNCG Steering Committee (2009b) Galvanizing action: conclusions and next steps for mainstreaming zinc interventions in public health programs. Food Nutr Bull 30:S179–S184PubMedGoogle Scholar
  10. Brown KH, Hambidge KM, Ranum P, Tyler V, and the Zinc Fortification Working Group (2009c) Zinc fortification for cereal flours. Current recommendations and research needs. Food Nutr Bull 31:S62–S74Google Scholar
  11. Brown KH, Engle-Stone R, Krebs NF, Peerson JM (2009d) Dietary intervention strategies to enhance zinc nutrition: promotion and support of breastfeeding for infants and young children. Food Nutr Bull 30:S144–S171PubMedGoogle Scholar
  12. Cakmak I (2009) Enrichment of fertilizers with zinc: an excellent investment for humanity and crop production in India. J Trace Elem Med Biol 23:281–289CrossRefGoogle Scholar
  13. Dewey KG, Adu-Afarwuah S (2008) Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries. Matern Child Nutr 4:24–85PubMedCrossRefGoogle Scholar
  14. Dewey KG, Yang Z, Boy E (2009) Systematic review and meta-analysis of home fortification of complementary foods. Matern Child Nutr 5:283–321CrossRefGoogle Scholar
  15. Frossard E, Bucher M, Machler F, Mozafar A, Hurrell R (2000) Potential for increasing the content and bioavailability of Fe, Zn and Ca in plants for human nutrition. J Sci Food Agric 80:861–879CrossRefGoogle Scholar
  16. Gibson RS (2005) Principles of nutritional assessment, 2nd edn. Oxford University Press, New YorkGoogle Scholar
  17. Gibson RS (2006) Zinc: the missing link in combating micronutrient malnutrition in developing countries. Proc Nutr Soc 65:51–60PubMedCrossRefGoogle Scholar
  18. Gibson RS, Anderson VP (2009) A review of interventions based on dietary diversification or modification strategies with the potential to enhance intakes of total and absorbable zinc. Food Nutr Bull 30:S106–S141Google Scholar
  19. Gibson RS, Ferguson EL (2005) An interactive 24-hour recall for assessing the adequacy of iron and zinc intakes in developing countries. HarvestPLus Technical Monograph Series 8. International Life Sciences Institute, Washington DCGoogle Scholar
  20. Gibson RS, Yeudall F, Drost N, Mtitimuni BM, Cullinan TR (2003) Experiences of a community-based dietary intervention to enhance micronutrient adequacy of diets low in animal source foods and high in phytate: a case study in rural Malawian children. J Nutr 133:3992S–3999SPubMedGoogle Scholar
  21. Gibson RS, Perlas L, Hotz C (2006) Improving the bioavailability of nutrients in plant foods at the household level. Proc Nutr Soc 65:160–168PubMedCrossRefGoogle Scholar
  22. Gibson RS, Hess SY, Hotz C, Brown KH (2008) Indicators of zinc status at the population level: a review of the evidence. Brit J Nutr 99:S14–S23PubMedCrossRefGoogle Scholar
  23. Haider BA, Bhutta ZA (2009) The effect of therapeutic zinc supplementation among young children with selected infections: a review of the evidence. Food Nutr Bull 30:S41–S59PubMedGoogle Scholar
  24. Hambidge KM (1997) Zinc deficiency in young children. Am J Clin Nutr 65:160–161PubMedGoogle Scholar
  25. Hambidge KM, Chavez MN, Brown RM, Walravens PA (1979) Zinc nutritional status of young middle-income children and effects of consuming zinc-fortified breakfast cereals. Am J Clin Nutr 32:2532–2539PubMedGoogle Scholar
  26. Hambidge KM, Huffer JW, Raboy V, Grunwald GK, Westcott JL, Sian L, Miller LV, Dorsch JA, Krebs NF (2004) Zinc absorption from low-phytate hybrids of maize and their wild-type isohybrids. Am J Clin Nutr 79:1053–1059.PubMedGoogle Scholar
  27. Hambidge KM, Miller LV, Westcott JE, Sheng X, Krebs NF (2010) Zinc bioavailability and homeostasis. Am J Clin Nutr 91:1478S–1483SPubMedCrossRefGoogle Scholar
  28. Hess SY, Brown KH (2009) Impact of zinc fortification on zinc nutrition. Food Nutr Bull 30:S79–S107PubMedGoogle Scholar
  29. Hess SY, King JC (2009) Effects of maternal zinc supplementation on pregnancy and lactation outcomes. Food Nutr Bull 30:S60–S78PubMedGoogle Scholar
  30. Holm PB, Krisiansen KN, Pedersen HB (2002) Transgenic approaches in commonly consumed cereals to improve iron and zinc content and bioavailability. J Nutr 132:514S–516SPubMedGoogle Scholar
  31. Hotz C, Gibson RS (2005) Participatory nutrition education and adoption of new feeding practices are associated with improved adequacy of complementary diets among rural Malawian children: a pilot study. Eur J Clin Nutr 59:226–237PubMedCrossRefGoogle Scholar
  32. Hotz C, McClafferty B (2007) From harvest to health: challenges for developing biofortified staple foods and determining their impact on micronutrient status. Food Nutr Bull 28:S271–S279PubMedGoogle Scholar
  33. Huo J, Sun J, Huang J, Li W, Wang L, Selenje L, Gleason GR, Yu X (2011) The effectiveness of fortified flour on micro-nutrient status in rural females adults in China. Asia Pac J Clin Nutr 20:118–124PubMedGoogle Scholar
  34. Iqbal TH, Lewis KO, Cooper BT (1994) Phytase activity in the human and rat small intestine. Gut 35:1233–1236PubMedCrossRefGoogle Scholar
  35. Keen CL, Gershwin ME (1990) Zinc deficiency and immune function. Annu Rev Nutr 10:415–431PubMedCrossRefGoogle Scholar
  36. Kiliç I, Ozalp I, Coŝkun T, Tokatli A, Emre S, Saldamli I, Köksel H, Ozboy O (1998) The effect of zinc-supplemented bread consumption on school children with asymptomatic zinc deficiency. J Pediatr Gastroenterol Nutr 26:167–171PubMedCrossRefGoogle Scholar
  37. King JC (1990) Assessment of zinc status. J Nutr 120:1474–1479PubMedGoogle Scholar
  38. Levenson CW, Morris D (2011) Zinc and neurogenesis: making new neurons from development to adulthood. Adv Nutr 2:96–100PubMedGoogle Scholar
  39. Lönnerdal B (2000) Dietary factors influencing zinc absorption. J Nutr 130:1378S–1383SPubMedGoogle Scholar
  40. Lowe NM, Fekete K, Decsi T (2009) Methods of assessment of zinc status in humans: a systematic review. Am J Clin Nutr 89(suppl):2040S–2051SPubMedCrossRefGoogle Scholar
  41. Mahomed K, Bhutta Z, Middleton P (2007) Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst Rev Apr 18;(2) CD000230.Google Scholar
  42. Nowak G, Szewczyk B, Pile A (2005) Zinc and depression. An update. Pharmacol Rep 57:713–718PubMedGoogle Scholar
  43. Prasad AS, Halstead JA, Nadimi M (1961) Syndrome of iron deficiency anemia, hepatosplenomegaly, hypogonadism, dwarfism and geophagia. Am J Med 31:532–546PubMedCrossRefGoogle Scholar
  44. Rosado JL, Hambidge KM, Miller LV, Garcia OP, Westcott J, Gonzalez K, Conde J, Hotz C, Pfeiffer W, Ortiz-Monasterio I, Krebs NF (2009) The quantity of zinc absorbed from wheat in adult women is enhanced by biofortification. J Nutr 139:1920–1925PubMedCrossRefGoogle Scholar
  45. Wang FD, Wei B, Ling WK, Fa JZ, Jun SG, Nai HJ (2001) Maternal zinc deficiency impairs brain nestin expression in prenatal and postnatal mice. Cell Res 11:135–141PubMedCrossRefGoogle Scholar
  46. Welch RM, Graham RD (2004) Breeding for micronutrients in staple food crops from a human nutrition perspective. J Exper Botany 55:353–364CrossRefGoogle Scholar
  47. WHO/UNICEF (2004) Clinical management of acute diarrhoea. WHO/UNICEF, GenevaGoogle Scholar
  48. WHO/UNICEF/IAEA/IZiNCG (2007) Report of a WHO/UNICEF/IAEA/IZiNCG interagency meeting on zinc status indicators. Food Nutr Bull 28:S399–S483Google Scholar
  49. Zlotkin SH, Cherian MG (1988) Hepatic metallothionein as a source of zinc and cysteine during the first year of life. Pediatr Res 24:326–329PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  1. 1.Department of Human NutritionUniversity of OtagoDunedinNew Zealand

Personalised recommendations