title: Determination of zinc status in humans: which indicator should we use?
abstract: Zinc deficiency has serious wide-ranging health consequences and is thought to be one of the most prevalent micronutrient deficiencies in the world. However, reliable indicators or biomarkers to assess zinc status are not available at present. Indirect indicators such as the prevalence of stunting or anemia, iron deficiency, as well as more direct indicators such as plasma zinc concentrations are being used at present to estimate the prevalence of zinc deficiency in populations. However, as this paper shows by using data from a recent national micronutrient survey in Vietnam, the estimates of the prevalence of zinc deficiency using these different indicators can vary widely, leading to inconsistencies. In this paper, zinc deficiency among children is four times more prevalent than iron deficiency and 2.3 times more than stunting prevalence for example. This can lead not only to confusion concerning the real extent of the prevalence of zinc deficiency in populations, but also makes it hard to inform policy on whether action is needed or not. Moreover, evaluation of programs is hampered by the lack of a clear indicator. Efforts should be made to identify the most suitable indicator to evaluate the impact of programs aimed at improving zinc status and health of populations.
authors.affiliation: Institute of Research for Development (IRD), UMR Nutripass IRD-UM2-UM1, 911 Avenue d'Agropolis, 34394 Montpellier, France. franck.wieringa@ird.fr.
authors.forename: Frank T
authors.initials: FT
authors.lastname: Wieringa
authors.affiliation: Department of Nutrition, Exercise and Sports (NEXS), Copenhagen University, Rolighedsvej 26, 1958 Frederiksberg, Denmark. madijkhuizen@gmail.com.
authors.forename: Marjoleine A
authors.initials: MA
authors.lastname: Dijkhuizen
authors.affiliation: Institute of Research for Development (IRD), UMR Nutripass IRD-UM2-UM1, 911 Avenue d'Agropolis, 34394 Montpellier, France. marionfiorentino@hotmail.com.
authors.forename: Marion
authors.initials: M
authors.lastname: Fiorentino
authors.affiliation: UNICEF, Maternal Child Health and Nutrition Section, No.11 street 75, 12200 Phnom Penh, Cambodia. alaillou@unicef.org.
authors.forename: Arnauld
authors.initials: A
authors.lastname: Laillou
authors.affiliation: Institute of Research for Development (IRD), UMR Nutripass IRD-UM2-UM1, 911 Avenue d'Agropolis, 34394 Montpellier, France. Jacques.Berger@ird.fr.
authors.forename: Jacques
authors.initials: J
authors.lastname: Berger
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003677:Deficiency Diseases / Q000097:blood / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D014744:Vietnam / Q000453:epidemiology; D015032:Zinc / Q000097:blood / Q000172:deficiency*
chemical_list: D015415:Biomarkers; D015032:Zinc