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Zinc deficiency in low- and middle-income countries: prevalence and approaches for mitigation.
Journal of Human Nutrition and Dietetics ( IF 3.3 ) Pub Date : 2020-07-06 , DOI: 10.1111/jhn.12791
S Gupta 1 , A K M Brazier 1 , N M Lowe 1
Affiliation  

This review addresses the prevalence of zinc deficiency in Low‐ and Middle‐income Countries (LMICs) and assesses the available strategies for its alleviation. The paucity of national‐level data on the zinc deficiency in LMICs is partially a result of the lack of a reliable biomarker. Zinc deficiency appears to be a public health problem in almost all the LMICs, irrespective of the recommended indicators (plasma zinc concentration, dietary zinc adequacy and stunting prevalence) used. Based on plasma/serum zinc concentration (PZC), which is the most appropriate indicator at present, the prevalence of zinc deficiency in LMICs is of concern. Among the 25 countries for which national PZC data were available, 23 had a zinc deficiency prevalence of >20% for at least one physiological group. Zinc supplementation is largely restricted as an adjunct therapy for diarrhoea management in children, and the best platform and the most effective way of preventive zinc supplementation delivery remains to be established. Impact assessment for current zinc fortification programmes in LMICs and the effectiveness of zinc supplementation as part of a multi‐micronutrient powder is to be determined. Dietary diversification, though promising for LMICs, is in the nascent stages of development at present. Inclusion of meat and animal products can be an important way of improving zinc status. Programmatic experience with the promotion of home processing techniques to increase absorbable zinc in the diet is lacking. Conventional biofortification techniques are gaining recognition in LMICs; however, transgenic biofortification as a strategy remains controversial.

中文翻译:

低收入和中等收入国家的锌缺乏症:流行率和缓解方法。

本综述讨论了低收入和中等收入国家 (LMIC) 缺锌的流行情况,并评估了缓解缺锌的可用策略。缺乏关于中低收入国家锌缺乏的国家级数据部分是由于缺乏可靠的生物标志物。无论采用何种推荐指标(血浆锌浓度、膳食锌充足率和发育迟缓发生率),几乎所有中低收入国家似乎都存在锌缺乏症的公共健康问题。基于血浆/血清锌浓度(PZC),这是目前最合适的指标,中低收入国家锌缺乏症的患病率值得关注。在可获得国家 PZC 数据的 25 个国家中,23 个国家至少有一个生理组的锌缺乏症患病率 >20%。补锌作为儿童腹泻管理的辅助疗法在很大程度上受到限制,预防性补锌的最佳平台和最有效方法仍有待建立。有待确定对中低收入国家当前锌强化计划的影响评估以及作为多微量营养素粉末一部分的锌补充剂的有效性。饮食多样化虽然对中低收入国家来说是有希望的,但目前正处于发展的初期阶段。加入肉类和动物产品可能是改善锌含量的重要方式。缺乏促进家庭加工技术以增加饮食中可吸收锌的计划经验。传统的生物强化技术在中低收入国家获得认可;然而,
更新日期:2020-07-06
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