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Background/Objective: Zinc deficiency is common worldwide and has been linked to reduced growth and immune function, increased risk of and slower recovery from infections, and increased risk of non-communicable diseases. To address the issue, zinc biofortification of wheat has been proposed as a sustainable approach to increase dietary zinc intake in countries like Pakistan, where zinc deficiency rates are high and wheat is the primary staple crop. Since plasma zinc concentration (PZC) does not reliably respond to small changes in zinc intake, biomarkers sensitive to small changes in zinc intake achievable though biofortification are needed. Activity indices for zinc-dependent metabolic steps of desaturation and elongation of omega-6 fatty acids (FAs) have been proposed as sensitive zinc biomarkers. Oxylipin metabolites of polyunsaturated FAs may also respond to changes in zinc intake and further mediate metabolic response to oxidative stress. The objective of the current study was to assess the effects of consuming zinc-biofortified wheat flour on plasma markers of fatty acid (FA) metabolism in females aged 10–16 years. Methods: A nested secondary analysis was conducted in samples from a double-blind, cluster-randomized controlled trial conducted in rural Pakistan, whereparticipants (n = 517) consumed either zinc-biofortified wheat flour or control flour for 25 weeks. Total plasma FAs and oxylipins were measured by liquid chromatography tandem mass spectrometry (LC–MS/MS). Activity indices were estimated from the ratios of product to precursor FAs. Results: Except for docosahexaenoic acid (DHA, p < 0.05), no significant intervention effect was observed on plasma FAs and FA activity index endpoints. Zinc-biofortified wheat intake reduced pro-inflammatory oxylipins and biomarkers of oxidative stress, 5-HETE (p < 0.05), 9-HETE (p < 0.05), 11-HETE (p < 0.05), and 15-HETE (p < 0.05), compared with the control. However, after adjustment for multiple comparisons, none of the intervention effects remained significant. Conclusions: Further study of the responsiveness and specificity of plasma oxylipins to changes in zinc intake is warranted. [ABSTRACT FROM AUTHOR]

BACKGROUND: Zinc biofortification of rice could sustainably improve zinc status in countries where zinc deficiency is common and rice is a staple, but its efficacy has not been tested. Fatty acid desaturases (FADS) are putative new zinc status biomarkers. OBJECTIVES: Our objective was to test the efficacy of zinc-biofortified rice (BFR) in preschool-aged children with zinc deficiency. Our hypothesis was that consumption of BFR would increase plasma zinc concentration (PZC). METHODS: We conducted a 9-mo, double-masked intervention trial in 12-36-mo-old rural Bangladeshi children, most of whom were zinc-deficient (PZC  0.05). There was a time-treatment interaction for height-for-age z-scores (P

The present study evaluated the effects of early supplementation with zinc proteinate (ZnP) or zinc oxide (ZnO) for 2 weeks on the growth performance, redox status, plasma trace element concentrations, and rectal microbiota of preweaned dairy calves. A total of 60 newborn healthy female Holstein dairy calves, with initial body weight (BW): 41.33 ± 0.62 kg, were randomly allocated to 5 groups of 12 each: a control group (CON); three groups supplemented with 261 (L-ZnP), 523 (M-ZnP), and 784 (H-ZnP) mg/day ZnP, equivalent to 40, 80, and 120 mg/day zinc, respectively; and one group supplemented with 232 mg/day ZnO, equivalent to 180 mg/day zinc (ZnO). Zinc supplements were administered on days 1–14, and the calves were followed up until day 70. Zinc supplementation increased total dry matter intake (DMI) and starter DMI compared with the CON group (p

BackgroundWe assessed the effects of providing a package of interventions including small-quantity lipid-based nutrient supplements (SQ-LNS) containing 0, 5 or 10 mg zinc and illness treatment to Burkinabe children from 9 to 18 months of age, on biomarkers of zinc, iron and vitamin A status at 18 months and compared with a non-intervention cohort (NIC).MethodsUsing a two-stage cluster randomized trial design, communities were randomly assigned to the intervention cohort (IC) or NIC, and extended family compounds within the IC were randomly assigned to different treatment groups. IC children (n = 2435) were provided with 20 g SQ-LNS/d containing 0, 5 or 10 mg zinc, 6 mg of iron and 400 μg of vitamin A along with malaria and diarrhea treatment. NIC children (n = 785) did not receive the intervention package. At 9 and 18 months, hemoglobin (Hb), zinc, iron and vitamin A status were assessed in a sub-group (n = 404). Plasma concentrations of zinc (pZC), ferritin (pF), soluble transferrin receptor (sTfR) and retinol-binding protein (RBP) were adjusted for inflammation.ResultsAt baseline, 35% of children had low adjusted pZC (8.3 mg/L) and 47% had low adjusted RBP (

Biofortification of wheat is potentially a sustainable strategy to improve zinc intake; however, evidence of its effectiveness is needed. A household-based, double-blind, cluster-randomized controlled trial (RCT) was conducted in rural Pakistan. The primary objective was to examine the effects of consuming zinc-biofortified wheat flour on the zinc status of adolescent girls aged 10–16 years (n = 517). Households received either zinc-biofortified flour or control flour for 25 weeks; blood samples and 24-h dietary recalls were collected for mineral status and zinc intake assessment. Plasma concentrations of zinc (PZC), selenium and copper were measured via inductively coupled plasma mass spectrometry and serum ferritin (SF), transferrin receptor, alpha 1-acid glycoprotein and C-reactive protein by immunoassay. Consumption of the zinc-biofortified flour resulted in a moderate increase in intakes of zinc (1.5 mg/day) and iron (1.2 mg/day). This had no significant effect on PZC (control 641.6 ± 95.3 µg/L vs. intervention 643.8 ± 106.2 µg/L; p = 0.455), however there was an overall reduction in the rate of storage iron deficiency (SF < 15 µg/L; control 11.8% vs. 1.0% intervention). Consumption of zinc-biofortified flour increased zinc intake (21%) but was not associated with an increase in PZC. Establishing a sensitive biomarker of zinc status is an ongoing priority. [ABSTRACT FROM AUTHOR]

Background Zinc biofortification of rice could sustainably improve zinc status in countries where zinc deficiency is common and rice is a staple, but its efficacy has not been tested. Fatty acid desaturases (FADS) are putative new zinc status biomarkers. Objectives Our objective was to test the efficacy of zinc-biofortified rice (BFR) in preschool-aged children with zinc deficiency. Our hypothesis was that consumption of BFR would increase plasma zinc concentration (PZC). Methods We conducted a 9-mo, double-masked intervention trial in 12–36-mo-old rural Bangladeshi children, most of whom were zinc-deficient (PZC <70 µg/dL) and stunted (n  = 520). The children were randomly assigned to receive either control rice (CR) or BFR provided in cooked portions to their households daily, with compliance monitoring. The primary outcome was PZC. Secondary outcomes were zinc deficiency, linear growth, infection-related morbidity, FADS activity indices, intestinal fatty acid binding protein (I-FABP) and fecal calprotectin. We applied sparse serial sampling for midpoint measures and analyzed data by intention-to-treat using mixed-effects models. Results At baseline, median (IQR) PZC was 60.4 (56.3–64.3) µg/dL, 78.1% of children were zinc deficient, and 59.7% were stunted. Mean ± SD daily zinc intakes from the CR and BFR during the trial were 1.20 ± 0.34 and 2.22 ± 0.47 mg/d, respectively (P  < 0.001). There were no significant time-by-treatment effects on PZC, zinc deficiency prevalence, FADS activity, I-FABP, or fecal calprotectin (all P  > 0.05). There was a time–treatment interaction for height-for-age z -scores (P  < 0.001) favoring the BFR group. The morbidity longitudinal prevalence ratio was 1.08 (95% CI: 1.05, 1.12) comparing the BFR and CR groups, due to more upper respiratory tract illness in the BFR group. Conclusions Consumption of BFR for 9 mo providing ∼1 mg of additional zinc daily to Bangladeshi children did not significantly affect PZC, prevalence of zinc deficiency, or FADS activity. The trial was registered at clinicaltrials.gov as NCT03079583. [ABSTRACT FROM AUTHOR]

Adherence to supplementation provided during an intervention trial can affect interpretation of study outcomes. We compared different approaches for estimating adherence to small-quantity lipid-based nutrient supplements (SQ-LNS) and dispersible tablets in a randomised clinical trial in Burkina Faso. A total of 2435 children (9-18 months) were randomly assigned to receive daily 20 g SQ-LNS with varying contents of zinc and a dispersible tablet containing 0 or 5 mg zinc. Adherence to SQ-LNS and tablets was assessed for all children through weekly caregiver interviews, and disappearance rate was calculated based on empty and unused packages returned during home visits. Additional adherence data were collected in different randomly selected subgroups of children: 12-h home observations were completed for children 11 and 16 months of age (n = 192) to assess consumption of SQ-LNS and dispersible tablets, and plasma zinc concentration was measured at baseline and 18 months (n = 310). Apparent adherence to SQ-LNS and dispersible tablets differed according to the assessment method used. Average daily caregiver-reported adherence to both SQ-LNS and dispersible tablets was 97 ± 6%. Disappearance rates showed similarly high average weekly adherence (98 ± 4%). In contrast, only 63% and 54% of children at 11 and 16 months, respectively, received SQ-LNS during the 12-h home observation periods, and fewer (32% and 27%) received a tablet. The lack of change in plasma zinc concentration after 9 months of supplementation suggests low adherence to the zinc tablet. Better methods are needed to assess adherence in community-based supplementation trials.

Objective: Zn deficiency and diarrhoea are prevalent and may coexist in children living in low-resource settings. Recently, a novel approach for delivering Zn via microbiologically treated, Zn-fortified water was shown to be effective in improving Zn status in West African schoolchildren. We assessed the effectiveness of Zn-fortified, microbiologically purified water delivered as a household intervention on Zn intake, status and morbidity in children aged 2-6 years from rural western Kenya.Design: Randomised controlled trial. Intervention included households assigned to water treatment device with (ZFW) or without (FW) Zn delivery capability SETTING: Rural households in Kisumu, western Kenya.Subjects: Children aged 2-6 years.Results: The ZFW group had higher dietary Zn intake compared with the FW group. ZFW contributed 36 and 31 % of daily requirements for absorbable Zn in children aged 2-3 and 4-6 years, respectively, in the ZFW group. Consumption of Zn-fortified water resulted in lower prevalence of reported illness (risk ratio; 95 % CI) in the ZFW group compared with the FW group: for cold with runny nose (0·91; 0·83, 0·99; P=0·034) and abdominal pain (0·70; 0·56, 0·89; P=0·003) in the intention-to-treat analysis and for diarrhoea (0·72; 0·53, 0·96; P=0·025) in the per-protocol analysis. We did not detect an effect of treatment on plasma Zn concentration.Conclusions: Daily consumption of Zn-fortified, microbiologically treated water results in increased intake of absorbable dietary Zn and may help in preventing childhood infections in pre-school children in rural Africa. [ABSTRACT FROM AUTHOR]

Background: Information is needed on the national prevalence of zinc deficiency to guide program development and evaluation.Objective: To summarize results of national surveys that assessed plasma or serum zinc concentrations (PZC) and compare the prevalence of low PZC with other methods used to estimate countries' risk of zinc deficiency.Methods: National surveys that included PZC were identified through Internet searches and personal contacts. A survey was eligible if a nationally representative sampling scheme was used, PZC was analyzed, and the survey was implemented in a low- or middle-income country. Twenty surveys were eligible; 19 countries assessed PZC in young children and 14 in women of reproductive age.Results: In 13 of the 19 surveys, the prevalence of low PZC in children was >20%. Only Afghanistan, Azerbaijan, Nigeria, the Republic of Maldives, Sri Lanka, and China found a low prevalence of inadequate PZC among children. Some of these conclusions may be due to the lower than recommended cutoff that was used. Similarly, in 13 of 14 surveys, the prevalence of low PZC in women was >20%. Estimates of percentage population with inadequate dietary zinc intake based on food balance sheets underestimate the risk of zinc deficiency. The national stunting prevalence seems to be a useful proxy, as both indicators categorized countries similarly into high versus low risk of zinc deficiency, with some exceptions.Conclusions: Results from 20 countries suggest that zinc deficiency is a public health concern in the majority of these countries and zinc intervention strategies should be considered. [ABSTRACT FROM AUTHOR]

Background: Three commonly recommended indicators for risk assessment of population zinc deficiency are stunting rates among children aged <5 y, prevalence of inadequate dietary zinc intake, and prevalence of low plasma zinc (PZn). Data on zinc status in Benin are mainly drawn from stunting rates and data on PZn and dietary zinc intake are lacking.Objectives: The aims of this study were 1) to assess the risk of zinc deficiency in preschool and school-age children from rural communities in northern Benin by means of the 3 indicators for population assessment, 2) to evaluate their level of agreement, and 3) to identify predictors of PZn and height-for-age z scores (HAZ).Methods: We analyzed preintervention data collected during 2 efficacy trials and cross-sectionally assessed the risk of zinc deficiency in preschool (1-5 y, n = 326) and school-age children (5-10 y, n = 272) by 1) conducting a 3-d weighed food record survey, coupled with direct zinc and phytic acid analysis of consumed foodstuffs, and calculating usual dietary zinc intakes in a subsample of school-age children (n = 36); 2) analyzing PZn in all children (n = 598); and 3) measuring anthropometry indexes for assessment of stunting (HAZ <-2 SD) in all children (n = 594) and in <5-y-old children only (n = 273). We derived predictors of PZn and HAZ by using multivariate regression with mixed-effect models.Results: Prevalence of inadequate intakes of zinc ranged from 11% to 80% depending on whether the estimated average requirements (EARs) by the International Zinc Nutrition Consultative Group or the EARs derived from the WHO's recommended nutrient intakes were used. Prevalence of low PZn adjusted for acute-phase protein status was 45.7%, with higher rates among preschoolers than school-age children (P = 0.002). The stunting rate in <5-y-old children was 51.3%. PZn was predicted by age, methodologic factors, and socioeconomic status, whereas HAZ was predicted by age, sex, hemoglobin, and socioeconomic status.Conclusions: The prevalence of <5-y stunting and the prevalence of low PZn indicate that the risk of zinc deficiency is elevated in this population. Risk estimates based on the prevalence of inadequacy of zinc intakes varied depending on the EARs used, and a consensus would facilitate nutrition survey evaluations. These trials were registered at clinicaltrials.gov as NCT01472211 and NCT01790321. [ABSTRACT FROM AUTHOR]

Objective: To perform zinc nutritional assessment of children aged 2- 5years in rural areas of China according to the joint recommendation by the WHO /UNICEF / IAEA / IZi NCG., Methods: Based on the project of China Nutrition and Health Survey 2002( CNHS 2002), a stratified sampling combined with the probability proportional to population size sampling method was employed. The concentration of plasma zinc was determined by high resolution inductively coupled plasm mass spectrometry, and the data of dietary zinc intake and the physical examination was collected. The assessment of zinc nutrition was obtained by 3 aspects of indicators involving plasma zinc, dietary zinc intake and the development of growth., Results: Plasma zinc concentration was 714. 9 μg / L, and 45. 5% of children with zinc deficiency. Dietary zinc intake was 5. 9 mg / d, and the prevalence of inadequate dietary zinc intake was 18. 1%. The height for age Z score was- 0. 8, with 18. 2% of children who were stunted., Conclusion: Zinc nutritional status of children aged 2- 5 years in rural areas is poor in the CNHS 2002. The status of plasma zinc is utmost serious in comparison withother indicators. The status of zinc nutrition in children aged 2- 5 years from the 4th rural areas is required to be continuous attention. Zinc nutrional assessment provides an extremely useful information and technical reference for early childhood.