Effects of Foods Fortified with Zinc, Alone or Cofortified with Multiple Micronutrients, on Health and Functional Outcomes: A Systematic Review and Meta-Analysis
| Autor: | Robert E. Black, Laura A Rowe, Becky L. Tsang, Mduduzi N. N. Mbuya, Mari S Manger, Kenneth H. Brown, Erin Holsted, Christine McDonald, Frederick Grant |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Clinical Trials and Supportive Activities Population fortification Medicine (miscellaneous) chemistry.chemical_element morbidity Review Zinc Gastroenterology AcademicSubjects/MED00060 systematic review Clinical Research Internal medicine Complementary and Integrative Health Behavioral and Social Science Humans Medicine Micronutrients Child 3.3 Nutrition and chemoprevention education Nutrition Minerals education.field_of_study anthropometry Nutrition and Dietetics medicine.diagnostic_test business.industry Prevention Incidence (epidemiology) Malnutrition zinc Neurosciences biomarkers Fortified Micronutrient medicine.disease Diarrhea chemistry Food Meta-analysis Serum iron Zinc deficiency medicine.symptom Digestive Diseases business absorption Food Science |
| Zdroj: | Advances in Nutrition Advances in nutrition (Bethesda, Md.), vol 12, iss 5 |
| ISSN: | 2161-8313 |
| DOI: | 10.1093/advances/nmab065 |
| Popis: | Seventeen per cent of the world's population is estimated to be at risk of inadequate zinc intake, which could in part be addressed by zinc fortification of widely consumed foods. We conducted a review of efficacy and effectiveness studies to ascertain the effect of zinc fortification [postharvest fortification of an industrially produced food or beverage; alone or with multiple micronutrients (MMN)] on a range of health outcomes. Previous reviews have required that the effect of zinc be isolated; because zinc is always cofortified with MMN in existing fortification programs, we did not impose this condition. Outcomes assessed were zinc-related biomarkers (plasma or serum, hair or urine zinc concentrations, comet assay, plasma fatty acid concentrations, and the proportion of and total zinc absorbed in the intestine from the diet), child anthropometry, morbidity, mortality, cognition, plasma or serum iron and copper concentrations, and for observational studies, a change in consumption of the food vehicle. Fifty-nine studies were included in the review; 54 in meta-analyses, totaling 73 comparisons. Zinc fortification with and without MMN increased plasma zinc concentrations (efficacy, n = 27: 4.68 μg/dL; 95% CI: 2.62–6.75; effectiveness, n = 13: 6.28 μg/dL; 95% CI: 5.03–7.77 μg/dL) and reduced the prevalence of zinc deficiency (efficacy, n = 11: OR: 0.76, 95% CI: 0.60–0.96; effectiveness, n = 10: OR: 0.45, 95% CI: 0.31–0.64). There were statistically significant increases in child weight (efficacy, n = 11: 0.43 kg, 95% CI: 0.11–0.75 kg), improvements in short-term auditory memory (efficacy, n = 3: 0.32 point, 95% CI: 0.13–0.50 point), and decreased incidence of diarrhea (efficacy, n = 3: RR: 0.79, 95% CI: 0.68–0.92) and fever (efficacy, n = 2: RR: 0.85, 95% CI: 0.74–0.97). However, these effects cannot be solely attributed to zinc. Our review found that zinc fortification with or without MMN reduced the prevalence of zinc deficiency and may provide health and functional benefits, including a reduced incidence of diarrhea. Zinc fortification increased plasma/serum zinc concentrations and reduced the prevalence of zinc deficiency; limited evidence indicated that MMN + zinc-fortified food increased body weight and reduced the incidence of fever and diarrhea. |
| Databáze: | OpenAIRE |
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