Nutrition intervention strategies to combat zinc deficiency in developing countries

Gibson, Rosalind S.; Ferguson, Elaine

doi:10.1079/nrr19980008

Cited by 98 publications

(96 citation statements)

References 71 publications

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“…These include germination, fermentation, and soaking. A detailed discussion of these strategies is given in Gibson et al (1997) and Gibson & Ferguson (1998). All three methods induce some enzymatic and/or non-enzymatic hydrolysis of phytic acid (hexa-inositol phosphate) and penta-inositol phosphate to lower inositol phosphates that do not inhibit zinc and iron absorption Brune et al, 1992).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, if these complementary foods are consumed with breast milk, they may actually compromise the bioavailability of certain trace minerals (iron and zinc) in the breast milk (Bell et al, 1987). Unfortunately, the phytic acid, dietary ®bre and polyphenol content of many plant-based complementary foods is high: these dietary components are known to inhibit the absorption of some major and trace minerals (Gibson & Ferguson, 1998). As a result infants in rural areas in developing countries are especially vulnerable to trace mineral de®ciencies, exacerbated by low body stores at birth because of prematurity and/or low birth weight, induced by poor maternal nutritional status during pregnancy (Gibson, 1994).…”

Section: Introductionmentioning

confidence: 99%

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Complementary foods for infant feeding in developing countries: their nutrient adequacy and improvement

Lehrfeld³

1998

Eur J Clin Nutr

227

240

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Objective: To assess the energy and nutrient adequacy of a variety of complementary foods used in parts of Africa, India, Papua New Guinea, the Philippines and Thailand. Method: The energy, nutrient and anti-nutrient (dietary ®bre and phytic acid) content (per 100 g as eaten, per 100 kcal, and per day) of twenty-three plant-based complementary foods consumed in developing countries was calculated from food composition values based on chemical analysis for the trace minerals, non-starch polysaccharide and phytic acid, and the literature. Results were compared with the estimated nutrient needs (per day; per 100 kcal) from complementary foods for infants 9±11 months, assuming a breast milk intake of average volume and composition and three complementary feedings per day, each of 250 g. Results:Complementary foods should provide approximately 25±50% of total daily requirements for protein, ribo¯avin and copper; 50±75% for thiamin, calcium and manganese; and 75±100% for phosphorus, zinc and iron. Most or all appear to meet the estimated daily nutrient needs (per day; per 100 kcal) from complementary foods for protein, thiamin and copper (per day), but not for calcium, iron, and in some cases zinc, even if moderate bioavailability for iron and zinc is assumed. Some of those based on rice are also inadequate in ribo¯avin (per day; per 100 kcal). Conclusions: Even if strategies to improve the bioavailability of iron and zinc are employed, they are probably insuf®cient to overcome the de®cits in calcium, iron and zinc. Therefore, research on the feasibility of fortifying plant-based complementary foods in developing countries with calcium, iron and zinc is urgently required. Sponsorship: This study was supported by the Micronutrient Initiative through the Canadian International Development Agency.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Complementary foods for infant feeding in developing countries: their nutrient adequacy and improvement

Lehrfeld³

1998

Eur J Clin Nutr

227

240

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“…Zinc supplementation may improve pregnancy outcomes for chronically deficient pregnant women (JC King, unpublished observations, 2000). Prophylactic doses of 20-25 mg elemental zinc/d have generally been used in pregnant women in developing countries (58), and the WHO (49) set the UL at 35 mg/d.…”

Section: Supplementationmentioning

confidence: 99%

Nutrition in pregnancy: mineral and vitamin supplements

Ladipo

2000

The American Journal of Clinical Nutrition

211

129

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Pregnancy is associated with physiologic changes that result in increased plasma volume and red blood cells and decreased concentrations of circulating nutrient-binding proteins and micronutrients. In many developing countries, these physiologic changes can be aggravated by undernutrition, leading to micronutrient deficiency states, such as anemia, that can have disastrous consequences for both mothers and newborn infants. Multiple micronutrients are often taken by pregnant women in developed countries, but their benefits are limited, except for prophylactic folic acid taken during the periconceptional period. Women in developing countries may benefit from multiple-micronutrient prophylaxis in pregnancy, but the underlying basis and rationale for changing from supplementation with iron and folate to supplementation with multiple micronutrients has not been debated in the context of existing program objectives. There is an urgent need for this discussion so that both program effectiveness and program efficacy can be improved. Am J Clin Nutr 2000;72(suppl):280S-90S. KEY WORDSNutrition, vitamins, trace elements, minerals, pregnancy, requirements INTRODUCTIONThe demand for both energy and nutrients is increased during pregnancy (1). For well-nourished women, only a small amount of additional energy is required because the body adapts to the increased energy requirements and becomes more energy efficient through reduced physical activity and a lowered metabolic rate. Although the average-sized, well-nourished woman requires Ϸ10 460 kJ/d (2000 kcal/d) during the last trimester of pregnancy (2), many women in developing countries restrict their food intake during pregnancy to have smaller infants, on the premise that smaller infants will carry a lower risk of delivery complications (3). Recent evidence suggests, however, that infants who are small or disproportionate at birth have increased health risks later in life (4-6). The hypothesis is that such infants have had to adapt to a limited supply of nutrients and that in so doing their physiology and metabolism are permanently changed, although the rationale for this hypothesis has been challenged (7).Requirements for many, but not all, micronutrients increase during pregnancy. Deficiencies can exist because of losses or malabsorption associated with disease or inadequate intakes, lack of knowledge about adequate prenatal nutrition, or dietary taboos associated with pregnancy (8), with potential adverse consequences for both mothers and newborn infants. Rush (9) notes that anemia in pregnancy and pregnancy-induced hypertension are common and thought to contribute significantly to maternal mortality and morbidity in developing countries. Maine (10), however, shows there is little evidence that nutrition plays a role in pregnancy-induced hypertension.This paper discusses minerals and trace elements as well as fat-and water-soluble vitamins in pregnancy-their concentrations, the requirements for them, the consequences of their deficiency, and the functional eff...

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“…Our intervention employed dietary diversification and traditional household methods for preparing and processing indigenous foods 19 . Specifically, our dietary strategies involved:…”

mentioning

confidence: 99%

“…Incorporating absorption enhancers of iron, zinc, provitamin A carotenoids and vitamin A in household diets; and 3. Employing germination, fermentation and soaking to reduce the phytate content of maize and/or legumes by enzyme-induced hydrolysis of phytate and/or passive diffusion of water-soluble phytate 19 .…”

mentioning

confidence: 99%

Efficacy of a community-based dietary intervention to enhance micronutrient adequacy of high-phytate maize-based diets of rural Malawian children

Yeudall

Gibson

Cullinan

et al. 2005

Public Health Nutr.

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Objective: To evaluate the efficacy of a community-based dietary intervention to reduce risk of micronutrient inadequacies in high-phytate maize-based Malawian diets. Design: Quasi-experimental post-test design with a non-equivalent control group. Setting: Four villages in Mangochi District, Southern Malawi. Participants: Households with children aged 3-7 years in two intervention (n ¼ 200) and two control (n ¼ 81) villages participated in a 6-month intervention employing dietary diversification, changes in food selection patterns, and modifications to food processing to reduce the phytate content of maize-based diets. Baseline comparability between the groups was confirmed via assessment of sociodemographic characteristics, anthropometry, knowledge and practices, morbidity, haemoglobin and hair zinc. After 12 months, knowledge and practices and dietary intakes were assessed by interactive 24-hour recalls, one during the food plenty and a second during the food shortage season. Nutrient adequacy for the two groups was compared via dietary quality indicators and predicted prevalence of inadequate intakes using the probability approach. Results: Intervention children had diets that were significantly more diverse and of a higher quality than those of controls. Median daily intakes of protein, calcium, zinc (total and available), haem iron, vitamin B 12 and animal foods (grams; % of total energy) were higher (P , 0.05) whereas phytate intakes, phytate/zinc and phytate/iron molar ratios were lower (P , 0.01) in the intervention group; some spread of knowledge and practices to controls occurred. Conclusions: Our community-based dietary strategies reduced the predicted prevalence of inadequate intakes of protein, calcium, zinc and vitamin B 12 , but not iron, in children from Malawian households with very limited resources.

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Nutrition intervention strategies to combat zinc deficiency in developing countries

Cited by 98 publications

References 71 publications

Complementary foods for infant feeding in developing countries: their nutrient adequacy and improvement

Complementary foods for infant feeding in developing countries: their nutrient adequacy and improvement

Nutrition in pregnancy: mineral and vitamin supplements

Efficacy of a community-based dietary intervention to enhance micronutrient adequacy of high-phytate maize-based diets of rural Malawian children

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