The three major categories of nutrition-focused zinc intervention strategies are:
Dietary diversification and modification
Zinc fortification
Zinc supplementation
The choice of intervention(s) will depend on several factors including the level of risk of zinc deficiency, whether an approach that reaches the entire population or a specific subgroup is warranted, and the in-country resources available to develop and maintain the infrastructure and/or technology necessary to deliver and sustain the intervention.
Because it is unlikely that zinc deficiency will occur in isolation of other nutritional deficiencies and health problems, programs to address zinc deficiency should be incorporated into more comprehensive new or existing health programs when possible.
+ Dietary diversification and modification
IZiNCG Technical Documents
- Brown KH, Engle-Stone R, Krebs NF, Peerson JM. Dietary intervention strategies to enhance zinc nutrition: Promotion and support of breastfeeding for infants and young children. Food Nutr Bull. 2009 Mar;30(1 Suppl):S144-71.
- Gibson RS, Anderson VP. A review of interventions based on dietary diversification or modification strategies with the potential to enhance intakes of total and absorbable zinc. Food Nutr Bull. 2009 Mar;30(1 Suppl):S108-43.
- International Zinc Nutrition Consultative Group (IZiNCG). Chapter 3: Developing Zinc Intervention Programs. In: Assessment of the risk of zinc deficiency in populations and options for its control. Hotz C and Brown KH, eds. Food Nutr Bull 2004;25:S91-S204.
Relevant publications
- Gupta S, Brazier AKM, Lowe NM. Zinc deficiency in low- and middle-income countries: prevalence and approaches for mitigation [published online ahead of print, 2020 Jul 6]. J Hum Nutr Diet. 2020;10.1111.
- Eaton JC, Rothpletz-Puglia P, Dreker MR, Iannotti L, Lutter C, Kaganda J,Rayco-Solon P. Effectiveness of provision of animal-source foods for supporting optimal growth and development in children 6 to 59 months of age. Cochrane Database Syst Rev. 2019 Feb 19;2:CD012818.
- Gibson RS, Raboy V, King JC. Implications of phytate in plant-based foods for iron and zinc bioavailability, setting dietary requirements, and formulating programs and policies. Nutr Rev. 2018 July 13.
Read more about dietary assessment of zinc intake here
+ Zinc fortification
IZiNCG Technical Brief
- Technical Brief no. 4, 2007 - Zinc Fortification
IZiNCG Technical Documents
Tsang BL, Holsted E, McDonald CM, Brown KH, Black R, Mbuya MNN, Grant F, Rowe LA, Manger MS. Effects of Foods Fortified with Zinc, Alone or Cofortified with Multiple Micronutrients, on Health and Functional Outcomes: A Systematic Review and Meta-Analysis. Adv Nutr. 2021 Oct 1;12(5):1821-1837.
Hotz C. The potential to improve zinc status through biofortification of staple food crops with zinc. Food Nutr Bull. 2009 Mar;30(1 Suppl):S172-8.
International Zinc Nutrition Consultative Group (IZiNCG). Chapter 3: Developing Zinc Intervention Programs. In: Assessment of the risk of zinc deficiency in populations and options for its control. Hotz C and Brown KH, eds. Food Nutr Bull 2004;25:S91-S204.
IZiNCG Case Studies and advocacy briefs
Addressing Zinc Deficiency Through Wheat Flour Fortification in Cameroon
Call to Action: Addressing Zinc Deficiency Through Zinc Fortification
Relevant Publications
Tarini A, Manger MS, Brown KH, Mbuya MNN, Rowe LA, Grant F, Black RE, McDonald CM. Enablers and Barriers of Zinc Fortification; Experience from 10 Low- and Middle-Income Countries with Mandatory Large-Scale Food Fortification. Nutrients. 2021; 13(6):2051.
Gupta S, Brazier AKM, Lowe NM. Zinc deficiency in low- and middle-income countries: prevalence and approaches for mitigation [published online ahead of print, 2020 Jul 6]. J Hum Nutr Diet. 2020;10.1111.
Shah D, Sachdev HS, Gera T, De-Regil LM, Peña-Rosas JP. Fortification of staple foods with zinc for improving zinc status and other health outcomes in the general population. Cochrane Public Health Group. 2016 Jun 9.
Das JK, Kumar R, Salam RA, Bhutta ZA. Systematic Review of Zinc Fortification Trials. Annals of Nutrition & Metabolism. 2013.
Brown KH, Hambidge KM, Ranum P, Zinc Fortification Working Group. Zinc fortification of cereal flours: current recommendations and research needs. Food Nutr Bull. 2010 March.
Relevant External links
- Food Fortification Initiative
- Global Alliance for Improved Nutrition
- Global Fortification Data Exchange
+ Zinc Supplementation
IZiNCG Technical Brief
- There is no technical brief on this topic.
IZiNCG Technical Documents
Brown KH, Peerson JM, Baker SK, Hess SY. Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Food Nutr Bull. 2009 Mar;30(1 Suppl):S12-40. Review. PubMed PMID: 19472600.
Hess SY, King JC. Effects of maternal zinc supplementation on pregnancy and lactation outcomes.. Food Nutr Bull. 2009 Mar;30(1 Suppl):S60-78.
International Zinc Nutrition Consultative Group (IZiNCG). Chapter 3: Developing Zinc Intervention Programs. In: Assessment of the risk of zinc deficiency in populations and options for its control. Hotz C and Brown KH, eds. Food Nutr Bull 2004;25:S91-S204.
Relevant publications
- Gupta S, Brazier AKM, Lowe NM. Zinc deficiency in low- and middle-income countries: prevalence and approaches for mitigation [published online ahead of print, 2020 Jul 6]. J Hum Nutr Diet. 2020;10.1111.
- Systematic reviews of preventive zinc supplementation in children
- Systematic reviews of zinc supplementation during pregnancy
Cost effectiveness
- Brown KH, Hess SY, Vosti SA, Baker SK. Comparison of the estimated cost-effectiveness of preventive and therapeutic zinc supplementation strategies for reducing child morbidity and mortality in sub-Saharan Africa. Food Nutr Bull. 2013 Jun;34(2):199-214. PubMed PMID: 23964393
- Fink G, Heitner J. Evaluating the cost-effectiveness of preventive zinc supplementation. BMC Public Health. 2014 Aug 15;14:852. doi: 10.1186/1471-2458-14-852. PubMed PMID: 25128210; PubMed Central PMCID: PMC414358.