Determinants of Zinc Status of 2-3-Year-Old Children in Laguna, Philippines

Introduction: Zinc deficiency has been considered a micronutrient problem of high magnitude in the Philippines. The effect of zinc deficiency on physical growth manifests during the first two years of life and is associated with high rates of infection and inadequate nutrition. The study aims to assess the zinc status of children and identify factors that affect zinc status. Methods: A multi-stage stratified random sampling was used in a cross-sectional study of 2 -3-year-old children currently residing in the province of Laguna, Philippines. Data were collected through a structured questionnaire. A 24-hour food recall data sheet was used for evaluation of food intake. The physical dimensions of children were measured using salter weighing scale and height board. A static biochemical test of nutrients in the blood was carried out to assess the level of zinc and presence of infection in the body. The Early Childhood Care and Development program checklist, Metro Manila Developmental Screening Test and Child Development Index were adapted to determine the level of cognitive development of children. Results: Correlation analysis revealed that anthropometric indices and food intake had a significant and positive linear association with zinc status (energy r=.014; P=.000; protein r=.027; P=.000; zinc r=.044; P=.000; iron r=.070; P=.000). The presence of infection was found to have a negative but significant relationship with zinc status. Zinc status was significantly associated with cognitive development. Conclusion: The study showed that determinants of zinc status are nutrient intake (such as energy and zinc), infection, height-for-age index and cognitive development.

Zinc Nutritional Status and anthropometriciIndices of Preschool children living in a rural community in Edo State, Nigeria

@#Zinc deficiency impairs growth and development but epidemiological data for zinc nutrition status among preschool children living in rural areas of Nigeria is lacking. The aim of the present study was to assess the zinc status and anthropometric indices of children aged between 6 and 60 months, living in a rural community in Edo State, Nigeria. In this community-based cross-sectional study, five out of the nine political wards (quarters) in the community were randomly selected; all the households with children aged between 6 and 60 months were included the study. A total of 252 children were selected to participate after obtaining informed consent from their parents. Steps were taken to avoid exogenous zinc contamination of the blood samples which were collected in the mornings. The serum zinc levels of the subjects were determined, using flame atomic absorption spectrophotometry. The weights, heights, head and mid-upper arm circumferences of each child were measured, using standard procedures. Z- scores of anthropometric indices of height-for-age, weight-for-age and weight-for-height were computed to assess the nutritional status of the children. The mean age of the study population was 32.7±17.0 months. The prevalence rates of stunting, underweight and wasting among the children were 18.2%, 14.7% and 11.1%, respectively. The overall mean serum zinc concentration was 4.77±3.02μmol/L, with a range of 1.0 16.52μmol/L. Of the 252 children, 220 (87.3%) had mean serum zinc concentration below 7.65μmol/L, representing severe zinc deficiency. The highest mean serum zinc concentration was found among children aged 6 to 12 months and this was followed by a progressive decline in serum zinc concentration from the age of 13 months up to 48 months. Correlation between the serum zinc concentration of the children and their age and social class of the parents were as follows: age, r = 0.09, at p = 0.15; social class, r = 0.08; at p = 0.21. The children with wasting had the lowest mean serum zinc concentration compared with either the group with underweight or stunting. The zinc nutritional status of preschool-age children in this community clearly indicates a suboptimal zinc status at the time of this study. According to the IZiNCG criteria, this should be considered as a public health problem among preschool-age children in this community. To effectively address the issue, social mobilization, intensive education and awareness campaign, with all target groups and policy makers are urgently required. Public health measures aimed at improving their zinc nutritional status should also be considered.

Compromised zinc status of experimental rats as a consequence of prolonged iron & calcium supplementation.

Background & objectives: Iron supplementation is usually given to pregnant and lactating women who may also have marginal deficiency of zinc. The negative impact of supplemental iron and calcium on zinc status is a cause of concern. The present investigation was undertaken to examine the effect of inclusion of iron and calcium in the diet at supplementary levels on zinc status of experimental rats. Methods: Groups of experimental rats were maintained on diets supplemented with iron (Molar ratio - Zn:Fe 1:30) and calcium (Molar ratio - Zn:Ca 1:667) both individually and in combination for six weeks. Zinc status of these rats was assessed by determining zinc concentration in circulation and in organs, and the activities of zinc containing enzymes in serum and liver. Results: The zinc status of experimental rats receiving supplemental levels of iron and calcium was significantly compromised. Zinc concentration in serum, kidney, spleen and liver was reduced significantly by both these minerals. Six weeks of supplementation of iron and calcium individually, significantly reduced the activity of liver and serum superoxide dismutase and alkaline phosphatase. Activity of liver alcohol dehydrogenase was lowered in calcium supplemented group and in calcium + iron supplemented group, while that of carbonic anhydrase was significantly reduced by iron, calcium and their combination. Interpretation & conclusions: Supplemental levels of iron and calcium, both individually and in combination, significantly compromised the zinc status of experimental rats. This negative effect of these two minerals was more prominent when these were supplemented for a period of six weeks.

Zinc status and growth of Korean infants fed human milk, casein-based, or soy-based formula: three-year longitudinal study

To evaluate the effect of feeding methods on growth and zinc nutritional status of infants early in life, we monitored from birth to 36 months in 51 infants who were exclusively fed human milk (HM, n = 20), casein-based formula (CBF, n = 12), or soy-based formula (SBF, n = 19) during the first five months of life. Zinc status was assessed by analyzing serum zinc concentrations and zinc intakes. Zinc contents in HM and formulas were measured. Zinc intake was estimated by weighing infants before and after feeding in the HM group and by collecting formula-intake records in the CBF and SBF groups. After solid foods were introduced, all foods consumed were also included to estimate zinc intake. The growth of infants in all groups was similar to that established for normal Korean infants. Human milk zinc concentrations declined as lactation progressed. Zinc concentrations in all formulas tested in this study were higher than HM and were also higher than those claimed by the manufacturers. During the first twelve months, mean serum zinc concentrations of infants were similar in all groups, although infants in the HM group consistently had the lowest zinc intake among the groups, and the overall zinc intake in infants fed SBF was highest. This finding could be explained by the different zinc bioavailability of HM and formulas. In conclusion, infants fed HM, CBF or SBF has normal growth up to three years of age, although HM contained the lowest zinc concentration followed by CBF, then SBF.

The Effect of Zinc Status on Salty Taste Acuity, Salty Taste Preference, Sodium Intake and Blood Pressure in Korean Young Adults

High sodium intake is one of the risk factors for the development of hypertension. According to 2007 Korean National Health and Nutrition Examination Survey, sodium intake of Korean was three times higher than adequate intake (1.5 g/day) recommended by Korean Dietary Reference Intakes. High sodium intake is related to high threshold and preference of salty taste. And zinc status is known to affect taste acuity. The hypothesis of this study is that zinc status is associated with salty taste acuity, preference, sodium intake and blood pressure. The subjects included in this study were 50 men and 41 women aged 20-29 y who did not smoke and not take supplements or medications regularly. Dietary intake data for 3 days were collected by 24-h recall for 1 day and dietary record for 2-days. Salty taste acuity and preference were determined by sensory test. Fasting serum concentration of zinc, height, weight, body composition and blood pressure data were collected. Salt taste preference in high zinc intake group (> or = estimated average requirement, EAR; men-8.1 mg/day, women-7 mg/day) was higher than that in low zinc intake group (< EAR). Salty taste preference was inversely correlated with serum zinc concentration in people with low concentration of serum zinc (<== 81microgram/dL)(r = -0.3520, p < 0.05). Diastolic blood pressure was higher in high sodium intake group than in low sodium intake group (p < 0.05), positively correlated with salty taste preference (r = 0.3866, p < 0.05) in subjects with daily zinc intake below the EAR. We conclude that low zinc status may be related to high salty taste preference and high blood pressure in Korean young adults.

Zinc status and dietary quality of type 2 diabetic patients: implication of physical activity level

The purpose of this study was to analyze the relationships among zinc status, diet quality, glycemic control and self-rated physical activity level of type 2 diabetic patients. Dietary intakes for two non-consecutive days were measured by 24-hour recall method for seventy-six diabetic patients. Fasting blood glucose and HbA1c were measured for the assessment of glycemic control. We evaluated the extent of dietary adequacy by the percentage of subjects with a dietary intake of a nutrient less than the estimated average requirement(EAR), the dietary diversity score(DDS) and the dietary variety score(DVS). Zinc status was assessed from serum levels and urinary excretion. Dietary inadequacy was serious for five nutrients: riboflavin, calcium, thiamin, zinc and vitamin C. Dietary intakes from the meat, fish, and egg food groups and the milk food group were below the recommended level. We found that subjects with high levels of physical activities had significantly higher DVS and serum zinc levels compared to others (p<0.05). Fasting blood glucose levels and HbA1c were not significantly different across self-reported physical activity levels. Therefore, we suggest that maintaining physical activity at or above a moderate level is beneficial to improving dietary quality and zinc status.

Serum Zinc Level and Its Related Dietary Factors in Male Patients with Coronary Heart Disease

Zinc is an antioxidant trace mineral, scavenging free radicals and known to be involved in inflammatory reactions. The prevalence of atherogenic diseases such as coronary heart disease (CHD) are increasing in Korean adults of middle age and elderly. The increased cell damage from free radicals and inflammation have been implicated in etiology of CHD, and the evidence is accumulating that low zinc status is involved in the prevalence of this inflammatory atherogenic disease. However, little is known about the zinc status of Korean CHD and its relationship with dietary zinc intake and zinc bioavailabilty. In this study the serum zinc levels of male patients with CHD over 40 yrs. were compared with that of healthy adult males and its associations with dietary zinc intake and zinc bioavailabilty affecting factors were examined. Serum zinc level was measured by HANARO research reactor using neutron activation analysis (NAA) method. The overall proportion of patients with zinc deficiency, serum zinc concentrations below 74.0 microgram/dL was 32.8% compared to the 10.3% in healthy group. The average serum zinc levels were 80.7 microgram/dL and 88.3 microgram/dL in patients and healthy group, respectively, showing significantly low zinc status in CHD patients compared to healthy group. The intake of nutrients such as energy, carbohydrate, iron, and copper of CHD patients was significantly higher compared to that of the healthy group. In addition, the intake of calcium, iron, and protein from vegetable foods was significantly higher in CHD patients than that of healthy group. The dietary zinc intake was 12.7+/-4.5 mg and 11.5+/-6.9 mg in CHD patients and control group, respectively, which showed no difference. The phytate intake of patients group, which is 1389.0 mg, was significantly higher than the control group which showed 1104.8 mg. However, the ratio of phytate :zinc or phytate *calcium :zinc per 1000 kcal energy intake did not show any difference between two groups. The serum zinc levels did not show any correlation with zinc or factors that affect the bioavailability of zinc. The dietary factors influencing the zinc status were not found in CHD patients.

A Study on the Zinc Intake and Urinary Excretion of Preschool Children in Busan

To assess zinc status by dietary intake and urinary excretion of preschool children in Busan and to evaluate the relationship of intakes of food and nutrient with urinary zinc excretion, zinc food frequencies of 40 common foods affecting intakes of zinc by food fequency method, nutrient intake by 24hr recall and 24hr urinary zinc excretion were measured with 97 preschool children. The mean zinc intake was 4.29 mg and 43.0% of RDA. The mean zinc intake per 1,000 kcal was 3.09 mg.97.9% of subjects had zinc intake less than 75% of RDA. Grains food group was the primary source of zinc intake and supplied 38.9% of the total daily zinc intake. Altogether, plant food products supplied 49.7% of zinc intake. The mean urinary zinc excretion and zinc excretion per gram of creatinine were 0.19 mg and 1.00 mg respectively. The urinary zinc excretion showed positive significant correlations with height and weight (p<0.05, p<0.05) , urine volume and urinary creatinine excretion (p<0.05, p<0.001) , urinary zinc excretion per creatinine (p<0.001) , urinary zinc excretion per weight (p<0.001) , intakes of energy and carbohydrate (p<0.05, p<0.01) and usual intake of zinc from eggs food group (p<0.05) . In conclusion, these results show that the zinc intake of preschool children is low and that sources of dietary zinc are mainly plant foods, suggesting low bioavailability. So nutritional education is needed in order to inc-rease usual intake of animal food group. Interpretation of urinary zinc excretion data is complicated by current uncertainty about "normal" zinc level at this age group. Further studies are needed to obtain extensive data on urinary zinc excretion for this age group.age group.

Nutrients Intake, Zinc Status and Health Risk Factors in Elderly Korean Women as Evaluated by the Nutrition Screening Inistiative (NSI) Checklist / 대한지역사회영양학회지

The purpose of this study was to investigate whether the health status as determined by a self-assessment checklist was related to the nutritional status of elderly Korean women. We interviewed 59 female subjects living in the Daegu area aged over 55 years. Information on their dietary intake on two consecutive days was collected by the 24-hour Recall Method. Their body compositions were measured using a Bio-electrical Impedence Fatness Analyzer. Their zinc status was evaluated according to their dietary zinc intake and urinary zinc excretion in urine samples collected for 24 hours. Their heath status was determined by a NSI Checklist. While 50.9% of the total subjects belonged to a moderate nutritional risk group, 23.7% of the subjects were at a high nutritional risk. It appeared that only 25.4% of the subjects were evaluated as being healthy. Therefore, the overall nutritional health status of the elderly females belonged to the moderate nutritional risk group. Except for vitamin C, the average daily nutrient intake of the subjects was below the level of the recommended dietary allowances (RDA) for Koreans. The lower the nutritional health score, the better was their dietary intake of energy (p < .05), protein (p < .001), and zinc (p < .01). A positive relationship between their nutritional health score and body fat ratio was also observed (p < .05). Therefore, we suggest that the NSI Checklist could be used as a practical screening tool at the beginning of nutritional surveillance of the elderly in the community.

Zine Status of Adult Female in the Taegu Region as Assessed by Dietary Intake and Urinary Excretion / 대한지역사회영양학회지

This study was intended to examine the zinc status of free-living adult women living in the Taegu region. Zine intake of 102 female subjects was measured by food frequency method for 3 consecutive days. Urinary zine was assessed from urine samples collected fir twenty four hours. Average dietary zinc intake of adult female subjects using food record was 5.9+/-1.8 mg which was 49% of Korean RDA. When zine intake by frequency method was higher than by food record. Average urinary zine intake by frequency method was higher than that by food record. Thus, it appeared that zinc intake by frequency method was higher than that by food record. Average urinary zinc excretion of 102 adult female subjects was 0.28+/-0.16 mg, which belonged to marginal zinc deficiency range. Fifty nine of 102 subjects showed marginal zinc deficiency as assessed by urinary zinc excretion. If we compare the zinc status of adult female subjects by age group, zinc intake in the 50s was significantly higher than any other age groups. However, there were no significant differences in zinc status according to BMI groups and BMI groups. Significant correlations were found between zinc intake and energy, protein, carbohydrate and fat intake. Based on dietary zinc intake and urinary zinc, we concluded that zinc status of adult female living in the Taegu region is marginally deficient.