Applying Zinc Nutrient Reference Values as Proposed by Different Authorities Results in Large Differences in the Estimated Prevalence of Inadequate Zinc Intake by Young Children and Women and in Cameroon

• Type of Material: Article
• Authors: Demewoz Haile, University of California, Davis; Kenneth H Brown, University of California, Davis; Christine M McDonald, University of California, Davis; Hanqi Luo, Emory University; Michael Jarvis, University of California, Davis; Ismael Teta, Helen Keller International, Yaoundé; Alex Ndjebayi, Helen Keller International, Yaoundé; Guintang Assiene Jules Martial, Nutrition International, Yaoundé; Stephen A Vosti, University of California, Davis; Reina Engle-Stone, University of California, Davis
• Language: English
• Date: 2022-02-19
• Publisher: MDPI AG
• Publication Version: Final Published Version
• Copyright Statement: © 2022 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/nu14040883
• Title of Journal or Parent Work: Nutrients
• Volume: 14
• Issue: 4
• Grant/Funding Information: The dietary data collection was supported by the Michael and Susan Dell Foundation. The analyses of dietary intake data were supported in part by a grant to UC Davis by the Bill & Melinda Gates Foundation (#OPP1170661).
• Keywords: women; fortification; zinc; Cameroon; children; modeling; dietary assessment
• Research Categories: Biology, Biostatistics; Health Sciences, Public Health; Health Sciences, Nutrition; Health Sciences, Epidemiology

Abstract

Nutrient reference values (NRVs) for zinc set by several expert groups differ widely and may affect the predicted prevalence of inadequate zinc intake. We examined this possibility using NRVs published by four different authorities and nationally representative dietary intake data collected among children aged 12–59 months and women in Cameroon. Usual zinc intake was estimated from 24 h recall data using the National Cancer Institute method. Prevalences of total zinc intake below the dietary requirement and of “absorbable zinc intake” below the physiological requirement were estimated using NRVs published by the World Health Organization (WHO), US Institute of Medicine (IOM), International Zinc Nutrition Consultative Group (IZiNCG), and European Food Safety Authority (EFSA). The prevalence of inadequate zinc intake ranged from 10% (IZiNCG—physiological requirement, 95% CI 7–13%) to 81% (EFSA—physiological requirement, 95% CI 78–84%) among children and 9% (WHO—physiological requirement, 95% CI 8–11.0%) to 94% (IOM—physiological requirement, 95% CI 92–95%) among women These differences in the prevalence of inadequate intake translated into sizeable differences in the predicted benefit and cost-effectiveness of zinc fortification programs. Depending on the NRVs applied, assessments differ regarding the need for and design of zinc fortification programs. Efforts are needed to harmonize NRVs for zinc.