Zinc Deficiency in Low and Middle Income Countries: Prevalence and Approaches for Mitigation

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 due to 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), the most appropriate indicator at present, the prevalence of zinc deficiency in LMICs are 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, but the best platform and the most effective way of preventive zinc supplementation delivery needs to be determined. 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 ascertained. Dietary diversification, though promising for LMICs, is in nascent stages of development at present. Inclusion of meat and animal products can be an important way to improve 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

Efficacy of iron-fortified Ultra Rice in improving the iron status of women in Mexico

Background: Universal fortification of staple foods with iron has been widely promoted as a cost-effective strategy to reduce iron deficiency in developing-country populations. Nonetheless, relatively few efficacy trials have been reported to date to demonstrate impact on iron status. The Ultra Rice technology provides a means of delivering fortificant iron via rice. Objective: The objective of this study was to test the efficacy of rice fortified with microencapsulated, micronized iron pyrophosphate to improve the iron status of women in Mexico in a randomized, controlled intervention trial. Methods: Nonpregnant, nonlactating women 18 to 49 years of age were recruited from six factories. The women received a daily portion of cooked rice 5 days per week for a period of 6 months, before and after which iron status indicators were determined in venous blood samples. Results: The average intake of iron from the fortificant was 13 mg/day. Mean plasma ferritin concentration and estimated body iron stores were significantly higher, and transferrin receptors were lower, in the iron-fortified rice group following the intervention. Mean hemoglobin concentration also increased in the treatment group, but the increase was significant only when the analysis was restricted to those with baseline hemoglobin < 12.8 g/dL. The absolute reduction in anemia and iron deficiency was 10.3 and 15.1 percentage points, respectively. Total iron intake from fortificant was a significant covariate of change in body iron stores. The overall prevalence of anemia was reduced by 80%. Conclusions: Fortification of rice with iron using this technology is an efficacious strategy for preventing iron deficiency