Functional indicators for assessing zinc deficiency

Zinc is an essential micronutrient for growth and proper immune function. There is currently no simple recommendation for the assessment of population-level zinc deficiency. Trials of zinc supplementation have shown positive effects of supplementation on clinical outcomes and growth. We reviewed the results of randomized trials of zinc supplementation and correlation studies that assessed infectious diseases, growth, and development outcomes among children under 5 years of age. The results indicate that zinc supplementation decreases the incidence and prevalence of diarrhea and pneumonia, but the use of trial data to make population-level estimates of zinc deficiency is not practical and is difficult to quantify. The data also indicate that zinc supplementation increases growth, especially among children who are stunted. Stunting rates are commonly estimated and can be used to estimate zinc deficiency. Previous recommendations suggest that stunting rates at or above 20% should be indicative of zinc deficiency among children under 5 years of age. This review provides additional data and analysis to support the current recommendation.