A high prevalence of zinc- but not iron-deficiency among women in rural Malawi: a cross-sectional study.
BACKGROUND
Zinc deficiency is often associated with nutritional iron deficiency (ID), and may be exacerbated by low selenium status.


OBJECTIVE
To investigate risk of iron and zinc deficiency in women with contrasting selenium status.


METHODS
In a cross-sectional study, 1-day diet composites and blood samples were collected from self-selected Malawian women aged 18-50 years from low- (Zombwe) (n=60) and high-plant-available soil selenium (Mikalango) (n=60) districts. Diets were analyzed for trace elements and blood for biomarkers.


RESULTS
Zinc deficiency (>90 %) was greater than ID anemia (6 %), or ID (5 %), attributed to diets low in zinc (median 5.7 mg/day) with high phytate:zinc molar ratios (20.0), but high in iron (21.0 mg/day) from soil contaminant iron. Zombwe compared to Mikalango women had lower (p<0.05) intakes of selenium (6.5 vs. 55.3 µg/day), zinc (4.8 vs. 6.4 mg/day), iron (16.6 vs. 29.6 mg/day), lower plasma selenium (0.72 vs. 1.60 µmol/L), and higher body iron (5.3 vs. 3.8 mg/kg), although plasma zinc was similar (8.60 vs. 8.87 µmol/L). Body iron and plasma zinc were positive determinants of hemoglobin.


CONCLUSIONS
Risk of zinc deficiency was higher than ID and was shown not to be associated with selenium status. Plasma zinc was almost as important as body iron as a hemoglobin determinant.
Department of Home Economics and Human Nutrition, Lilongwe University of Agriculture and Natural Resources, Bunda College Campus, Lilongwe, Malawi.
Edwin W P
EW
Siyame
Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, UK.
Rachel
R
Hurst
Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, UK.
Anna A
AA
Wawer
School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, UK.
Scott D
SD
Young
School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, UK.
Martin R
MR
Broadley
Ministry of Agriculture, Irrigation and Water Development, Department of Agricultural Research Services, Lunyangwa Research Station, Mzuzu, Malawi.
Allan D C
AD
Chilimba
British Geological Survey, Keyworth, Nottingham, UK.
Louise E
LE
Ander
British Geological Survey, Keyworth, Nottingham, UK.
Michael J
MJ
Watts
Community Health Sciences Unit, Ministry of Health, Lilongwe, Malawi.
Benson
B
Chilima
Community Health Sciences Unit, Ministry of Health, Lilongwe, Malawi.
Jellita
J
Gondwe
Nutrition Unit of Ministry of Health, Lilongwe, Malawi.
Dalitso
D
Kang'ombe
Department of Home Economics and Human Nutrition, Lilongwe University of Agriculture and Natural Resources, Bunda College Campus, Lilongwe, Malawi.
Alexander
A
Kalimbira
Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, UK.
Susan J
SJ
Fairweather-Tait
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Karl B
KB
Bailey
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Rosalind S
RS
Gibson
D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000032:analysis; D000090463:Iron Deficiencies; D008295:Malawi / Q000453:epidemiology; D008875:Middle Aged; D009752:Nutritional Status; D012424:Rural Population; D012643:Selenium / Q000008:administration & dosage / Q000097:blood / Q000172:deficiency; D015032:Zinc / Q000008:administration & dosage / Q000097:blood / Q000172:deficiency*
D006454:Hemoglobins; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron; D012643:Selenium; D015032:Zinc
Malawi; Se status; anemia; body iron; diet composites; plasma Zn; women