Preventing and Controlling Zinc Deficiency Across the Life Course: A Call to Action

Abstract

Preventing and Controlling Zinc Deficiency Across the Life Course: A Call to Action Nicola M Lowe 1,*, Andrew G Hall 2,3, Martin R Broadley 4,5, Jennifer Foley 6, Erick Boy 6, Zulfiqar A Bhutta 7,8 1 Center for Global Development, University of Central Lancashire, Preston, United Kingdom; 2 Department of Nutrition, University of California, Davis, CA, United States; 3 Department of Nutritional Sciences & Toxicology, University of California, Berkeley, CA, United States; 4 Rothamsted Research, West Common, Harpenden, United Kingdom; 5 School of Biosciences, University of Nottingham, Loughborough, United Kingdom; 6 HarvestPlus, International Food Policy Research Institute, Washington, DC, United States; 7 Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; 8 Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan A B S T R A C T Through diverse roles, zinc determines a greater number of critical life functions than any other single micronutrient. Beyond the wellrecognized importance of zinc for child growth and resistance to infections, zinc has numerous specific roles covering the regulation of glucose metabolism, and growing evidence links zinc deficiency with increased risk of diabetes and cardiometabolic disorders. Zinc nutriture is, thus, vitally important to health across the life course. Zinc deficiency is also one of the most common forms of micronutrient malnutrition globally. A clearer estimate of the burden of health disparity attributable to zinc deficiency in adulthood and later life emerges when accounting for its contribution to global elevated fasting blood glucose and related noncommunicable diseases (NCDs). Yet progress attenuating its prevalence has been limited due, in part, to the lack of sensitive and specific methods to assess human zinc status. This narrative review covers recent developments in our understanding of zinc’s role in health, the impact of the changing climate and global context on zinc intake, novel functional biomarkers showing promise for monitoring population-level interventions, and solutions for improving population zinc intake. It aims to spur on implementation of evidence-based interventions for preventing and controlling zinc deficiency across the life course. Increasing zinc intake and combating global zinc deficiency requires context-specific strategies and a combination of complementary, evidence-based interventions, including supplementation, food fortification, and food and agricultural solutions such as biofortification, alongside efforts to improve zinc bioavailability. Enhancing dietary zinc content and bioavailability through zinc biofortification is an inclusive nutrition solution that can benefit the most vulnerable individuals and populations affected by inadequate diets to the greatest extent. Keywords: zinc, zinc deficiency, biofortification, life course, evidence-based nutrition interventions